Multiple Sclerosis

Nerves are very similar to electrical cables and communicate by transmitting electrical & chemical signals. Many of them are coated with an insulating material, myelin, which helps the electrical signal be conducted in a swift and efficient manner.

In MS, the myelin insulation is damaged or destroyed, and scar tissue or “sclerosis” occurs, leading to slowed or blocked transmission of electrical information.

In addition to myelin damage, the nerve wire or “Axon” is damaged as well. These areas of nerve damage can be seen on MRI and are referred to as “plaques”.

Because MS attacks multiple parts of the CNS, it can produce many different symptoms. The hallmark characteristic of multiple sclerosis is the presence of multiple areas of inflammation and scarring (sclerosis) in the central nervous system. These areas, known as lesions or plaques, can be detected through magnetic resonance imaging (MRI) scans.

The symptoms of multiple sclerosis vary widely and can affect different parts of the body. Common symptoms include:

• Fatigue
• Numbness or tingling
• Weakness
• Incoordination
• Visual disturbances
• Muscle spasms
• Change in bladder, bowel or sexual dysfunction
• Problems with mood and memory and thinking

DMT are medications that interfere with the immune system’s ability to attack the nerves.

They help prevent future areas of nerve damage, and slow disease progression. They do not reverse existing scars or treat symptoms.

Most symptoms of MS can be greatly relieved or ameliorated.

This usually involves a combination of appropriate medications and other treatment modalities such as rehabilitative therapies, equipment, lifestyle practices including exercise and alternative and complementary therapies where appropriate. Pacific Neuroscience Institute also offers speech pathology services for patients with multiple sclerosis.

For people with MS, exercise and physical activity can be variously challenging. However, being physically active is one of the most beneficial adaptations to a lifestyle with MS. The six pillars of brain health are nutrition, exercise, sleep, stress management, social connection and avoidance of risky substances. Advice and educational resources in these areas are part of our neurologic treatment plan.

Multiple sclerosis is a lifelong condition, but its course varies widely from person to person. With today’s disease-modifying therapies, most people experience fewer relapses, slower to no disease progression, and better long-term outcomes than in the past. Most individuals with MS have a near-normal life expectancy and are able to manage symptoms effectively with ongoing care.

Yes. Many people with MS lead full, active, and meaningful lives—working, going to school, raising families, traveling, and pursuing hobbies. Advances in treatment, symptom management, rehabilitation, and lifestyle support allow many individuals to maintain independence and quality of life for decades after diagnosis.

Early symptoms of MS can be subtle and vary, but commonly include:

• Numbness or tingling in the face, arms, or legs
• Vision problems, such as blurred or double vision, or loss of vision only in one eye
• Fatigue that is disproportionate to activity
• Muscle weakness or stiffness
• Problems with balance or coordination
• Brain fog or difficulty concentrating

Because symptoms can come and go, MS is sometimes difficult to recognize early.

The exact cause of MS is unknown. It is believed to result from a combination of genetic susceptibility and environmental factors. Factors that increase the risk of developing MS include viral infections (Epstein-Barr virus), vitamin D deficiency in early life, obesity in adolescence or early adulthood, smoking, and a family history of MS. MS itself is not contagious.

Most people with MS live independently, especially in the early and middle stages of the disease. Even if physical or cognitive symptoms develop, adaptive strategies, rehabilitation therapies, assistive technologies, and home modifications can help individuals maintain independence for many years.

Not necessarily. While some people with MS develop mobility challenges over time, the majority do not require a wheelchair. Early diagnosis and treatment have significantly reduced the likelihood of severe disability, and many individuals with MS remain fully ambulatory throughout their lives.

There is no fixed timeline. MS progression varies widely—some people experience only mild symptoms for decades, while others may develop disability more quickly. Modern therapies have been shown to slow disease progression and reduce long-term disability, especially when started early.

MS cannot currently be cured, but early diagnosis and treatment can significantly slow disease activity, reduce relapses, and delay disability. Starting disease-modifying therapy early is one of the most effective ways to improve long-term outcomes.

Several conditions can mimic MS symptoms and/or findings on MRI, including migraines, vitamin B12 deficiency, lupus, Lyme disease, fibromyalgia, stroke, and certain other spinal or brain disorders. This is why a thorough neurological evaluation, imaging, and laboratory testing are essential for an accurate diagnosis.

Stress does not cause MS. However, chronic stress may worsen symptoms or trigger relapses in some individuals. Stress management—through exercise, mindfulness, therapy, or relaxation techniques—can be an important part of comprehensive MS care.

People with MS are generally encouraged to stay active and engaged, but it’s important to:

• Avoid smoking, which can worsen disease progression
• Not skip medications or follow-up appointments
• Avoid excessive heat if it worsens symptoms
• Avoid pushing through extreme fatigue without rest
• Discuss trying any unproven therapies or supplements with your doctor
• Working closely with a neurology care team helps tailor lifestyle choices and treatments to individual needs

Lifestyle choices are a very important part of treating people with MS. These include:

• Eating a diet abundant in fruits and vegetables, lean proteins, whole grains and “good” fats, and avoiding processed and fatty foods
• Getting regular exercise and/or physical activity, at least 150 minutes/week
• Avoiding harmful substances, especially smoking, and excessive alcohol
• Getting 7-9 hours/night restful sleep
• Maintaining social connections
• Managing stress