Mayo Clinic Explains Multiple Sclerosis
Summary
TLDRDr. Oliver Tobin, a neurologist at Mayo Clinic, discusses multiple sclerosis (MS), a condition where the immune system attacks the protective myelin sheath of nerve cells. He explains how MS can affect the brain, optic nerve, and spinal cord, leading to symptoms like vision loss, weakness, numbness, and mobility issues. Risk factors include low vitamin D, smoking, obesity, and infections. Diagnosis involves symptoms, MRI, and spinal fluid analysis. Treatment focuses on managing relapses with corticosteroids, plasma exchange, and medication. Dr. Tobin emphasizes the importance of a multidisciplinary team for effective management and living well with MS.
Takeaways
- 🧠 Multiple sclerosis (MS) is a neurological disorder where the immune system attacks the myelin sheath, the protective covering of nerve cells in the brain and spinal cord.
- 👨⚕️ Dr. Oliver Tobin, a neurologist at Mayo Clinic, explains that the damage to the myelin sheath can slow or block nerve signals, and while the body can repair the damage, it's not always effective, leading to lesions or scars.
- 🚫 MS can affect anyone, but it most commonly appears in people between the ages of 20 and 40, with women being three times more likely to develop it than men.
- ☀️ Low levels of vitamin D and reduced sunlight exposure are associated with an increased risk of developing MS.
- 🚫 Overweight individuals and smokers are more likely to develop MS and may experience more severe disease progression.
- 🌐 The prevalence of MS is higher in northern and southern latitudes, with people of Northern European descent at the highest risk, and those of Asian, African, and Native American ancestry at the lowest risk.
- 🏥 There is no single test for MS diagnosis; instead, diagnosis relies on a combination of symptoms, physical examination, MRI scans, and spinal fluid analysis.
- 💊 Treatment options for MS include corticosteroids for relapses, and over 20 medications are approved for the prevention of MS attacks and new MRI lesions.
- 🏋️♀️ Physical activity is strongly recommended for people with MS, and consulting with physiatrists or therapists can help manage physical difficulties.
- 🤝 Maintaining social connections, staying involved with hobbies, and joining support groups can be beneficial for mental health and emotional well-being for those with MS.
- 🔬 Ongoing research is expanding our understanding of MS and leading to the development of more effective treatments and medications.
Q & A
What is multiple sclerosis (MS)?
-Multiple sclerosis (MS) is a disorder in which the body's immune system attacks the protective covering of the nerve cells in the brain, optic nerve, and spinal cord, called the myelin sheath. This damage can slow or block signals being transmitted within the nervous system.
What happens when the myelin sheath is damaged in MS?
-When the myelin sheath is damaged, it exposes the actual nerve fibers, which can slow or block the transmission of signals. The body can repair the myelin sheath, but not perfectly, leaving lesions or scars, which is where the name 'multiple sclerosis' (multiple scars) comes from.
Who is most likely to develop MS?
-MS can occur at any age, but it mostly first appears in people between the ages of 20 and 40. Women are up to three times more likely than men to develop relapsing-remitting MS. Other risk factors include low levels of vitamin D, obesity, smoking, and infections like the Epstein-Barr virus.
What are the common symptoms of MS?
-Common symptoms of MS include loss of vision in one eye, loss of power in an arm or leg, numbness in the legs, fatigue, depression, spasms, walking difficulties, incontinence issues, and sexual dysfunction. Symptoms often come on over 24-48 hours, last for a few days to weeks, and then improve.
How is MS diagnosed?
-MS is diagnosed through a combination of symptoms, physical examination, MRI scans, and spinal fluid analysis. There's no single test for MS, but these methods help doctors confirm the diagnosis.
What is relapsing-remitting multiple sclerosis (RRMS)?
-Relapsing-remitting MS (RRMS) is the most frequent type of MS, characterized by attacks or relapses where symptoms worsen, followed by periods of remission where symptoms improve or disappear.
What treatments are available for MS attacks or relapses?
-Treatments for MS attacks or relapses include corticosteroids to reduce inflammation and improve symptoms. If corticosteroids are not effective, plasmapheresis (plasma exchange) is another option, with around 50% of patients seeing improvement after this treatment.
What preventive medications exist for MS?
-There are over 20 medications approved for the prevention of MS attacks and the prevention of new MRI lesions. These medications help manage the progression of the disease.
How can people with MS manage their condition long-term?
-Long-term management of MS involves working with a trusted interdisciplinary medical team, including specialists like physiatrists, physical or occupational therapists. Regular physical activity, maintaining mental health, and staying connected with friends and family are also crucial for managing MS.
What ongoing research is being done on MS?
-Scientists are actively researching MS to better understand the disease and develop new treatments. This includes expanding knowledge about MS risk factors, disease mechanisms, and creating more effective medications.
Outlines
🧠 Introduction to Multiple Sclerosis
Dr. Oliver Tobin, a neurologist specializing in multiple sclerosis at Mayo Clinic, introduces the basics of MS. He discusses what MS is, its symptoms, diagnosis, and treatment options. MS is an autoimmune disorder where the immune system attacks the myelin sheath, the protective covering of nerve cells in the brain and spinal cord. This can slow or block nerve signals and potentially damage the nerve fibers. The body can repair the myelin, but the process is imperfect, leading to lesions or scars, which is where the name 'multiple sclerosis' comes from. MS typically presents first in individuals between the ages of 20 and 40 and is more common in women. Risk factors include low vitamin D levels, obesity, smoking, and certain genetic and environmental factors. Common symptoms include vision loss, weakness in limbs, and sensory disturbances. Diagnosis involves a combination of symptoms, physical examination, MRI scans, and spinal fluid analysis.
💊 Managing Multiple Sclerosis
The video script explains the management and treatment of MS attacks, which can be treated with corticosteroids or plasmapheresis if steroid treatment is ineffective. Over 20 medications are approved for preventing MS attacks and new MRI lesions. The importance of a multidisciplinary medical team is emphasized for managing the disease and its symptoms. Physical activity is strongly recommended for individuals with MS, and mental health is also a significant consideration. The script suggests maintaining personal connections, being kind to oneself, and considering support groups. The Mayo Clinic is actively involved in research to improve understanding and treatment of MS, and viewers are encouraged to seek more information through their resources.
Mindmap
Keywords
💡Multiple Sclerosis (MS)
💡Myelin Sheath
💡Relapsing-Remitting MS
💡Vitamin D
💡Risk Factors
💡Symptoms
💡Diagnosis
💡Treatment
💡Interdisciplinary Medical Team
💡Quality of Life
💡Research
Highlights
Multiple sclerosis is a disorder where the immune system attacks the myelin sheet, the protective covering of nerve cells.
Damage to the myelin sheet can slow or block nerve signals, and may also damage the nerve fibers themselves.
The body can repair the myelin sheet, but this repair is often imperfect, leading to lesions or scars.
Multiple sclerosis gets its name from the multiple scars left by the damage.
MS can lead to nerve cells dying off faster in damaged areas compared to normal areas.
The most common type of MS is relapsing-remitting, characterized by episodes of symptoms followed by remission.
MS typically first appears in people between the ages of 20 and 40.
Low levels of vitamin D and low sunlight exposure are associated with an increased risk of developing MS.
Overweight individuals and those who smoke are more likely to develop MS and experience more severe disease.
Women are three times as likely as men to have relapsing-remitting MS.
Certain infections, including the Epstein-Barr virus, have been linked to MS.
MS is more prevalent in higher northern and southern latitudes, with higher risk for people of Northern European descent.
People of Asian, African, and Native American ancestry have the lowest risk for MS.
Having other autoimmune diseases slightly increases the risk for MS.
Symptoms of an MS relapse usually come on quickly and last for days to weeks.
Common MS symptoms include vision loss, limb weakness, numbness, spasms, fatigue, and depression.
Diagnosing MS involves looking at symptoms, physical examination, MRI results, and spinal fluid analysis.
There is no single test for MS, but a combination of tests can help secure a diagnosis.
Blood tests and OCT scans may be recommended to rule out other diseases or to assess the optic nerve.
A multidisciplinary medical team is essential for managing MS and addressing individual symptoms.
Corticosteroids and plasma exchange are treatments that can help during an MS attack.
Over 20 medications are approved for preventing MS attacks and new MRI lesions.
Physical activity, mental health support, and maintaining personal connections are important for living well with MS.
Support groups can provide valuable connections and understanding for those living with MS.
Scientists continue to research MS, developing new treatments and medications.
Transcripts
I'm Dr. Oliver Tobin and neurologists
specializing in
multiple sclerosis at Mayo Clinic.
In this video, we'll be covering
the basics of multiple sclerosis.
What is it? Who gets
us the symptoms, diagnosis, and treatment?
Whether you're looking for answers about
your own health or that of someone you love.
We're here to provide you
with the best information available.
Multiple cirrhosis is a disorder in which
the body's immune system attacks
the protective covering of
the nerve cells in the brain,
optic nerve and spinal cord
called the myelin sheet.
And this sheet is often compared
the insulation on an electrical wire.
When that covering is damaged,
it exposes the actual nerve fiber,
which can slow or block
the signal is being transmitted within.
The nerve fibers themselves
might also be damaged.
The body can repair
damage to the myelin sheet,
but it's not perfect.
The resulting damage leaves lesions are
scars and this is where the name comes from.
Multiple sclerosis, multiple scars.
Now everyone loses brain cells
and spinal cord cells as they get older.
But if part of the brain or spinal cord
has been damaged by MS,
the nerve cells in that area will die
off faster than the areas
around it that are normal.
This happens very slowly,
usually over decades and
typically shows up as
gradual walking difficulty
happening over several years.
When you read about multiple cirrhosis,
you may hear about different types.
The most frequent being
relapsing-remitting multiple sclerosis.
And this is characterized by
a tax or relapses.
We don't know what causes MS,
but there are certain factors that may
increase the risk for trigger its onset.
So while MS can occur at any age,
it mostly makes its first appearance in
people between the ages of 20 and 40.
Low levels of vitamin D
and low exposure to sunlight,
which enables our body to make
vitamin D are associated with
an increased risk of developing
MS. As people who have MS,
you have low vitamin D tends
to have more severe disease.
So people who are overweight are
more likely to develop MS and
people who have MS and
are overweight tended to have
more severe disease and
a faster onset of progression.
People who have MS and who
smoke tends to have more relapses,
worst progressive disease,
and worst cognitive symptoms.
Women are up to three times as
likely as men to have relapsing-remitting MS.
The risk for MS in
the general population is about 0.5%.
If a parent or sibling has,
is your risk is about twice that or about 1%.
Certain infections are also important.
A variety of viruses
have been linked to amass,
including Epstein-Barr virus,
which causes mono.
Northern and southern latitudes
have a higher prevalence,
including Canada, the Northern US,
New Zealand, southeastern
Australia, and Europe.
White people, especially
of Northern European descent,
are at the highest risk.
People of Asian, African,
and Native American ancestry
have the lowest risk.
A slightly increased risk is seen if
a patient already has
autoimmune thyroid disease,
pernicious anemia, psoriasis,
type 1 diabetes,
or inflammatory bowel disease.
Symptoms of a relapse usually
come on over 24 to 48 hours,
last for a few days to a few weeks and then
improve in the region of 80 to a 100 percent.
Those symptoms include
loss of vision in and I,
loss of power and an arm or leg
or a rising sense of numlist and the legs.
Other common symptoms associated
with MS include spasms,
fatigue, depression, incontinence issues,
sexual dysfunction, and walking difficulties.
There's currently no single test
to make a diagnosis of MS.
However, there are four key features
which helped to secure the diagnosis.
Firstly, either
typical symptoms of multiple sclerosis.
Again, those are loss of vision and an eye,
loss of power and an arm or leg,
or sensory disturbance in an arm or
leg lasting for more than 24 hours.
Secondly, do you have
any physical examination
findings consistent with MS?
Next is the MRI of
your brain or spine consistent with MS.
Now here it's important to know
that 95 percent of
people over the age of 40
have an abnormal brain MRI,
just the same as many of
us have wrinkles on our skin.
Lastly, are the results of
the spinal fluid analysis consistent with MS.
Your doctor may recommend
blood tests to check for
other diseases that share the same symptoms.
They may also recommends
an OCT test or optical coherence tomography.
This is a short scan of
the thickness of the layers
at the back of your eye.
So the best thing to do when
living with MS is to find
a trusted interdisciplinary medical team
that can help you monitor
and manage your health.
Having a multidisciplinary
team is essential for
addressing the individual's symptoms
that you're experiencing.
If you have an MS attack or relapse,
your doctor may prescribe
corticosteroids to reduce or
improve your symptoms and if
your attack symptoms do
not respond to steroids.
Another option is
plasmapheresis or plasma exchange,
which is a treatment similar to dialysis.
About 50 percent of people
who do not respond to steroids
have a significant improvement with
a short course of plasma exchange.
There are over 20 medications
currently approved for
prevention of MS attacks
and prevention of new MRI lesions.
As learning to function with
MS can be challenging.
There are medical experts ready to
work with you to help you manage.
So you can still live a full life.
Consulting with a physiatrist,
physical or occupational therapist
can help you deal with physical difficulties.
Physical activity is strongly
recommended for all people with MS,
mental health and also
an important consideration.
So keeping
our personal connections with friends and
family and trying to stay
involved with your hobbies is important,
but also be kind to yourself and
realistic about what you report.
This can change from day to day,
so it's okay to give yourself
permission if something
seems like too much or
if you need to counsel plans.
You may also find support groups
helpful to connect with people who
understand what you are going through and
discuss your feelings and
concerns with a doctor or a counselor.
Meanwhile, scientists are hard at work,
expanding our understanding
of this disease and
developing new treatments and
medications which are ever more effective.
If you want to learn more,
watch more of our videos
or visit Mayo Clinic.org.
We wish you well.
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