You Have Trouble Swallowing Or Speaking Sometimes
Issues with speech and swallowing typically go hand-in-hand , per the National MS Society.
As far as speech goes, damaged areas of the brain can affect speech patterns, causing slurring or a more nasal sound to your voice.
Your brain is also largely in control of swallowing and yeah, not being able to swallow properly should definitely raise a red flag.
Symptoms Of Multiple Sclerosis
The symptoms of MS vary widely from person to person and can affect any part of the body.
The main symptoms include:
- problems with balance and co-ordination
- problems with thinking, learning and planning
Depending on the type of MS you have, your symptoms may come and go in phases or get steadily worse over time .
Age And Efficacy Of Dmt
Nowadays, treatment of older patients affected by MS can be really challenging. Patients with LOMS are less frequently exposed to DMTs and consequently very little is known about the efficacy of DMTs in this understudied old population. However, considering the increase of older people affected by MS, it seems clear that a better understanding of the characteristics of these patients and their potential response to DMTs is needed .
A recent meta-analysis confirms that age results an essential modifier of drug efficacy in patients with MS . Aging and immunosenescence in turn interact with the progressive phase of the disease that tend to compare as age increases. The role of progression may thus have a key role when we evaluate the efficacy of DMTs related to the age. Actually, during the fifth decade MS patients frequently experience a transition to a progressive disease with a shift from active inflammation to a compartmentalized inflammation and a faster accumulation of disability. This different inflammatory milieu in elderly raise doubts about the efficacy of immunomodulatory agents that are active against the peripheral inflammatory process underlying MS pathogenesis .
Among the other first-line DMT, dimethyl fumarate , peginterferon-β-1a , and teriflunomide reduced annual relapses rate in both young and old patients however, all these DMTs failed to reduce the risk of disability accumulation.
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Muscle Stiffness And Spasms
MS can cause spasticity, which refers to muscle stiffness and involuntary muscle spasms in the extremities, especially the legs. It affects 4080% of people with MS at some point.
Some of the symptoms of spasticity include:
- tightness in or around the joints
- painful, uncontrollable spasms in the arms and legs
- hips and knees that bend and become difficult to straighten
- hips and knees that stiffen while close together or crossed
Causes And Risk Factors Of Multiple Sclerosis
The cause of MS is unknown no one knows what sets off the disease process that leads to MS lesions in the first place. But it is thought that some combination of genetic susceptibility and environmental causes is necessary to trigger the disease.
Approximately 20 percent of people with MS have a family member who has it, but even having an identical twin with MS increases the risk by only 20 to 40 percent. So even though having a family history of MS raises the risk somewhat, MS is not considered a genetic or hereditary disease.
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Common Signs And Symptoms Of Ms
Knowing the common signs and symptoms of MS is key to a prompt diagnosis.
Its cause is unknown, but impacting over one million people in the U.S. alone, multiple sclerosis can result in an extensive and unpredictable range of symptoms and severity. What we do know is that women are much more likely to develop MS, and that every person will experience it in different ways, with symptoms changing and evolving during the advancement of the disease.
Managing multiple sclerosis can be very difficult however, it is much easier to manage when you understand the symptoms to watch out for and stay in communication with your healthcare team regarding any changes noted, to allow for the most effective treatment option.
To that end, we have put together some of the more common signs and symptoms of MS, as well as outlying symptoms that an individual with MS may experience:
Common Symptoms
Less Common Symptoms
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Physical Trauma From Falling
Many MS symptoms, including balance problems, muscle weakness, fatigue, dizziness, blurred vision, and numbness, raise the risk of falling.
Falls, in turn, raise the risk of serious injuries, such as broken bones and head trauma. Falling can also lead to fear of falling, which typically causes a person to become less active, weaker, and even more prone to falling.
While not all falls can be prevented, many can, through a range of strategies to build leg strength, improve balance, fall-proof your home, and address potential causes of dizziness.
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How Is Multiple Sclerosis Treated
The reason its important to go see a doctor is that this is a very, very treatable condition, says Dr. Giesser. Disease-modifying medication combined with exercise, following a healthy diet, and not smoking can help to control multiple sclerosis. Some of these treatments can actually slow the progression of MS and prevent future damage.
You’re Tired Like All The Time
Youre inevitably going to come across those days when you just cant even. But sudden spells of severe exhaustion that last for weeks and mess with your ability to function normally on a day-to-day basis might be an indication that MS is destroying the nerves and fibers in your spinal column.
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People with MS describe their fatigue as overwhelming, making even simple tasks difficult, says Costello. It is often out of proportion with your activity, is not relieved by sleep, and is worsened if you become overheated.
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What Is A Multiple Sclerosis Relapse
A relapse, or flare, is a worsening of existing MS symptoms physical and cognitive often accompanied by the appearance of new symptoms. Relapses occur because of inflammation of previously existing lesions, new areas of inflammation in the central nervous system, or both.
Typically, relapses come on over hours or days and can last for days or weeks.
A true relapse occurs at least 30 days after your most recent relapse and lasts for at least 24 hours. Shorter periods of symptom worsening, called pseudoexacerbations, can be triggered by heat, stress, and fatigue, among other things. Once the underlying cause of a pseudoexacerbation is reduced or eliminated, the MS symptoms should abate too.
Treatment for a relapse often includes a short course of high-dose steroids, such as Solu-Medrol , delivered intravenously in an outpatient clinic or infusion center. Steroids speed recovery but cannot repair any new damage to the nervous system caused by the inflammation.
Multiple Sclerosis
At What Age Does Ms Usually Start
There are around nearly 1 million adults in the U.S. who are living with MS. The autoimmune disease affects women more than men.
And for most people, theyll receive their MS diagnosis somewhere between the ages of 20 and 40.
These are the years where the immune system is quite active, and factors like prior exposure to Epstein-Barr Virus , the virus that causes mononucleosis, are increasingly thought to play a role, says Dr. Bermel.
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Blurred Or Loss Of Vision
Youâre reading a book and suddenly you see two of the same line or the page becomes a gray jumble. Vision problems caused by MS usually come on suddenly. They include:
- Blurry, gray, or double vision
- Blindness or a dark spot in one eye
- Eye movements you canât control
If your sight is slowly getting worse, thereâs most likely another issue to blame. Some blurriness is a normal part of aging — you may just need a new pair of glasses. A more serious issue, such as glaucoma, macular degeneration, or diabetic retinopathy, can also lead to vision problems like blind spots. To rule out these diseases, have a checkup with your eye doctor. Learn more about symptoms of common vision problems.
When To See Your Doctor
If you have sudden numbness on one side of your body or trouble seeing or speaking, get medical help right away. These are signs of a life-threatening stroke.
If your symptoms are out of the ordinary for you and last for more than a day, make an appointment to see your doctor. They can talk to you about what youâre feeling and do some tests to see if your issues are because of MS or another health problem.
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Hormones And Other Female Factors
When a condition affects women more than men, scientists are likely to take a look at the role of sex hormones such as testosterone and estrogen.
Between boys and girls, Mowry says theres less difference in the rate of MS among children before puberty, but in older children and adults the trend changes, striking more females in adolescence and adulthood.
Age At Diagnosis And Ms Progression
The thinking used to be that MS progressed more quickly in people diagnosed at an older age. Indeed, research published in the Journal of Neurology, Neurosurgery & Psychiatry found that children diagnosed with MS took longer to develop secondary-progressive disease than adults diagnosed with MS , and they also took longer to reach disability milestones.
But the study authors note that those diagnosed as children hit disability milestones at a younger age and therefore could be considered to have a poorer prognosis.
Helen Tremlett, PhD, Canada research chair in neuroepidemiology and multiple sclerosis and a professor at the University of British Columbia in Vancouver, says that her work since 2006 has shown that late-onset MS does not necessarily mean a worse outcome for the patient.
Dr. Tremlett participated in a study published in April 2015 in the European Journal of Neurology, which investigated whether the use of the widely prescribed MS drugs known as beta interferons delays the onset of secondary-progressive MS it found that they do not.
However, a study published in January 2019 in the Journal of the American Medical Association suggests otherwise. When researchers compared MS medications including beta interferons, glatiramer , fingolimod , natalizumab , and alemtuzumab versus no treatment at all, they found that treatment with any of these medications was associated with a lower risk of transition to SPMS.
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Why Are Females More At Risk
Females may be more at risk of MS because their bodies suppress the immune system while pregnant.
There may also be a link between Vitamin D deficiency and MS. Some researchers believe that there is a connection between MS and the differences in how male and female bodies process vitamin D. Experts say there is growing evidence that low vitamin D levels affect both the risk of developing MS and the levels of disease activity in people with the condition. However, more studies are necessary to confirm this.
Other researchers theorize that X chromosomes play a direct role in autoimmune function. X chromosome inactivation in females may result in them having more MS susceptibility genes. Again, more research into this is necessary.
Detecting Early Symptoms Of Ms Is Really Important
Dr. Vollmer calls M.S. a relatively invisible disease since many of the symptoms arent obvious to an outside observer. Plus, the symptoms of the disease can also be common symptoms of many other less serious ailments, which often makes M.S. difficult to spot. “They’re often subtle enough that health care providers miss it,” Dr. Vollmer adds. He also notes that when people present with their first M.S. symptoms, it’s very likely they’ve had the condition for some time and have already suffered significant brain volume lossthis atrophy is a strong predictor of disability, so it’s key to catch it early.
Another thing to keep in mind is that, in general, everyone experiences M.S. differently, at any stage of the disease, according to the Mayo Clinic. So when we talk about early symptoms of M.S., keep in mind that its not a checklist but a collection of possible flags.
With all of that said, here are some of the most common early signs of M.S. women should look out for. Though everyone should be aware of the disease, its prevalence in women and onset age suggest it’s even more important for women in their 20s and 30s to pay attention to potential early signs of M.S.
Dr. Vollmer recommends that any young woman who has serious, unexplained fatigue that interferes with her ability to function on a daily basis should get an MRI. Its one of the various diagnostic tools used when it comes to M.S.
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Charities And Support Groups For Multiple Sclerosis
There are 2 main MS charities in the UK:
These organisations offer useful advice, publications, news items about ongoing research, blogs and chatrooms.
They can be very useful if you, or someone you know, has just been diagnosed with MS.
There’s also the shift.ms website, an online community for younger people affected by MS.
You’re Having Trouble Multitasking Or You’ve Been Really Moody
About 60 percent or more of those diagnosed with MS experience some form of cognitive or emotional distress, according to Kathleen Costello, a nurse practitioner and associate vice president of healthcare access at the National Multiple Sclerosis Society.
Those with MS can suffer from impaired recall, difficulty with depression, irritability, sudden mood swings, and uncontrollable fits of crying or laughter.
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The Cause Of Multiple Sclerosis Is Still Unknown
Based on current research, there seem to be genetic, hormonal, and environmental factors at play. Family history of multiple sclerosis makes you more susceptible to it, Dr. Vollmer says . Researchers have also identified genes that are associated with an increased risk of developing M.S., Dr. Vollmer says, who adds that there’s a powerful association between M.S. risk and low vitamin D exposure in utero and early in life. This vitamin D connection may help explain the latitude-based geographical trend: M.S. is more common in geographical areas farther from the equatorthough there are still some ethnic groups that rarely get the disease despite their location on the map. That said, your location appears to have the chance to affect your M.S. risk only in your first 15 years of life, the Merck Manual explains.
Treatments For Ms Symptoms
Doctors can prescribe a wide variety of drugs to relieve symptoms related to MS, include analgesics for pain antispasmodics, such as baclofen, and muscle relaxants, such as Zanaflex , to ease muscle spasticity and Ampyra to improve walking ability.
Physical therapy can also be helpful for dealing with fatigue, weakness, pain, and spasticity. A physical therapist can prescribe exercises, stretches, and alternative ways of performing physical tasks to improve energy levels and physical functioning.
Occupational therapy is often used to find easier or alternative ways to achieve tasks of daily living, including by using assistive devices and energy conservation techniques.
Your doctor can also refer you for speech-language therapy to address problems with speaking or swallowing, cognitive rehabilitation for help with memory and thinking tasks, and psychotherapy for help with depression, anxiety, grief, or simply distress related to living with a chronic condition.
In addition to formal rehabilitation and therapy, exercise and meditation have both been shown to improve function and quality of life for people living with MS.
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Multiple Sclerosis In The Elderly
Multiple sclerosis is a nerve disease that reaches its peak in the senior years of life. It starts earlier in life, usually between the 20s and 40s, and gradually worsens. By the time a person with multiple sclerosis reaches the senior years the condition can reach a point where it causes irreversible muscle weakness or paralysis and other debilitating complications. This further complicates the age-related limitations of an older person and multiple sclerosis sufferers often need the help of caregivers in the senior years. Despite being incurable, it is important for younger multiple sclerosis patients to seek treatment so as to avoid these complications later in life even if the MS symptoms are mild.
Know The Risk Factors
MS affects more than 2.3 million people globally. Though MS is not contagious or even directly inherited, some factors may increase the risk for this disease, including the following:
Shoemaker also cites other specific factors, either alone or in combination that may contribute to the disease, which include the following:
- Certain gene variations
- Exposure to the Epstein-Barr virus
- Low vitamin D or sun exposure
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About Dr Barbara Giesser
Dr. Barbara S. Giesser, FAAN, FANA, is an internationally recognized clinician and award-winning educator who has specialized in the care of persons with Multiple Sclerosis since 1982. Dr. Giessers approach to the diagnosis & management of persons with MS combines state-of-the-art diagnostics and a personalized medication plan for each patient with an emphasis on integrating lifestyle and wellness strategies into the neurologic treatment plan.