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AutoimmuneICD-10: G35Nearly 1 million adults in the US; about 2.8 million worldwide

Multiple Sclerosis

Also known as: MS

Multiple sclerosis (MS) is a chronic autoimmune disease in which the immune system attacks the protective myelin sheath surrounding nerve fibers in the brain and spinal cord. This demyelination disrupts communication between the brain and the body, leading to a wide range of neurological symptoms. MS most commonly appears between ages 20 and 40 and is more prevalent in women.

Symptoms

Numbness or tingling in the limbs, face, or trunk
Muscle weakness or spasticity
Vision problems including optic neuritis and double vision
Fatigue that is disproportionate to activity level
Balance and coordination difficulties (ataxia)
Cognitive changes (memory, attention, processing speed)
Bladder and bowel dysfunction
Electric shock sensations with neck flexion (Lhermitte's sign)
Dizziness and vertigo

Causes

  • Autoimmune attack on central nervous system myelin
  • Genetic susceptibility involving multiple genes (HLA-DRB1)
  • Environmental factors including low vitamin D and EBV infection
  • Immune dysregulation with T-cell and B-cell involvement

Risk Factors

  • Female sex (2–3 times more common in women)
  • Age 20–40 at onset
  • Northern European ancestry and living at higher latitudes
  • History of Epstein-Barr virus infection
  • Low vitamin D levels
  • Smoking

Diagnosis

  • MRI of the brain and spinal cord showing demyelinating lesions
  • Lumbar puncture revealing oligoclonal bands in cerebrospinal fluid
  • Evoked potential tests measuring nerve signal speed
  • McDonald criteria for dissemination in space and time
  • Blood tests to rule out other conditions

Treatment

  • Disease-modifying therapies (interferons, glatiramer acetate, dimethyl fumarate, ocrelizumab, natalizumab)
  • High-dose corticosteroids for acute relapses
  • Physical and occupational therapy
  • Symptom management (baclofen for spasticity, modafinil for fatigue, bladder medications)
  • Rehabilitation programs for cognitive and physical function

Prevention

  • No proven way to prevent MS, but modifiable risk factors include:
  • Maintaining adequate vitamin D levels
  • Not smoking or quitting smoking
  • Maintaining a healthy weight

When to See a Doctor

  • New onset of numbness, weakness, or visual changes
  • Rapid worsening of existing neurological symptoms (possible relapse)
  • Sudden loss of vision in one eye
  • Significant changes in bladder or bowel function

Frequently Asked Questions

Related Conditions

Peripheral Neuropathy

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Myasthenia Gravis

Autoimmune

Lupus

Autoimmune

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