It’s a time of hope and optimism for people living with multiple sclerosis. The once untreatable condition is better understood by neurologists and federal regulators have approved a number of highly effective medications.
Still, everyone experiences MS differently, said Dr. Jill Conway, a neurologist at Novant Health Neurology & Sleep – Midtown.
“Symptoms and frequency of relapses vary widely from person to person," Conway said. "It depends on the type of MS they have and where attacks to the central nervous system occur.”
As director of Novant Health's multiple sclerosis program in Charlotte, which was certified as a partner in MS Care by the National MS Society in 2019, Conway explained who is at risk of developing it, what symptoms to look for and how the unpredictable disease is diagnosed and treated.
Who gets MS?
Nearly 1 million people in the U.S. have MS, according to the National MS Society, and it’s more prevalent among women than men.
Anyone may develop MS, though most people are diagnosed between the ages of 20 and 50. While there is no known cause, Conway said both genetics and environment play a role.
“For instance, having a first-degree relative with MS can increase the risk of developing it. It has also been linked to lower levels of vitamin D, smoking and certain viruses, such as the Epstein-Barr virus, which causes mononucleosis,” she said.
A chronic, unpredictable disease
Autoimmune conditions occur when the body’s immune system wrongfully attacks healthy tissue rather than a “foreign invader,” such as a virus, bacteria or cancer cell.
With MS, a person’s immune system targets their central nervous system, including the brain, spinal cord or optic nerves. It is a chronic and unpredictable disease.
MS can cause a variety of symptoms, including:
- Fatigue.
- Difficulty with thinking and memory.
- Numbness or tingling in arms or legs.
- Difficulty with balance and walking.
- Urinary, bowel, and sexual dysfunction.
- Muscle spasticity, including stiffness or tightness of muscles, painful cramps, and spasms.
- Depression, anxiety, or other mood changes.
- Weakness.
- Double vision or vision loss.
- Pain.
How it’s diagnosed
Diagnosing MS relies on evidence of the disease, as well as symptoms reported by the patient. Accompanying test results and physical exam findings also play a significant role.
“There is no blood test or simple 'yes/no' test for multiple sclerosis,” Conway said. “We use a set of diagnostic criteria that involves medical history, neurologic exam, and MRI findings. Labs can help rule out other similar conditions and sometimes, cerebrospinal fluid studies obtained by a spinal tap can help clarify the diagnosis.”
Treating MS
There is no cure for MS, but there are a number of disease-modifying therapies to help people manage the disease. The goal, Conway said, is to limit the damage caused by the autoimmune condition.
“Newer treatments are significantly more effective at slowing down multiple sclerosis than some of the first-generation medications,” Conway said.
She stressed that choosing the right disease-modifying therapy is important and should be discussed with your doctor.
In addition to starting patients on medication, Conway helps patients manage their symptoms. “Effective symptom management plays a huge role in a patient’s quality of life,” she said. “Optimizing a patient’s functioning makes them more resilient to any damage that may occur as a result of their disease.”
Treatments include medications, therapy, counseling, fitness, medical equipment, yoga and more. People with MS are also encouraged to eat a healthy diet, get regular exercise, work on stress management and get adequate sleep.
“Quality of life is key,” Conway said. “Working with patients to stay physically active, be engaged with family and friends, quit smoking, and get enough vitamin D – these are a few of the issues we work on every visit.”
If you or a loved one has been recently diagnosed with MS, this story may help.
Fast facts about Dr. Jill Conway, director of Novant Health's MS program in Charlotte
Conway, a neurologist, earned her Doctor of Medicine from the University of Illinois at Urbana-Champaign.
She completed both her neurology residency and a fellowship in multiple sclerosis at the University of Pennsylvania Health System in Philadelphia.
She and her team provide a multidisciplinary, personalized treatment approach to care and deliver treatments that address MS and other neurological conditions, including:
- Neuromyelitis optica.
- Anti-myelin oligodendrocyte glycoprotein Ab (anti-MOG).
- Optic neuritis.
- Transverse myelitis.
- Neurosarcoidosis.
- Acute disseminated encephalomyelitis.
- CNS vasculitis.
