Multiple Sclerosis

A doctor checks the reflexes of a patient during an office visit.

Multiple sclerosis is a chronic autoimmune condition that affects your body’s central nervous system (CNS), including the brain, spinal cord, and optic nerves. The CNS sends signals from the brain throughout the body through nerves, which are covered by a layer of cells called myelin. MS occurs when your immune system turns against itself:

Inflammation triggers demyelination, which breaks down myelin cells.
Those cells harden into lesions called plaques.
Plaques slow, garble, or block the electrical signals between your brain and nerve cells, disrupting movement, communication, and function.

An MS diagnosis used to be a devastating prospect. Now, significant treatment advances mean that for many patients, MS can be a manageable condition.

MedStar Health unites a team of specialists who will help reduce the impact of MS on your life. MedStar Health Georgetown University Hospital was the first neuroimmunology practice worldwide to be recognized as a Level 3 Patient-Centered Specialty Practice™ by the National Committee for Quality Assurance—your health and quality of life drive our care.

Multiple sclerosis (MS) is an autoimmune disorder - which means that the body's immune system turns against itself.

Symptoms of MS

MS can affect nerves anywhere in the CNS, so symptoms can change as the disease progresses. While men and women have similar MS symptoms, many women report worsening symptoms during menstruation, pregnancy, and menopause.

Early intervention provides the best chance at successful management. Your first signs of MS might include:

Balance issues
Bladder control problems
Intermittent or constant dizziness
Muscle weakness or stiffness
Tingling, numbness, or pain in the arms, legs, torso, or face
Vision problems

Most people with MS have mild pain, usually associated with muscle spasms. Plaques affecting the nerves in your face can trigger eye pain or trigeminal neuralgia. Severe flareups can cause noticeable signs such as:

Extreme mental or physical fatigue
Difficulty expressing or controlling emotion
Lapses in memory or concentration
Mood changes, such as anxiety, depression, or difficulty managing emotions

Frequently asked questions about MS

How is multiple sclerosis diagnosed?

MS symptoms can look the same as those of many other conditions. Getting an accurate diagnosis calls for some detective work:

Your care team will listen to your symptoms and review your medical history.
The neurologist may order tests, such as MRI, spinal fluid analysis, or evoked potential (EP) tests to assess brain response to nerve stimulation.

Sometimes a neurologist can confirm or rule out MS on the first visit. For most people, the diagnosis takes time. Your care team will monitor your symptoms and recommend additional MRIs or other testing to confirm whether you have MS and what type:

Clinically Isolated Syndrome (CIS) is characterized by an initial episode of symptoms that may or may not reoccur.
Relapsing-Remitting MS (RRMS) is characterized by flare-ups of symptoms that occur periodically, but do not worsen. This is the most common type of MS.
Primary-Progressive MS (PPMS) is characterized by symptoms that worsen over time.
Secondary-Progressive MS (SPMS) is diagnosed when RRMS symptoms, which were once periodic but stable, begin to change or become more frequent.

Treatment options

While there is not yet a cure for MS, new research and advanced therapies support active lifestyles, fewer flare-ups, and a higher quality of life for many people with MS. Today, there are more than 20 MS therapies, with dozens more in development.

Exercise & nutrition

Decades of research show regular exercise can significantly improve MS symptom management. Any aerobic activity you enjoy is beneficial, such as walking, aquatic therapy, or gardening. We will help you customize a plan that works for you.

Nutrition is especially important for people with MS. Recent research suggests a connection between maintaining a healthy gut microbiome and managing inflammation-related MS symptoms. Poor nutrition can lead to excess body weight and heart problems that increase the risk for MS-related disabilities.

Medication

Two types of therapies offer quick relief from flare-ups:

Corticosteroids like methylprednisolone can reduce inflammation. The neurologist might have you start with IV medication followed by an oral formulation. Steroids can cause lasting side effects, so your care team will monitor your body’s reactions carefully.
Plasma exchange (plasmapheresis) removes harmful components from the plasma in your blood to reduce severe symptoms during flare-ups.

Disease modification therapies (DMTs)

If your MS flare-ups get worse or your body can’t tolerate steroids, DMTs may provide long-term symptom control. DMTs are approved for adults with CIS, RRMS, and progressive forms of MS. Each DMT has its own target, such as cell proteins or antibodies in the blood. They come in oral, injectable, and infusion form.

Patient-centered care

No one knows better than you how MS affects your body and your life. MedStar Health MS experts will listen to you and guide you in the latest ways to improve your function, manage symptoms, and slow the progress of your disease. We put you at the center of a full suite of specialists to achieve your goals:

Neurologists to manage your care.
Neuroradiologists who interpret MRI scans to monitor for changes.
Physical and occupational therapists to help maintain physical function
Urologists to address bladder symptoms.
Mental health experts to manage anxiety and depression, which are common in MS due to chronic inflammation and social isolation.
Dietitians to build healthy eating plans
Liaisons to achieve insurance approvals for medication, home care, and assistive devices.

MS can strike in the prime of life for women and men who are raising families and building careers. Treatment cannot reverse all deficits, but almost all symptoms can be improved with personalized treatment.