The symptoms of multiple sclerosis can vary, and they can be difficult to overlook. They can include visual loss in one eye and what is commonly described as a “squeezing” sensation around the waist. Furthermore, there are variations throughout instances of this inflammatory disease, which is why neuropsychologist Meghan Beier, an assistant professor of physical medicine and rehabilitation at Johns Hopkins University School of Medicine, notes that “many people call MS the snowflake disease.'” Some people just experience minor symptoms that don’t really affect their daily lives, while others require care around-the-clock due to really severe symptoms. Cognitive symptoms can affect some persons more than others. While some don’t, some do experience physical signs. Not everyone experiences suffering.
To make matters more complicated, multiple sclerosis (MS), which targets the brain and spinal cord, can have radically different effects on the same individual depending on whether they are experiencing an acute episode (also called a flare or attack). The majority of MS patients experience attacks interspersed with tranquil intervals; this is known as the “relapsing-remitting” version of the illness.
Beier is hesitant to use the term “remission,” even though some refer to the less active period as such since it falsely implies that the disease and all associated symptoms have abated. She notes that even when a patient is not experiencing an episode, they typically still struggle with issues like exhaustion or persistent pain; they are simply not as sick as they would be during a flare-up.
It helps to grasp this heterogeneity by having a basic understanding of the causes and treatments of multiple sclerosis. According to Beier, “the immune system targets the myelin sheath that surrounds neurons in the brain and spinal cord when someone has multiple sclerosis.” “That can result in signals being transmitted very slowly or intermittently, or it can cause cell death, in which case signals are not transmitted at all.”
Relapsing-remitting MS is known to give way to what is known as the “secondary progressive” course with increasing disability and markedly worsening neurologic function with time.
Because of the significant advancements in disease-modifying drugs over the past few decades, it is impossible to predict when a specific patient may need to deal with a substantial permanent handicap. “We were told in graduate school in the ’90s that it would take approximately 15 years after diagnosis to use a cane or walker, and possibly 30 years to require a wheelchair, but that is no longer the case,” Beier explains. She points out that because “they’re not having the same progression,” many long-term patients of the illness are nonetheless able to walk on their own.