Multiple sclerosis (MS) has an invisible and a visible component. The invisible, or silent, aspect of MS is the disease activity occurring below the surface - disease activity not overtly seen. It includes swelling in the brain and the spinal cord (inflammation), damage to nerves (axonal transection), and brain tissue loss (atrophy). Brain changes caused by MS can be seen on an MRI scan (magnetic resonance imaging; a special test that allows doctors to get a picture of the brain). Your eyes can't see these damaging changes, but MRI scans show that they are occurring even before a person experiences any symptoms.
The goal of starting treatment early is to preserve your ability, even if you feel you are symptom-free. These invisible effects may often lead to progression of disability by manifesting as visible symptoms, such as physical disability (loss of sensory and/or motor skills), relapses (flare-ups that can affect a person's vision, walking, or speech), and cognitive dysfunction (difficulty with problem solving, recent memory retention, and processing information).
Even though a person may feel fine and may not be experiencing a flare-up, MS may still be progressing. Fortunately, research has also shown that treating MS early can help slow its progression. Although current treatments cannot cure MS, some help maintain an individual's current level of functioning so that they may continue doing the things that are important to them, thereby delaying progression to disability.
MS experts are now recommending that people should start treatment with a disease-modifying medication as soon as possible after they have been diagnosed with MS. Early treatment will help in the fight to preserve ability and to delay disability.
Your doctor may use a tool called the Expanded Disability Status Scale (EDSS) to help measure disability in MS. The scale ranges from 0 to 10, with higher numbers indicating more severe impairment and disability.
Deal with the risk of disability early on by talking to your doctor about how to choose the right treatment that will allow you to live well with MS.
Early treatment is very important because irreversible damage to the brain and nerves can occur even in the early stages of MS, and because people can develop brain lesions (damaged areas in the brain) even when they are not showing any symptoms of MS. Disease-modifying medications work best when started early - especially when EDSS scores are lower. Lower EDSS scores mean mild-to-moderate disability, so starting treatment early may increase your chances of preventing further damage and possible long-term disability.
Disease-modifying medications for MS include:
Talk to your doctor about your treatment options. With the right treatment, you can live well with MS.
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