Multiple sclerosis Tirohanga whānui ki te wharanga uwhi iaia

The cause of MS is still not known. It may be an autoimmune disease, possibly triggered by an infection.

In autoimmune conditions, your immune system starts to attack parts of your own body. You cannot catch MS from someone else.

MS affects around one in 1,000 people in Aotearoa New Zealand. It is more common in some groups. You are more likely to have MS if:

• you are aged 20 to 40 — a diagnosis is often made in a person's early 30s
• you are female — women are 3 times as likely to have MS
• your mother, father or a sibling has it — this increases your chances to about 30 in 1,000
• your ancestry is from Northern Europe — this is the most commonly affected group (it is less common in Māori, Pacific and Asian peoples)
• you live further from the equator — people living in the south of the South Island are about twice as likely to get MS as those in the upper North Island
• you have low levels of vitamin D and low exposure to sunlight
• you smoke.

MS is an unpredictable disease that affects people differently. Everyone has slightly different symptoms depending on the location, size and number of areas with damaged nerve tissue (demyelinated areas). These areas can heal over time and symptoms may go away or can be permanent.

Some people only have mild symptoms. Others may lose the ability to speak, walk or see.

Depending on what type of MS you have, symptoms usually get worse for several days, then stay the same for a few days or weeks, then improve over the next month. Some people have a progressive type of MS, where symptoms gradually get worse.

The most common early symptoms are:

• reduced vision in one eye, usually with pain when you move your eye
• vision problems, such as blurred or double vision
• weakness or paralysis in an arm or leg
• numbness in an arm or a leg
• vertigo (where you feel that you, or the world around you, is moving or spinning)
• poor coordination and lack of balance
• bladder or bowel problems.

Symptoms may get worse due to:

• stress
• tiredness (fatigue)
• increased body temperature from exercise, spas, hot baths or sun exposure
• infection
• trauma
• new medicines.

It can be hard to diagnose MS because there is no single test for it. You may need to be assessed by your healthcare provider and have blood tests to rule out other conditions which cause similar symptoms.

You may be referred to a specialist doctor (neurologist). They will ask about your symptoms and examine you. Before they can confirm you have MS they may need to wait to see if new symptoms appear or earlier symptoms come back. Getting a diagnosis can sometimes take months.

MS may be diagnosed from the symptoms that are typical with demyelination. Other tests may also help get a diagnosis, such as an MRI scan of your spinal cord or brain, or a lumbar puncture.

Types of multiple sclerosis

• Relapsing remitting MS — relapses (periods with symptoms) are followed by remissions (when you have no symptoms or only minor symptoms). This is the most common type (about 85% of people with MS).
• Primary progressive MS — your symptoms gradually get worse. This affects about 10% of people with MS.
• Secondary progressive MS — people who had relapsing remitting MS later develop progressive symptoms unrelated to relapses. About 65% of people with relapsing remitting MS develop secondary progressive MS around 15 years after being diagnosed.
• Progressive relapsing MS — the least common type (about 5% of people with MS). There is a progression of disability from the onset, but with clear relapses, with or without full recovery to the pre-relapse state in between.

Being diagnosed with MS can be a difficult and worrying time. Being well informed and getting support can help. It can also prepare you for the future.

MS is a progressive disease, meaning it gets worse over time. There is no cure. Treatment, which might include medication, aims to:

• slow down the rate at which your MS worsens
• reduce how often you experience relapses
• reduce how severe your relapses are and speed up recovery afterwards
• manage your symptoms
• minimise disability.

Your neurologist will recommend the best options for you. Your healthcare provider may also prescribe medications to help manage your symptoms.

Multiple Sclerosis New Zealand has detailed information about treatment options.

MS treatments — Multiple Sclerosis New Zealandexternal link

There is no way to determine:

• how severe your MS will be
• how fast it will progress
• what other symptoms you will get.

There are many things you can do to improve and maintain your health if you have MS.

Maintaining a healthy lifestyle gives you the best chance of continuing to live well. There are things you can do to help manage your symptoms, maintain muscle function and handle daily challenges.

• Keep active — this helps to keep you mobile and maintains your strength and balance while reducing your risk of falls. Being active may also help with tight, stiff muscles (common symptoms with MS).
• Manage any stress — options might include learning relaxation techniques, connecting with your support network (including whānau, friends or support groups), identifying stressors and working out ways to best manage them.
• Eat well — this helps manage your weight as well as looking after your physical health.
• Keeping your mind active. Do activities which involve problem solving, memory and thinking skills.
• Stop smoking if you are a smoker. Smoking can make MS worse.
• Limit your alcohol intake.
• Keep taking other medicines your healthcare provider has prescribed.
• Avoid getting overheated from the sun, a hot bath or spa, or from over-exercising. Overheating can cause MS symptoms to come back or get worse.
• Keep working if possible, accepting that symptoms such as fatigue and limited mobility can affect your work. Work helps with your mental and physical wellbeing.
• Manage your fatigue levels. Learn how to conserve energy, prioritise tasks and plan ahead so you can do the things that are important to you.

Conserving energy