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What Triggers Multiple Sclerosis?

There are several types of multiple sclerosis (MS), an autoimmune disease that disrupts the connections in the brain and spinal cord and causes a range of symptoms. Triggers for multiple sclerosis relapses include stress, infections, vaccinations (e.g., influenza, hepatitis B, or any travel vaccines), smoking, high temperatures (hot weather, saunas, hot tubs, and hot showers and baths), pregnancy, and skipping medications.
There are several types of multiple sclerosis (MS), an autoimmune disease that disrupts the connections in the brain and spinal cord and causes a range of symptoms. Triggers for multiple sclerosis relapses include stress, infections, vaccinations (e.g., influenza, hepatitis B, or any travel vaccines), smoking, high temperatures (hot weather, saunas, hot tubs, and hot showers and baths), pregnancy, and skipping medications.

Multiple sclerosis (MS) is an autoimmune disease in which the body attacks and damages the myelin sheaths that surround nerve cells, disrupting their connections in the brain and spinal cord and resulting in a range of symptoms. 

There are several types of multiple sclerosis:

  • Relapsing-remitting
    • The most common type of MS
    • Symptoms come and go
    • When symptoms flare up, it is called an attack or relapse that can last days to weeks 
    • In between attacks, people may feel normal
  • Secondary progressive
    • Symptoms come and go at first but eventually worsen
  • Primary progressive
    • Symptoms steadily worsen from the onset
  • Progressive relapsing 
    • Symptoms steadily worsen, along with attacks that come and go

Triggers for multiple sclerosis relapses include: 

  • Stress
  • Infections
  • Vaccinations (e.g., influenza, hepatitis B, or any travel vaccines) 
  • Smoking 
  • High temperatures, such as from hot weather, saunas, hot tubs, and hot showers and baths
  • Pregnancy
    • Risk of relapse is increased in the months immediately after giving birth (though many women with MS have fewer relapses during pregnancy)
  • Skipping medications

The cause of multiple sclerosis is unknown, but it is believed to be a combination of factors, including:

  • Genetics
  • Environment
  • Immune system dysfunction
  • Infections

What Are Symptoms of Multiple Sclerosis?

Symptoms of multiple sclerosis (MS) can be mild, moderate, or severe and may include:

  • Numbness, tingling, “pins and needles” feeling
  • Muscle weakness or spasms
  • Fatigue
  • Vision problems
  • Unusual eye movements
  • Eye pain
  • Dizziness
  • Spinning sensation (vertigo)
  • Loss of coordination 
  • Difficulty walking or speaking
  • Loss of balance/falls
  • Bowel or bladder problems
  • Sexual dysfunction 
  • Sensitivity to heat (may worsen symptoms)
  • Trouble thinking clearly
  • Memory problems
  • Mood swings

Children may have seizures and extreme fatigue in addition to any of the symptoms above. 

What Is the Treatment for Multiple Sclerosis?

Treatment for multiple sclerosis (MS) depends on the type of MS. 

Treatment for MS attacks includes steroids to reduce inflammation.

Disease-modifying therapy medications can help reduce flares and can help slow down progressive MS:

  • Injectable medications
    • Glatiramer acetate (Copaxone, Glatopa)
    • Interferon beta-1a (Avonex, Rebif)
    • Interferon beta-1b (Betaseron, Extavia)
    • Ofatumumab (Kesimpta)
    • Peginterferon beta-1a (Plegridy)
  • Oral medications
    • Cladribine (Mavenclad)
    • Dimethyl fumarate (Tecfidera)
    • Diroximel fumarate (Vumerity)
    • Fingolimod (Gilenya)
    • Monomethyl fumarate (Bafiertam)
    • Ozanimod (Zeposia)
    • Siponimod (Mayzent)
    • Teriflunomide (Aubagio)
  • Infused medications
    • Alemtuzumab (Lemtrada)
    • Mitoxantrone (Novantrone)
    • Natalizumab (Tysabri)
    • Ocrelizumab (Ocrevus)

Other medications may be used to treat specific symptoms of multiple sclerosis, such as: 

  • Antibiotics for infections 
  • Medicines for dizziness and vertigo
  • Central nervous system stimulants for fatigue
  • Bladder and bowel medications for bladder and bowel dysfunction
  • Antidepressants for depression and mood changes
  • Antihistamines for itching
  • Antidepressants and anti-seizures medications for nerve pain
  • Muscle relaxants, benzodiazepines, and onabotulinumtoxinA (Botox) for muscle spasticity
  • Medicines to treat tremors
  • Potassium channel blockers to treat difficulty walking 
  • Erectile dysfunction medicines for sexual dysfunction

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References
https://www.uptodate.com/contents/multiple-sclerosis-in-adults-the-basics?search=Multiple%20Sclerosis&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.nationalmssociety.org/

https://www.mssociety.org.uk/about-ms/types-of-ms/relapsing-remitting-ms

https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms/relapsing-remitting-multiple-sclerosis