Multiple Sclerosis (MS) is a lifelong condition that affects the brain and spinal cord, disrupting communication between the brain and the rest of the body. Often misunderstood and sometimes mistaken for other illnesses, MS doesn't look the same for everyone. This is because its symptoms and impact can vary greatly depending on when it first shows up.
To help us better understand this complex condition, Dr Prabhjeet Singh, Director and Chief Neurologist, Dr Prabhjeet’s Neuro Centre, Amritsar, breaks down how age plays a role, what early signs to watch for, and how MS is diagnosed and treated today.
Also Read: From Numbness To Brain Fog: Expert Lists Early Signs Of Multiple Sclerosis You Should Watch Out For
Who Is Most Likely To Develop Multiple Sclerosis (MS)?
According to the National Institute of Neurological Disorders and Stroke, women are more likely to develop MS than men. While people of all races and ethnicities can get the condition, it is most common in white people.
Additionally, a family history of MS increases one's risk of developing the condition.
It is also interesting to note that several viruses have been found in people with MS, but the virus most consistently linked to the development of MS is the Epstein-Barr virus (EBV), which causes infectious mononucleosis.
What Is The Age Of Onset For Multiple Sclerosis?
The average age of MS diagnosis is around 30 years, with the most common onset occurring between 20 and 40 years of age, shares Dr Singh. “This age range is significant because it coincides with the prime of a person’s personal, academic, and professional life — often leading to profound implications for long-term quality of life and productivity if left untreated.”
He adds that it is during this time that individuals are most likely to begin experiencing the onset of MS symptoms, which include visual disturbances, cognitive decline, fatigue, muscle weakness, and issues with mobility and balance.
While MS is most commonly diagnosed in young adults, it’s important to remember that it can also appear much earlier—or much later—in life.
Paediatric-Onset MS (POMS)
In rare cases, children and teenagers can develop MS, accounting for about 3–10% of all diagnoses. Because it’s so unexpected at that age, symptoms are often mistaken for other neurological conditions. Young patients may experience more frequent flare-ups in the early stages. And since the disease begins so early, there’s a higher risk of living with long-term disability as they grow older.
Late-Onset MS (LOMS)
MS that begins after the age of 50 is known as late-onset MS. It tends to progress more steadily from the start, often showing up in ways that can be confused with ageing or conditions like stroke or spinal problems. This can lead to delays in getting the right diagnosis and starting treatment, which may result in the disease advancing more quickly.
Early Signs Of MS
According to Dr Singh, MS symptoms arise due to damage to the myelin sheath, the protective covering of nerve fibres in the CNS. This damage disrupts nerve signalling, leading to a wide range of symptoms.
Common early warning signs of MS include:
- Visual disturbances, such as blurred vision, double vision, or pain with eye movement (often due to optic neuritis)
- Numbness or tingling, typically in the limbs or face
- Muscle weakness, particularly in the legs
- Fatigue, which is often profound and not relieved by rest
- Dizziness and balance issues
- Bladder and bowel dysfunction
- Cognitive challenges, such as memory lapses or slowed processing
How Is MS Diagnosed?
There is no single test for MS, but a combination of diagnostic tools is used to confirm the disease, shares Dr Singh. These include:
Magnetic Resonance Imaging (MRI): This is one of the most important tests where MRI scans and identifies lesions (patches of demyelination) in the brain and spinal cord.
Cerebrospinal Fluid (CSF) Analysis (Lumbar Puncture): A sample of CSF is taken from the spine and analysed for abnormalities. This test helps identify oligoclonal bands (OCBs), which are unique antibodies found in the cerebrospinal fluid but not typically in the blood. It also looks for an elevated IgG index, indicating heightened immune activity within the central nervous system. Both findings are strong indicators of MS.
Evoked Potential (EP) Tests: The tests quantify the electrical responses generated by the nervous system to stimulation (visual, auditory, sensory). Disruption in these responses indicates nerve injury and can detect lesions in regions that are not visible on MRI or via clinical testing.
Blood Tests: Blood tests are unable to diagnose MS, but they are important to help exclude other conditions that may present as MS symptoms, including some infections, vitamin deficiencies (e.g., vitamin B12 deficiency), and other autoimmune diseases.
Treatment And Management For Multiple Sclerosis
Although there is no cure for MS, early diagnosis and comprehensive treatment can significantly improve long-term outcomes. Management includes:
Disease-Modifying Therapies (DMTs): These reduce the frequency and severity of relapses, slow progression, and limit new lesion formation. Starting a DMT early is crucial.
Symptom Management: Includes medications and lifestyle changes for fatigue, mobility issues, spasticity, and cognitive symptoms.
Rehabilitation: Physical therapy, occupational therapy, and counselling help maintain independence and quality of life.
New Hope in India: With the recent availability of High-Efficacy Therapies (HETs) offering less frequent dosing, Indian MS patients now have more accessible and sustainable treatment options.
Conclusion
Multiple sclerosis is a complex condition that many people don’t fully understand. It can touch lives at different ages but most often starts when people are in their early adulthood. Knowing the early signs and how symptoms might change with age can make a big difference in getting diagnosed early. And while there’s no cure yet, today’s treatments and personalised care plans give those living with MS hope and the ability to lead fuller, more independent lives.