MS is a chronic disease of the central nervous system, which is made up of the brain and spinal cord. MS is unpredictable and can range from benign to disabling. Some people with MS may be mildly affected. Others may lose the ability to write, speak, or walk.
Many things may cause MS, including viruses, autoimmune disorders, environmental factors, and genetic factors. But, all of the possible causes share the common feature that the body's immune system attacks its own nervous tissue. In MS, the immune system attacks the layer of protein called myelin that surrounds the nerve fibers in the central nervous system. Myelin insulates the electrical signals the nervous system uses to communicate. When this insulation is destroyed, communication is interrupted. Parts of the nervous system become permanently damaged.
Symptoms of MS are erratic. They may be mild or severe, and of long duration or short. They may appear in various combinations, depending on the area of the nervous system affected. Throughout the course of the illness, you may have any or all of these symptoms:
MS may also cause cognitive effects. The effects may be mild, often found only after thorough testing. They may include problems with:
The symptoms of multiple sclerosis may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.
Your healthcare provider will do a thorough medical history and a physical exam as the first steps toward diagnosis of MS. You will be asked about all of your symptoms, how often they occur, and how long they last.
You will likely have an MRI (magnetic resonance imaging). This test can detect the unique scars in the central nervous system.
In some cases, you may need lab tests or a lumbar puncture to confirm the diagnosis.
Fortunately, pregnancy does not appear to speed up the course or worsen the effects of MS. However, if you have unrecognized MS you may be more likely to start having symptoms during pregnancy. Some studies have found that MS symptoms decrease in pregnancy and increase after delivery.
The disabling effects of the disease may make it physically hard to carry a pregnancy. Muscle weakness and coordination problems may increase the likelihood for falls. Fatigue may worsen. Wheelchair dependence may increase the risk for urinary tract infections. There is no evidence that MS causes infertility. Studies have shown that pregnancy, delivery, and rate of birth defects are not significantly different in women with MS compared with those without MS.
During pregnancy, you will need close monitoring to keep track of the disease and the health of the fetus. You may need more frequent prenatal visits. There is no established treatment that alters the course of MS. But, you may be given medicines such as steroids and anti-inflammatory drugs. A procedure called plasmapheresis (a method for removing toxic elements from the blood) has been used in trials for treatment of MS. Consult your doctor for more information.
Supportive treatment and rehabilitation for MS are especially important during pregnancy. Rehabilitation varies depending on your symptoms but may help with the following:
Call the doctor if you have several of the classic symptoms of MS so that treatment can begin right away.
If you have MS and want to get pregnant, discuss the benefits and risks of a pregnancy with your MS specialist before becoming pregnant.
If you are pregnant and having the symptoms of MS, tell your doctor as soon as possible.
If you have MS and you are pregnant, let you doctor know as soon as possible.
Tips to help you get the most from a visit to your healthcare provider:
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