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Multiple Sclerosis

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system, including the brain, spinal cord and optic nerves. Experts believe MS is an autoimmune disease caused by the immune system attacking and damaging the nervous system. It generally progresses gradually, with alternating periods of remission, good health and disabling flare-ups.

About 400,000 Americans, mostly young adults, suffer from MS. It occurs almost twice as frequently among women than men.

Although there is no cure, most MS patients lead active lives for many years after their diagnosis and have a normal life span. But MS can be tiring and require schedule and lifestyle adjustments. A regular exercise program that includes walking, swimming, stretching or riding a stationary bike can reduce some symptoms. Our physical therapists and staff can help you learn to cope with your condition by improving your walking ability, balance, range of motion and stamina.

At UCSF Medical Center, the Multiple Sclerosis Center provides treatment to reduce the severity and duration of MS attacks, relieve symptoms and halt or slow the progression of the disease. UCSF neurologists are also part of the Multiple Sclerosis Genetics Group, which studies the role heredity plays in the disease in an effort to better understand MS and develop new therapies.

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Causes of Multiple Sclerosis

Multiple sclerosis damages the outer covering of nerve cells, called myelin, a fatty tissue that protects nerve cells in the same way that insulation protects electrical wiring in a house. Myelin helps nerve fibers conduct electrical impulses to and from the brain. Scar tissue, called sclerosis, accumulates when multiple areas of myelin are damaged. These damaged areas are known as plaques or lesions. Sometimes the nerve fiber itself is damaged and dies.

The exact cause of MS is not known, but factors such as disease, poisons and drug or alcohol abuse can damage the myelin sheath in children and adults. Heredity may contribute to the development of MS. About 5 percent of patients have a sister or brother who has the disease and about 15 percent have a close relative with MS.

When MS damages the protective myelin sheath of nerve cells, the sheath sometimes repairs itself and nerves work correctly again. In other cases, the myelin is so damaged that the underlying nerve can't be repaired and dies.

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The symptoms of multiple sclerosis depend on which particular pathway of nerve fiber is damaged. Tingling, numbness, sensations of tightness or weakness may result when myelin in the spinal cord is damaged. If nerve fibers to the bladder are affected, urinary incontinence may occur. Likewise, damage to the cerebellum portion of the brain may result in imbalance or a lack of coordination. MS patients can have a wide range of symptoms, depending on where the damage occurs in the central nervous system.

Because MS can cause a wide variety of symptoms in different people, doctors frequently struggle to diagnose the disease. However, common symptoms of MS include changes in sensation or sensory symptoms such as tingling and numbness, and changes in muscle function or motor symptoms such as difficulty walking, stiffness or tremors.

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When considering a diagnosis of multiple sclerosis, your doctor will be particularly interested in hearing about your symptoms, when they started and how they've eased or progressed over time.

Your diagnosis also will be based on a physical examination and tests. These tests may include:

  • Blood and urine tests to help rule out other possible disorders
  • Electrocardiogram (ECG or EKG) to measure electrical activity in the heart
  • Magnetic resonance imaging (MRI) to look for abnormalities in the brain
  • Lumbar puncture or spinal tap to determine if there are abnormalities in the cerebrospinal fluid, one of the signs of MS
  • Evoked potentials test, which records electrical activity in the brain when nerves are stimulated

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Your neurology team at UCSF Medical Center, along with your primary care physician, will design a treatment plan tailored to your medical condition, state of health and individual needs. You may need more than one kind of treatment, or a treatment requiring several visits to the Multiple Sclerosis Center. Also, you may be referred to other doctors or health professionals.

Doctors and researchers have identified four categories of treatment for patients with MS:

  • Treatment that reduces the severity and duration of attacks
  • Treatment to cure or eliminate the biological activity of MS in the body
  • Treatment to relieve various symptoms such as incontinence, visual disturbances or fatigue
  • Treatment that repairs damage caused by MS

Treatments may involve some risks or complications, which will be fully explained to you by your neurologist.

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Reviewed by health care specialists at UCSF Medical Center.

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UCSF Clinics & Centers

Neurology and Neurosurgery

Multiple Sclerosis
1500 Owens St., Suite 320
San Francisco, CA 94158
Phone: (415) 353-2069
Fax: (415) 353-2633
Appointment information