It’s normal to feel upset and afraid upon hearing a diagnosis of MS. But the good news is that MS can usually be managed successfully with a combination of medication, a healthy lifestyle, and social support from friends, family, healthcare providers, and other people living with MS. Knowing the facts about multiple sclerosis can help you understand what’s going on in your body and why your MS isn’t exactly like anyone else’s. It can inform the discussions you have with your doctor about how to best manage the disease. And it can help you explain to others what MS is and what it isn’t. Take this quiz to assess your knowledge of MS — and maybe learn a few new things in the process.
1. Multiple Sclerosis Is an Autoimmune Disorder
True Most experts believe that MS is an autoimmune disorder in which the immune system attacks the myelin sheath that normally protects nerve fibers in the brain, spinal cord, and optic nerve. In an autoimmune disease, the immune system mistakenly reacts against a self-antigen, which is a normal protein or cell marker that should not provoke such a response. In the case of MS, researchers still don’t know what self-antigen triggers the immune system response. Some experts refer to MS as an “immune-mediated” disease but stop short of classifying it as an autoimmune disease.
2. Numbness, Tingling, Vision Changes, and Balance Problems Are Common Early Signs of MS
True Numbness and tingling, vision changes, and balance and walking problems are common early signs and symptoms of MS, but because many other conditions besides MS can also cause them, they are not always recognized as the beginnings of MS. In fact, MS is often misdiagnosed as something else. According to a 2017 survey conducted by MultipleSclerosis.net, of the 5,311 people with MS who responded, 25 percent were initially diagnosed with depression, 15 percent with migraine, 14 percent with fibromyalgia, 13 percent with a psychiatric disorder, 11 percent with vitamin B12 deficiency, and 10 percent with chronic fatigue disorder. It’s worth noting, however, that a person with multiple sclerosis can have other medical conditions besides MS at the same time as having MS.
3. Each Person With Multiple Sclerosis Has a Unique Pattern of Symptoms
True While some MS symptoms, such as fatigue, are very common and affect most people with the disease, each person with MS has a unique pattern and severity of symptoms. To some extent, a person’s MS symptoms depend on where their lesions, or areas of damage, are located in the brain or spinal cord. But it’s also common for an MRI scan to show lesions that can’t be connected to any symptoms, or for symptoms to worsen without any new lesions appearing on an MRI scan. A person’s symptoms can also be influenced by the drug therapy they’re using. If the disease-modifying therapy a person is using is working for them, they should not be acquiring new lesions and should not be developing new symptoms.
4. Diagnosing MS Is Easy and Straightforward
False Diagnosing MS can be challenging for several reasons. The early signs and symptoms of MS are not unique to MS. Many other conditions can cause such symptoms as numbness, blurred vision, double vision, headaches, dizziness, vertigo, and fatigue — not just MS. MS symptoms can come and go, which can lead some people to delay seeking a diagnosis and can also cause some doctors to delay making a diagnosis. No single test definitively diagnoses MS, so arriving at an MS diagnosis is a process of conducting tests to rule out other diseases and to look for indicators of MS. Those tests typically include a neurological evaluation, an MRI to look for characteristic brain lesions, and sometimes a lumbar puncture (also called a spinal tap) to look for abnormalities in the spinal fluid.
5. No One Really Knows What Causes or Triggers MS
True Most experts believe that some combination of genetic susceptibility and environmental causes is necessary to trigger MS. But no one knows what sets off the immune reaction that leads to MS lesions in the first place. Not surprisingly, much ongoing research is focused on developing an understanding of how the various possible environmental causes — such as a low vitamin D level or infection with the Epstein-Barr virus — might trigger MS. Unlike genetic susceptibility, which is generally difficult if not impossible to change, environmental factors might be relatively easy to change, if they could be identified and their role in MS understood.
6. Older Age Is a Risk Factor for MS
False Older age does not raise the risk of developing MS. While it is possible to be diagnosed with MS at any age, most people who have it experience their first symptoms between the ages of 20 and 40. Factors that are believed to raise the risk of MS include having a family member who has it, having vitamin D deficiency, smoking or being exposed to secondhand smoke, growing up far from the equator, and having obesity in childhood and adolescence. It is also thought that certain viral infections, particularly Epstein-Barr virus, the cause of most cases of mononucleosis, raise the risk of developing MS. But most people who have these risk factors do not develop MS, reinforcing experts’ belief that a combination of genetic predisposition and exposure to environmental risk factors is necessary to trigger multiple sclerosis.
7. Most People With MS Are Initially Diagnosed With Relapsing-Remitting MS
True Between 80 and 90 percent of people with MS are diagnosed with relapsing-remitting MS, a stage of MS characterized by periods of symptom worsening — known as relapses, flares, or exacerbations — and periods during which symptoms stay fairly stable. Relapses are caused by inflammation in the central nervous system and are generally treated with high doses of steroid drugs over several days to stop the inflammation. But even better than treating relapses is preventing them, which is where disease-modifying therapies for MS come in. These drugs have been shown to reduce the frequency and severity of relapses and to prevent the accumulation of disability over time. However, they also come with side effects, so decisions about drugs should be made jointly by you and your doctor.
8. There Are No Treatments for Primary-Progressive MS
False There is one drug therapy approved for primary-progressive MS (PPMS), a type of MS that affects about 15 percent of people with MS overall. Called Ocrevus (ocrelizumab), the drug was approved by the Food and Drug Administration in 2017. Ocrevus has been shown in studies to decrease the rate of disease progression and associated disability in people with PPMS. Several other drugs are currently being studied as potential treatments for progressive forms of MS, which include PPMS and secondary-progressive MS, a stage of MS that is often considered a second phase of relapsing-remitting MS. Besides drug therapy, treatments available to people with PPMS include various forms of rehabilitation and assistive devices to make daily tasks, communication, and mobility easier; treatments to ease symptoms such as spasticity or pain; and lifestyle measures such as a healthy diet and regular exercise for overall wellness.
9. Very Few People With MS Develop Thinking or Memory Problems
False Thinking and memory problems, sometimes called cognitive deficits or cognitive impairment, are common among people with multiple sclerosis, even early in the disease. Cognitive deficits may include forgetting what you are doing or losing your train of thought in conversation, having trouble learning new information, and having difficulty planning or organizing tasks or activities. Multitasking, or trying to pay attention to two things at once, tends to be particularly difficult for people with MS. Both cognitive impairment and physical disability are associated with unemployment among people with MS. Cognitive deficits can also affect a person’s social life and other aspects of daily functioning. Various forms of cognitive rehabilitation, as well as some self-help approaches, can improve cognitive functioning. If you’re having trouble focusing, remembering, or performing other mental tasks, talk to your doctor about seeing a rehabilitation specialist for an evaluation.
10. Multiple Sclerosis Shortens Life Expectancy
True Studies of populations in various European countries, Canada, and the United States have shown that multiple sclerosis shortens a person’s life expectancy by about six or seven years. Many people with MS die of complications of the disease, such as pneumonia or sepsis resulting from an infection. Others die from cardiac or vascular diseases. And still others die of causes unrelated to MS. The availability of newer and more effective disease-modifying therapies may change the effects of MS on life expectancy, although this remains to be seen.
