Multiple Sclerosis (MS)

MS symptoms vary from person to person, depending on where nerves in the brain and spinal cord are damaged. Common symptoms include:

• extreme tiredness (fatigue) - one of the most common and disabling symptoms

• vision problems, such as blurred or double vision, pain when moving your eyes or temporary loss of vision

• numbness, tingling or pins and needles in the face, body, arms or legs

• muscle weakness, stiffness or spasms, and difficulty walking

• problems with balance and coordination, and dizziness

• pain, including nerve pain (burning, stabbing or electric-shock sensations)

• bladder and bowel problems, such as constipation, needing to urinate often or incontinence

• problems with memory, attention and thinking

• depression, anxiety and mood swings

• slurred speech and difficulty swallowing

• symptoms that get temporarily worse in the heat

• less commonly, tinnitus

Symptoms can change over time. Many people have relapses, when symptoms flare up or new ones appear, followed by remission, when symptoms partly or fully improve.

Signs of MS in women

MS is two to three times more common in women than in men, according to MS Trust. Some women notice their symptoms get worse just before and during their period, and MS has been linked to irregular periods.

Earlier studies gave mixed results on whether MS progresses more quickly after menopause because of hormonal changes. However, a large 2025 study of nearly 1,000 women found no link between menopause and MS. This suggests more research is still needed on how hormonal changes affect MS.

Signs of MS in men

Although women are more likely than men to develop MS, a higher proportion of men with MS have primary progressive MS (PPMS). This is mainly because relapsing-remitting MS is much more common in women, while PPMS affects men and women at more similar rates, according to the same research.

PPMS also tends to start later in life, usually mid-life, about ten years later than relapsing MS. Research also suggests men with MS may find their condition progresses more quickly.

The exact cause of multiple sclerosis isn’t fully understood, but it’s believed to be a complex interplay of genetic, environmental and immunological factors.

Here are some of the key factors thought to contribute to the development of MS:

How the immune system is involved

MS is considered an autoimmune disease, which means the body's immune system mistakenly attacks its own tissues. In the case of MS, the immune system targets the myelin, the protective coating surrounding nerve fibres in the central nervous system. This immune attack leads to inflammation and damage to the myelin and nerve cells.

Genetics

MS is not directly inherited, but there is a genetic component. Certain genetic variations appear to increase the susceptibility to developing MS. Family history of MS can slightly increase the risk of developing the disease, but most people with MS have no family history of the condition.

Environmental triggers

Environmental factors are thought to play a role in triggering MS in individuals with a genetic predisposition. Some of these factors include infections, such as the Epstein-Barr virus (EBV), which has been linked to an increased risk of MS. Additionally, vitamin D deficiency, smoking, and certain toxins or pollutants may also contribute to the development of MS in susceptible individuals.

Risk factors for multiple sclerosis

Factors that can increase your risk of MS, according to NICE, include:

• being female

• having a close family member with MS

• previous Epstein-Barr virus (EBV) infection

• low vitamin D levels

• smoking

Having a risk factor makes MS more likely, but it does not mean you will develop it.

Why is MS more common in females?

The exact reason why MS affects more females than males is unclear, but experts think it may be due to the influence of female sex hormones, like oestrogen and progesterone. These hormones are believed to play a role in regulating the immune system, so they may contribute to the development of autoimmune diseases like MS.

There is no single test for MS. A consultant neurologist makes the diagnosis using your symptoms, medical history, a neurological examination and a combination of tests.

Tests used to diagnose MS:

• neurological examination - checks your movement, coordination, vision, balance and reflexes

• MRI scan - can show areas of damage to nerves in the brain and spinal cord

• blood tests

• lumbar puncture - a thin needle is inserted into the lower back to collect a small sample of spinal fluid (cerebrospinal fluid) for testing

• evoked potential (EP) tests - electrodes on the scalp record your brain's electrical response to a stimulus, to assess how well nerve pathways are working

There is currently no cure for multiple sclerosis, but treatment can reduce relapses, manage symptoms and slow disease progression for many people. The right treatment depends on the type of MS, how active it is, your symptoms and your needs.

Disease-modifying therapies (DMTs)

DMTs work by calming the immune system's attack on the brain and spinal cord. They can reduce how often relapses happen and how severe they are, and slow the progression of disability.

DMTs available at Welbeck include:

• ocrelizumab (Ocrevus), which targets specific immune cells involved in MS

• natalizumab (Tysabri)

Over time, MS can lead to:

• mobility problems - muscle weakness, stiffness, and difficulty walking

• bladder and bowel dysfunction - incontinence or constipation issues

• cognitive changes - difficulties with memory, attention, and problem-solving

• mental health issues - increased risk of depression and anxiety

• severe disability - in advanced cases, progressive loss of independence

Life expectancy

On average, MS reduces life expectancy by around six to seven years, according to MS Trust. With newer treatments, people are living longer with MS.

How long does a relapse last?

Relapse symptoms usually develop over hours or days and can last several weeks. Most relapses last less than a month, but this can vary, according to MS Society.

Unfortunately, there’s no cure for MS yet. However, treatments are available to manage symptoms, slow disease progression, and improve the quality of life for individuals living with the condition.

The approach to treatment often depends on the type of MS you have, the severity of your symptoms, and your specific needs. Here are some common treatment strategies for multiple sclerosis:

Disease-modifying therapies (DMTs)

DMTs have transformed outcomes for MS patients, and these are all available through specialists at Welbeck.

These medications are used to modify the course of the disease by reducing the frequency and severity of relapses, as well as slowing the progression of disability. DMTs work by modulating the immune system to reduce inflammation and the immune response against the central nervous system.

There are various DMTs available, and the choice of treatment depends on factors such as the type of MS, disease activity, and individual characteristics. Ocrelizumab is a disease-modifying therapy offered at Welbeck that targets specific immune cells involved in MS progression.

Clinical trials have shown that disease-modifying therapies (DMTs) can reduce the number of relapses and slow the progression of disability in MS. Some newer, high-efficacy DMTs have shown very strong results in trials.

In one clinical trial of ocrelizumab, a high-efficacy DMT given as an injection under the skin, 97% of patients had no relapses over 48 weeks.

Watch consultant neurologist Dr Karen Chung explain how ocrelizumab works (video)

Treatment for individual symptoms

Various medications and therapies are used to manage specific MS symptoms, such as muscle spasms, pain, fatigue, bladder and bowel problems, and depression. Symptomatic treatments aim to improve comfort and function and may include muscle relaxants, pain relievers, physical therapy, and counselling.

Rehabilitation

Physical therapy, occupational therapy, and speech therapy can be beneficial for individuals with MS to improve mobility, maintain independence, and manage speech and swallowing difficulties.

Lifestyle, monitoring and ongoing support

Lifestyle changes can play a significant role in managing MS. Regular exercise, a balanced diet, stress management techniques, and avoiding known triggers (e.g. excessive heat) can help improve overall well-being.

Relapse management

During relapses (flare-ups or exacerbations), when new symptoms appear or existing ones worsen, short courses of high-dose corticosteroids are often prescribed to reduce inflammation and hasten recovery.

Disease management and monitoring

Regular follow-up with healthcare professionals, including neurologists, is essential to monitor disease progression, assess treatment effectiveness, and make any necessary adjustments to the treatment plan.

Supportive care

Psychological and emotional support can be vital for individuals with MS. Support groups, counselling, and educational resources can help individuals and their families cope with the challenges associated with the condition.

See a doctor if you have neurological symptoms that persist or get worse, such as changes in your vision, numbness or tingling, weakness, or problems with balance.

MS symptoms can be similar to those that present in other conditions, so they should be assessed by a neurologist. An early diagnosis ensures treatment can begin sooner.

You can book an appointment directly with one of our consultant neurologists.

What to expect at Welbeck

1. Consultation with a consultant neurologist
2. Review of your symptoms and medical history
3. Neurological examination
4. Tests such as an MRI scan, blood tests or lumbar puncture, where needed
5. Review of your results
6. A personalised treatment and monitoring plan

While there is currently no cure for MS, appropriate treatment and management can help you lead a fulfilling life. At Welbeck, our experienced neurologists tailor treatment plans to ensure you receive personalised care for the best possible outcomes. We also offer:

• disease-modifying therapies, including ocrelizumab

• consultations, tests, treatment and follow-up take place at 1 Welbeck Street, London

• seamless referral pathway where our neurologists can refer you to other Welbeck specialists, such as Urology

• appointments for young people aged 13+

We aim to offer same-day appointments wherever possible. Our consultants are recognised by major health insurers, and we also see self-paying patients.