What causes MS?

Your brain and spinal cord make up your central nervous system (CNS). Nerves send signals from your brain to your body and back so that you can move and feel. Myelin is a fatty layer that protects your nerves.

In MS, your immune system attacks myelin. This can cause inflammation in the brain. It can interrupt your nerve signals, causing a communication breakdown between your body and your brain.

The cause of MS is unknown, and the course of the disease is difficult to predict. Although there is a genetic component, experts believe that environmental factors most likely cause MS.

Research also suggests that certain factors play a role in your risk for developing MS:

• Family history of MS
• Smoking
• Obesity
• Being female
• Being Black
• Having a low level of vitamin D

Viruses, gut bacteria and minimal sunlight exposure, seem to play important roles in your risk of developing MS as well.

Women* between the ages of 20 and 40 are most likely to receive an MS diagnosis. But MS can affect anyone from childhood to later in life.

“There have been increased cases of late-onset MS, even in people aged 50 and older,” says Dr. Graham.

What are the most common symptoms of MS?

Symptoms of MS can vary widely from person to person. This is because symptoms appear based on which part of the brain and nervous system are impacted. For example, if your body attacks the nerve cells that control your eyes, you may experience vision loss. MS symptoms typically occur as episodes that last longer than 24 hours.

Common types of MS episodes include:

• Loss of vision in one eye
• Double vision
• Trouble with balance and coordination
• Weakness or change in sensation, such as numbness
• Slurred speech
• Issues with bladder or bowel movements
• Changes in memory, concentration or fatigue
• “MS hug,” a squeezing sensation in the chest or abdomen
• Lhermitte’s sign, a sudden brief electric shock sensation running down spine when bending forward
• Uhthoff's phenomenon, which is worsening of symptoms in the heat

What are the different types of MS?

• Relapsing-remitting MS is the most common type of MS. People with relapsing-remitting MS will have isolated episodes called “attacks.” Then they may experience some persistent symptoms to a lesser degree or no symptoms at all.
• Primary-progressive MS is a progressive worsening of symptoms over time with no periods of recovery.
• Secondary-progressive MS occurs in some patients who have had relapsing-remitting MS for many years. Relapses become less common and instead patients experience progressive worsening over time without periods of recovery.

When should you see a physician about MS?

“We want to be cautious before jumping to any conclusions,” Dr. Graham explains. “When people seek information online, they believe symptoms like urinary frequency or brain fog could indicate MS. This is not always the case.”

If you experience ongoing symptoms that are not severe, mention them to your primary care physician. You can discuss whether these symptoms could signal MS, another neurologic problem or unrelated concerns.

MS symptoms typically develop gradually over days to weeks and persist for an extended period. Call 911 if you experience sudden onset of:

• Vision loss
• Slurred speech
• Trouble with balance and coordination
• Weakness

How do you get diagnosed?

First, you will get a clinical evaluation with detailed discussion of symptoms and a thorough exam. Then, your care team will perform an MRI scan of your brain and spinal cord.

Several diseases and syndromes are often mistaken for MS in clinical settings. These include migraine, fibromyalgia, functional neurological disorder, neuromyelitis optica, MOG antibody disorder, among other causes.

“If we are unsure, we will use more tests to check,” says Dr. Graham. “It’s important to be as specific as possible to get the right diagnosis.”

These tests may include:

• A lumbar puncture to test your cerebrospinal fluid (CSF)
• Blood tests
• Visual diagnostic testing

What are my treatment options for MS?

There is no cure for MS, but there are many ways to manage your symptoms and improve your quality of life in the long term. “Over the last decade, the number of FDA-approved treatments for MS has doubled,” explains Dr. Graham. “Now, we have many highly effective infusions, injectables and oral medications.”

Treatment options vary based on the type of MS you have. Treatment can help people with MS prevent relapses and progression of disease.

Scientists are actively researching options for promoting remyelination and repair, as well as therapy for progressive forms of MS.

Alongside medication, these treatments may also help manage MS:

• Physical therapy
• Diet
• Exercise

“MS treatment empowers patients to maintain independence, engage in meaningful activities and pursue their goals with confidence,” says Dr. Graham.

Learn more about our MS support groups. 

*Scientists do not always collect information from participants about gender identity. To avoid misrepresenting the results of this research, we use the same terminology as the study authors.