Multiple sclerosis
Also called: MS
The immune system attacks the myelin insulating nerve fibres in the brain and spinal cord, causing attacks of neurological symptoms and, over time, disability.
Condition-specific references are below. Individual claims and this page have not been clinically reviewed. Read about this content.
About 2.8 million people; usually starts at 20–40 and is more common in women.
Causes
- Autoimmune; triggered by genetic and environmental factors (Epstein–Barr virus infection is a key risk)
Risk factors
- Female sex
- Low vitamin D and distance from the equator
- Smoking
- Obesity in adolescence
- Epstein–Barr virus
- Family history
Symptoms
- Blurred or painful vision (optic neuritis)
- Numbness or tingling
- Weakness
- Balance problems
- Fatigue
- Bladder problems
- Electric-shock sensation on bending the neck
Diagnosis — tests and examinations
- MRI brain and spine showing lesions
- Lumbar puncture (oligoclonal bands)
- McDonald criteria
Treatment
Medicines and medical treatment
- Steroids for relapses
- Disease-modifying therapies: ocrelizumab, ofatumumab, natalizumab, cladribine, fingolimod, dimethyl fumarate, interferons
- Symptom treatment: spasticity, bladder, fatigue, pain
Operations and procedures
- Autologous haematopoietic stem cell transplantation for aggressive disease
Self-care, home remedies and lifestyle
- Stop smoking
- Exercise and physiotherapy
- Vitamin D if deficient
- Manage heat sensitivity and fatigue
Possible complications
- Progressive disability
- Depression
- Bladder infections
Prevention
- None proven; avoiding smoking and adequate vitamin D may help
Outlook
Modern treatments greatly reduce relapses and disability; life expectancy is near normal.
When to see a doctor
See a doctor for unexplained visual loss, numbness or weakness lasting more than a day.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
Educational overview, not medical advice. Treatment varies by person and location. Consult a qualified health professional for diagnosis or care. Read our content and model notes and privacy information.