Quick answer. Multiple sclerosis is a long-term condition in which the immune system attacks the protective covering of nerves in the brain and spinal cord, causing varied symptoms such as vision problems, numbness, weakness, balance difficulty and fatigue. It cannot be cured, but disease-modifying treatments can reduce relapses and slow its progress.
Multiple sclerosis, or MS, is an autoimmune condition affecting the brain and spinal cord. Because the affected nerves carry signals to every part of the body, the symptoms vary widely from person to person and can come and go, which sometimes makes MS difficult to recognise at first. While MS is less common in Singapore than in some Western countries, it is increasingly recognised here, and earlier diagnosis means earlier treatment.
If you or someone you care about has been investigated for unexplained vision changes, numbness or weakness, understanding multiple sclerosis can help. This guide explains what MS is, its typical symptoms, how it is diagnosed with an MRI and other tests, the treatments available, and when symptoms need urgent attention.
At a glance
| Area affected | Possible symptoms | Notes |
|---|---|---|
| Vision | Blurred or lost vision in one eye, eye pain | Often an early symptom |
| Sensation | Numbness, tingling, pins and needles | May affect face, limbs or trunk |
| Movement | Weakness, stiffness, clumsiness | Can affect walking and coordination |
| Balance | Dizziness, unsteadiness, vertigo | Increases the risk of falls |
| Energy and thinking | Severe fatigue, memory and concentration issues | Among the most common complaints |
What is multiple sclerosis?
Multiple sclerosis is a condition in which the immune system mistakenly attacks myelin, the protective coating around nerve fibres in the brain and spinal cord. This damage disrupts the signals travelling along the nerves, producing the wide range of symptoms seen in MS. The areas of damage are called lesions or plaques.
Most people are diagnosed between their twenties and forties, and it is more common in women. The most common pattern is relapsing MS, in which symptoms flare up in attacks (relapses) and then partly or fully settle, with stable periods in between. Over time, some people develop a more progressive course. MS is less common among Asian populations than in parts of Europe and North America, but it does occur in Singapore and is managed by neurologists.
Symptoms and signs
Symptoms depend on which nerves are affected and vary greatly between individuals. They may include:
- Vision problems, such as blurred vision, loss of vision in one eye, or pain on moving the eye.
- Numbness, tingling or pins and needles in the face, body or limbs.
- Weakness, stiffness or muscle spasms.
- Problems with balance and coordination, dizziness or vertigo.
- Severe fatigue that is out of proportion to activity.
- Bladder and bowel problems.
- Difficulty with memory, concentration and thinking.
- Mood changes, including depression.
Symptoms may appear, improve and then return, sometimes in different parts of the body, which is a characteristic feature of relapsing MS.
Causes and risk factors
The exact cause of MS is not fully understood, but it is thought to result from a combination of factors that lead the immune system to attack myelin. Recognised risk factors include:
- Age, with most diagnoses between the twenties and forties.
- Female sex, as MS is more common in women.
- A family history of MS, which modestly increases risk.
- Certain viral infections and low vitamin D levels, which have been linked to higher risk.
- Smoking, which is associated with a higher risk and faster progression.
MS is not directly inherited and is not contagious. Having a risk factor does not mean a person will develop the condition.
How it is diagnosed
There is no single test for MS, so doctors combine several findings to make the diagnosis. A neurologist will:
- Take a detailed history and perform a neurological examination of vision, sensation, strength, reflexes and coordination.
- Arrange an MRI scan of the brain and often the spinal cord, which is the key test and shows the areas of damage (lesions).
- Sometimes perform a lumbar puncture to examine the spinal fluid for markers of immune activity.
- Sometimes carry out evoked potential tests, which measure how quickly the nerves carry signals.
- Exclude other conditions that can mimic MS.
A diagnosis usually requires evidence that the damage has occurred in more than one area and at more than one point in time.
Treatment options
MS cannot currently be cured, but treatment can reduce relapses, manage symptoms and slow progression:
- Disease-modifying therapies: medicines that calm the immune system to reduce the frequency and severity of relapses and limit new damage. There are several types, given as tablets, injections or infusions, and the choice depends on the type and activity of the disease.
- Relapse treatment: short courses of steroids are often used to speed recovery from a significant relapse.
- Symptom management: treatments for fatigue, muscle stiffness and spasms, bladder problems, pain and mood, often with input from physiotherapy and other allied health professionals.
- Lifestyle and support: staying active, stopping smoking, managing stress and addressing vitamin D, alongside emotional and practical support.
Care is usually coordinated by a neurologist with a wider team, and the plan is tailored to each person.
When to see a doctor and which specialist
See a doctor if you have unexplained vision changes, persistent numbness or tingling, new weakness, or balance problems that last more than a day or two, so the cause can be investigated. Early assessment is important because early treatment can make a difference in MS.
Seek urgent care, or call 995 / go to A&E, if you develop:
- Sudden loss of vision, especially in one eye, or sudden double vision.
- Sudden weakness or numbness, particularly on one side of the body.
- Sudden difficulty speaking, severe loss of balance, or trouble walking.
- Any signs of a possible stroke, such as facial drooping, arm weakness or slurred speech.
For diagnosis and long-term management of MS, a neurologist is the appropriate specialist and will usually arrange an MRI. You can find one through our directory of the best neurologists in Singapore.
Related guides
- Best Neurology Clinics in Singapore — our editorial shortlist
- neurology clinics directory
- Cervicogenic headache
- Trigeminal neuralgia
- Baby blues
- Ectopic pregnancy
- Pelvic inflammatory disease
Sources
- NHS – Multiple sclerosis
- Mayo Clinic – Multiple sclerosis
- HealthHub Singapore – Diseases and conditions
- NHS – Stroke symptoms (FAST)
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