Multiple Sclerosis & Autoimmune Disorders

Overview

Without the sheath that covers your nerves, they cannot work as well as they should. This can cause:

• Pain
• Weakness
• Poor coordination of limbs and walking
• Loss of sensation
• Vision trouble
• Tingling in your fingers and toes
• Bowel and bladder problems

You may experience a single attack that never comes back. Initial attacks are sometimes given their own autoimmune disorder label, such as optic neuritis (inflammation of the optic nerve) or transverse myelitis (inflammation of the spinal cord). A diagnosis of multiple sclerosis means your body has endured multiple episodes at different points in time. With MS, you can have separate attacks in different parts of your brain or spinal cord.

Other autoimmune disorders similar to MS include:

• Acute disseminated encephalomyelitis (ADEM). With this condition your body attacks its own brain cells. The event happens all at once.
• Neuromyelitis optica. The immune system attacks the optic nerve and spinal cord and no other part of the central nervous system.
• Myasthenia gravis. This autoimmune disorder impacts your voluntary muscles including your limbs, eyes and throat.
• Guillain-Barré syndrome. The body attacks your peripheral nervous system, affecting your muscle movements.

Neurologists typically diagnose MS between the ages of 20 and 40, but it can start at any age. Symptoms generally begin with distinct episodes or attacks that often go into remission only to return later, referred to as relapsing-remitting multiple sclerosis. In some people, the symptoms of MS continue to get worse from the start, referred to as primary progressive multiple sclerosis.

With your nerves exposed without their protective covering, they stop working over time, leading to serious damage to your central nervous system.

Treatment for Multiple Sclerosis

At Indiana University Health, our neurologists use a comprehensive care model to help you manage your multiple sclerosis or autoimmune condition. Your neurologists partner with experts in many other areas, including physical therapy, behavioral health, urology, eye care and pain management to find the best treatments to manage your symptoms and to help slow the disease’s progress and keep you healthy.

Through your physicians’ affiliation with the Indiana University School of Medicine Department of Neurology, the neuroimmunology/multiple sclerosis program earned designation as a Partner in MS Care–Center for Comprehensive and Coordinated Care from the National Multiple Sclerosis Society. This recognizes their demonstrated excellence.

Children with autoimmune disorders receive pediatric neurological care from experts at Riley Hospital for Children at Indiana University Health. Pediatric rehabilitation services include a focus on spasticity management, a common symptom of multiple sclerosis and some autoimmune conditions.

Treatments for multiple sclerosis and autoimmune disorders involve medicines to slow disease progression or prevent attacks and therapies that help you manage and control symptoms.

• Diagnostic tests. Physicians at IU Health use different diagnostic tests to pinpoint your diagnosis, determine the best approach for you and monitor how your body reacts to treatments. These can include blood work to rule out other conditions and to evaluate your spinal fluid.
• Magnetic Resonance Imaging (MRI). Your physician will use an MRI study of your brain and spine to look for lesions of the myelin that covers your nerves and to check for changes in your spinal fluid.
• Evoked potentials studies. These studies track the electrical activity in your brain as you react to sights, sounds and touch. They detect problems with sensory function.
• Medicines. A variety of medicines and immunotherapies exist to treat MS attacks and symptoms.
  • Maintenance medicines treat symptoms such as muscle spasms. Some can also change the way the immune system works to reduce the body’s attacks on its own nerve cells. One specific medicine acts as a protective sheath around the nerves. It may prevent the immune system from attacking the sheath.
  • Corticosteroids in high doses can help during an attack. These steroid medicines, delivered intravenously or in pill form, reduce inflammation and can shorten the length of attacks.
  • New medicines can decrease the frequency of attacks, reduce their severity, decrease disease activity and prevent future disability. Weekly or monthly injections like interferon-beta, prevent immune system cells from entering the brain and spinal cord. Oral pills treat relapsing forms of multiple sclerosis.
• Rehabilitation. Depending on the severity of your condition and symptoms you may benefit from physical, occupational and speech therapy. Other therapies can help manage bowel and bladder incontinence.
• Psychiatry. Patients with multiple sclerosis or other autoimmune disorders often suffer from depression about their condition and prognosis. Your team will work with you to address these feelings so you can manage your situation to the best of your abilities.

Your physicians advance care through clinical and research studies:

• Research. Your team continuously studies new medicines and treatments to improve care for those with MS and autoimmune disorders. You receive access to many clinical trials and the newest therapies. IU Health researchers studied many of the drugs now available to you. They continue to search for new immunologic markers or toxins in the blood or urine at preclinical stages of the condition.