Multiple sclerosis

Multiple sclerosis is a chronic neurological condition that affects neurons – the nerve cells in your central nervous system (the brain and spinal cord). It involves:

• The immune system mistakenly attacking the protective coating called myelin that wraps around the fibres connecting neurons
• The damaged neurons struggling to pass electrical signals to one another and communicate

As the nervous system is responsible for a variety of functions, there are a wide range of symptoms affecting movement, thinking, the senses, and mood.
There are many treatments and management options available to help you control your multiple sclerosis, cope with the physical and emotional changes, and live life as fully as possible.

At Affidea neuraCare, you’ll receive personalized care from a world-class team every moment of your journey. Backed by deep experience and the latest innovations, we work to bring you the full potential of modern medicine.

Continue reading to learn more about the types of multiple sclerosis, the signs and symptoms, and diagnostics and treatments at Affidea neuraCare. 

Multiple sclerosis appears differently in each person. There are three main types, which depend on how your symptoms develop. 
A relapse is a period where symptoms suddenly flare up. A remission is when symptoms return to a baseline. Symptoms can also fluctuate day to day. 

• Relapsing remitting multiple sclerosis – the most common type of MS, where symptoms come and go in cycles of relapses and remission
• Secondary progressive multiple sclerosis – after a period of relapsing and remitting MS, symptoms are there continuously and disability increases with time
• Primary progressive multiple sclerosis – symptoms slowly increase from the start, and do not suddenly improve or worsen

Rare types of multiple sclerosis include Devic’s disease, Balo’s concentric sclerosis, Marburg variant multiple sclerosis, and Tumefactive multiple sclerosis.
Your neurologist may also describe your multiple sclerosis as active or not active, and with progression or without progression. 

• Active or not active – this refers to whether your immune system is currently attacking the nervous system
• With progression or without progression – this refers to whether your symptoms or level of disability are increasing over time

This extra description helps you and your neurologist understand your condition better, which is useful when planning the right kind of care for you.

Multiple sclerosis is caused by the immune system mistakenly attacking its own nervous system. It targets myelin, which is the fatty protective and conductive covering wrapped around neuronal fibres that helps them pass electrical messages to and from the brain.

These attacks reduce the neuron’s ability to pass on messages. It does this in two ways:

• By breaking down the myelin coating
• Causing inflammation

Researchers are still trying to understand the exact cause of MS. It’s likely to be a combination of:

• Genetics
• Environmental factors
• Lifestyle factors

There are several risk factors associated with a higher chance of developing multiple sclerosis, but it’s still unclear why some people go on to develop the condition and others do not. 

Risk factors

• Genetics – there are over 200 genes linked to an increased risk of multiple sclerosis, but  multiple sclerosis is not a hereditary condition
• Being aged 20 to 40
• More women have multiple sclerosis than men
• White-European ethnicity , but other ethnicities can also develop multiple sclerosis
• Living far north or south of the Equator , such as Europe, North America, or New Zealand
• Lack of vitamin D
• Smoking
• Being obese in childhood or adolescence
• Prolonged exposure to some solvents, such as paint varnishes and glues
• Infections – there is evidence that some infections, particularly Epstein-Barr virus (EBV), can trigger multiple sclerosis if you have certain risk factors

Risk factors for multiple sclerosis are very common. It’s important to remember, having them does not mean you will definitely develop multiple sclerosis. But maintaining a balanced and healthy lifestyle will help improve your overall wellbeing.

Symptoms of multiple sclerosis vary depending on where nerve damage occurs. They often change over time. How you feel today and how this affects you might be different from last week, or even an hour ago.

Symptoms vary between different people and over time, but common ones include:

• Fatigue – unexplained extreme tiredness that makes everyday tasks hard
• Pain – a tight, squeezing sensation, or aching, shooting pain around your body
• Skin sensations – numbness, tingling, or burning in your limbs
• Changes to bathroom habits – needing the toilet more often or trouble with control
• Muscle and movement issues – poor balance or coordination, spasms, stiffness, or difficulty walking
• Problems with talking and swallowing – slurred speech, forgetting words, or having trouble swallowing
• Vision problems – blurry vision, eye pain, or temporary vision loss in one or both eyes
• Cognitive issues – difficulty concentrating, being more forgetful, or indecision
• Mood changes – it’s normal to have feelings of anxiety or depression, but it can also be linked to nerve damage

Symptoms of multiple sclerosis are often called ‘invisible symptoms’ because they’re not always obvious to other people. You might appear well, but your experience is real and valid. With the right care, many symptoms can be managed effectively.

Early symptoms of multiple sclerosis

It’s difficult to say what the early signs of multiple sclerosis are, as the condition affects people in many different ways. Many people report the following symptoms as their first sign of having multiple sclerosis:

• Fatigue
• Stumbling or foot drop, where one foot drags along the floor
• Skin sensations, such as a tingling feeling in the face
• Unexplained changes to vision, such as seeing double
• Slowed thinking , including  difficulty recognizing facial expressions or emotions in others

It can take time to diagnose multiple sclerosis, as symptoms are quite common and appear in many other conditions too. Seeing a neurologist is crucial for a diagnosis of multiple sclerosis. 

Documenting the type and duration of your symptoms can be incredibly useful when diagnosing and monitoring your condition’s progression.

How is multiple sclerosis diagnosed?

Your neurologist will request a combination of tests to create a complete picture of your health, rule out other conditions, and confirm a multiple sclerosis diagnosis. 

Tests for multiple sclerosis can include:

• A neurological examination to review your medical history and assess your symptoms
• MRI scans to look for evidence of scarring (lesions) in your nervous system
• Pathology tests, including a lumbar puncture (spinal tap) to check the cerebrospinal fluid for white blood cells and pieces of myelin , and blood tests to look for antibodies and rule out other conditions, including other demyelinating conditions 

A multiple sclerosis diagnosis may take some time. This is because it’s important to make sure an accurate diagnosis is made before starting treatment.

The latest research and guidelines are improving the diagnosis of MS. In certain cases, the right tools and assessment can allow an earlier diagnosis.  

Once you receive your diagnosis, your care is shaped to focus on treating your individual symptoms, the underlying condition, and your flare ups or relapses.

Your personalized treatment plan may include a combination of:

• Disease modifying therapies - to slow, stop or even reverse disease progression
• Neuropsychology  – specialist treatment and support for any emotional, cognitive, and behavioral changes that can come with living with multiple sclerosis
• Occupational therapy  – involves practical strategies and assistive technology to adapt your routine, lifestyle, and surroundings to your changing needs
• Supportive care  – consists of ongoing emotional and practical support for you and your loved ones, including counselling, peer support groups, and guidance for carers

Researchers are currently working to expand the treatment options for multiple sclerosis. There are many opportunities to join clinical trials exploring new therapies, including through Affidea neuraCare. Find out more about the clinical trials we’re involved in  to improve access and treatment options for people with MS. 

Multiple sclerosis may be a lifelong condition, but you don’t have to face it alone. With a blend of medical care, emotional support, and practical strategies from a team of specialists who understand you, you can continue to adapt and live well with your condition.  

Greek Multiple Sclerosis Society (GMMS). The journey of a multiple sclerosis diagnosis: A guide to knowledge and strength. 

Mallawaarachchi, G. et al. Ethnic disparities in the epidemiological and clinical characteristics of multiple sclerosis. Multiple Sclerosis and Related Disorders. (2024). 

Polet, K. et al. Facial emotion impairment in multiple sclerosis is linked to modifying observation strategies of emotional faces. Multiple Sclerosis and Related Disorders. (2023).