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Multiple Sclerosis

MS is a chronic, typically progressive disease. It especially afflicts white Caucasians and the Nordic countries are an area of particularly high incidence.

Young adults most afflicted

Nerve cell with the axon wrapped in myelin
1. Nerve 2. Myelin 3. Spinal cord
4. Brain

Seventy percent of those afflicted by MS are young adults. The disease typically breaks out between the ages of 20 and 40.
 
The first symptoms of MS can be acute or insidious and progression varies between individuals. In 60-90% of the cases, it begins as a disease with distinct attacks, so called relapsing-remitting MS (RRMS). Months or even years can pass before the next relapse (attack), which can recede completely in the course of days or months (remission) or leave varying degrees of permanent symptoms. This variant is most common in women (60%). The average age at its debut is 30 years. Between incidents of attack and remission, the disease is stable. The frequency of attacks is higher during the first years. Its clinical symptoms are caused by acute inflammation with focal oedema and resulting fibrogliotic plaque tissue that most often afflicts the brain, the spinal cord, the optic nerve, medulla oblongata and/or the cerebellum.

After several years of illness, the attacks remit less and less, and the disease evolves to a secondary, progressive form (SPMS). For about 10-20% the disease will take the form of a continuous deterioration from the very start, possibly with superimposed attacks and remissions. This is called the primary progressive form (PPMS)

We do not know what causes MS

Many things point to MS being of autoimmune etiology, with inflammatory attacks on the myelin. In addition, axonal damage can occur. These lesions lead to a reduction in or cessation of the ability to transmit nerve impulses. Changes are most pronounced in the white matter, but the grey matter is also affected. With time, the process can lead to atrophy of the cerebrum as well as the spinal cord.

Bladder problems very common

Bladder problems are the first symptom in about 10–25% of MS patients. The most common symptoms of bladder dysfunction in MS patients are:

  • Overactive bladder – frequency, urgency and urge incontinence, with or without urinary retention
  • Detrusor-sphincter-dyssynergia with interrupted voiding and urinary retention
  • Urinary tract infection

Related Information
References
For reference see literature list.