Conditions & Treatments

MS Center - Conditions and Treatments

As specialists in neuroimmunology, or neurologic diseases mediated by the immune system, we are here to diagnose and treat the conditions so you can live as comfortably and fully as possible.


What is Neuroimmunology?SymptomsDiagnosis | Treatment | Learn More


What is Neuroimmunology?

The term “neuroimmunology” covers a wide scope of diseases which affect both the immune system and the nervous system. Some of these diseases include:

  • Multiple sclerosis, one of the most common neurological diseases, affecting up to 1 million people in the United States.
  • Neuromyelitis Optica (NMO) spectrum disorders
  • Encephalitis
  • Neuropathy
  • Myelopathy
  • Neurosarcoidosis
  • Autoimmune epilepsy
  • Other neurologic complications of autoimmune disease

We treat people with all of these conditions at Hartford HealthCare’s Neuroimmunology Department. If you are unsure if a condition falls under this specialty, please call us.

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Signs of multiple sclerosis (MS)

The symptoms and signs of MS can include:

Fatigue

About 80 percent of people with MS experience this, making it one of the most common symptoms. The exact cause is unknown but fatigue in MS can significantly impair a person’s ability to function. It is important to determine if your fatigue is caused by MS or something else. If you are experiencing fatigue, our specialists may order a work-up to rule out other common causes such as sleep apnea and vitamin deficiencies. There are many strategies to manage fatigue, which our specialists can address with you at your appointment.

Weakness

Neurologic weakness in MS is caused by the injury to myelin, which is the material covering neurons in the brain or spinal column that helps in signal transmission in the nervous system. This results in a problem conducting signals to the muscles. Weakness in the legs can cause trouble with mobility. Weakness in the arms can also limit activities of daily living, reducing independence. Weakness can also result from deconditioning of the muscles from lack of activity. Physical and occupational therapy can help manage these symptoms.

Tingling and numbness

Because MS affects nerves in the brain and spinal cord, numbness can also occur, usually in the legs, arms, face and fingers. Sometimes these sensory symptoms can include burning or tingling, which can be painful. Sensory symptoms are often among the first experienced by those diagnosed with MS.

Spasticity

Feelings of tightness and involuntary spasm in the muscles are a common symptom of MS. Spasticity can occur in any limb, though it is more common in the legs. It can be painful and limit mobility. There are medications and interventional methods to help treat this symptom.

Trouble walking and clumsiness

The effect of MS on the nervous system can also lead to coordination and balance problems, or even trouble walking. Some people eventually need aids such as a cane, walker, braces or even a wheelchair.

Vision problems

Inflammation from MS can affect the optic nerve which connects the eyes to the brain. This can cause blurry vision, pain in the affected eye(s), a dulling of colors or vision loss in one or both eyes.

Dizziness

Some people with MS may experience a feeling of being off balance or light-headedness. You may also experience a sensation of the room spinning around you. These symptoms might be due to interruptions in the pathways that maintain equilibrium and balance.

Bladder and bowel dysfunction

Many people with MS experience frequency or urgency of urination, hesitancy starting urination, frequent nighttime urination, incontinence or the inability to empty the bladder completely. Bowel dysfunction can include constipation, diarrhea and loss of bowel control. You may be referred to one of our urologists or gastroenterologists to help manage these symptoms.

Sexual dysfunction

Sexual arousal is initiated by the nervous system. Because MS affects the nervous system, sexual function can be impaired and being intimate can be challenging.

Cognitive problems

Most people with MS experience cognitive problems at some point in the disease course. These may include: memory problems, shortened attention span, language difficulties or trouble staying organized.

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Testing for MS

We use several tests to diagnose MS, including:

  • A comprehensive neurological exam in the clinic, during which the provider looks for signs of impaired neurologic function.
  • MRI to examine your brain and spinal cord.
  • Spinal tap to test the fluid circulating around your brain and spinal cord and check for elevated disease markers of MS or other conditions.
  • Blood tests to check for autoimmune markers, infection and other disease mimickers.
  • Eye exam, such as an OCT or visual evoked potentials, to look for evidence of damage to the optic nerves. You will be referred to an ophthalmologist for these tests.

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Treatment for MS

MS can be treated with medications called “disease modifying therapies (DMTs),” which modify the disease course to reduce relapses, delay the progression of disability and limit new disease activity as spotted on MRI. Unfortunately, DMTs do not treat symptoms of multiple sclerosis.

Your provider will recommend other ways of managing your symptoms. We work closely with a team of rehabilitation specialists, urologists, psychiatrists, pain management specialists and others to provide the best possible care to our patients.

Since every person’s multiple sclerosis – and medical history – is different, it can be difficult and confusing to determine the best DMT for you. It is important to discuss the options with your provider to make an educated decision. When we consider a new DMT for you, we will give you information on the medication so you can read about it before making a decision.

The following DMTsare approved for treating MS:

Injectable medications

  • Avonex (interferon beta-1a)
  • Betaseron (interferon beta-1b)
  • Copaxone (glatiramer acetate)
  • Extavia (interferon beta-1b)
  • Glatiramer Acetate (glatiramer acetate – generic equivalent of Copaxone 20 mg and 40 mg doses)
  • Glatopa (glatiramer acetate – generic equivalent of Copaxone 20 mg and 40 mg doses)
  • Plegridy (peginterferon beta-1a)
  • Rebif (interferon beta-1a)

Oral medications

  • Aubagio (teriflunomide)
  • Gilenya (fingolimod)
  • Tecfidera (dimethyl fumarate)
  • Mayzent (siponimod)
  • Mavenclad (cladribine)

Infused medications

  • Lemtrada (alemtuzumab)
  • Novantrone (mitoxantrone)
  • Ocrevus (ocrelizumab)
  • Tysabri (natilizumab)

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Learn more

From our Health Library:

Multiple sclerosis (MS): Modifying your home

What increases your risk for multiple sclerosis (MS)?

How is complementary and alternative medicine used to treat multiple sclerosis (MS)?

How can exercise help someone with multiple sclerosis (MS)?

Caring for yourself when you have multiple sclerosis (MS)

How are experimental treatments used to treat multiple sclerosis (MS)?

From our Video Library:

Contact the Multiple Sclerosis Center