Multiple sclerosis awareness month comes to an end as month of March concludes, but the need for awareness and further research surrounding MS continues throughout the year.

People develop multiple sclerosis when their immune system starts attacking their central nervous system, which consists of the brain and spinal cord, UW Health neurologist Dr. Christopher Luzzio said. The immune system attacks myelin, a fatty coating around the neuron. When the immune system attacks myelin, neurons are unable to send signals effectively. In the worst cases, the immune system can completely destroy the axon, the part of the neuron that sends signals.

Luzzio has worked at the UW Health treating multiple sclerosis patients for the past 21 years. He said multiple sclerosis causes a variety of different symptoms, and the severity varies depending on the person. Multiple sclerosis can cause problems with vision, weakness in certain limbs and numbness. On the cognitive level, it can cause depression, extreme mood swings and fatigue.

“[Multiple sclerosis] can be very different because it’s unpredictable,” Luzzio said. “It can be completely different person to person.”

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The variability of multiple sclerosis resulted in researchers needing a long time to realize that multiple sclerosis was in fact one disease, assistant professor of neurology Dr. Amanda Abuaf said.

Today, doctors have the option of utilizing around 30 different drugs to treat multiple sclerosis. Choosing which medication is the best fit depends a lot on the patient, Luzzio said. Doctors need to consider the severity of each person’s condition, their lifestyle and if they’re engaging in family planning.

Managing the physical limitations of multiple sclerosis is also difficult for patients. In addition to medicine, Luzzio uses his training as a mechanical engineer to help teach a medical devices class in the UW College of Engineering. In the class, students design assistive devices for people with disabilities.

One project Luzzio’s students are working on is a device for a person with multiple sclerosis who struggles with uncoordinated movements. The device is designed to help this person use a mouse more effectively, Luzzio said.

About one in 500 people in Madison are diagnosed with multiple sclerosis, making it a relatively common condition. But Luzzio said no one knows what exactly causes the immune system to start attacking the myelin in the central nervous system.

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Researchers think one of the primary triggers is the Epstein-Barr virus, which causes mononucleosis, Luzzio said. One study done on military personnel found a correlation between people with multiple sclerosis and past mononucleosis infections.

Another theory is that there are genetic factors that predispose certain people to developing autoimmune disorders. It is likely that some combination of genetics, past mononucleosis infection and other environmental factors contribute to development of multiple sclerosis, Luzzio said.

One of the biggest questions about multiple sclerosis and autoimmune disorders in general is why it affects significantly more women than men. In fact, for every one male with multiple sclerosis, there are four women with it. Abuaf said women’s immune systems are somewhat different than men’s and while there is some speculation as to what causes that difference, no one has definitively figured out the cause yet.

“What can we do to get the nervous system to regenerate?” Luzzio said. “Now there is a lot of work being done there, but it would be great if there was more.”

Many multiple sclerosis researchers devote a lot of time to developing medications that calm the immune system, but Luzzio said there is a limit to what these medications can accomplish, as they cannot regenerate any neurons or myelin that the immune system destroys.

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Some people with multiple sclerosis can undergo a bone marrow transplant, which essentially replaces a person’s immune system. While the transplant is effective initially, people often relapse years later, Luzzio said.

Despite the unknowns, the different medications available to people with multiple sclerosis are quite effective. Even in the past decade, researchers have developed many more treatments. Many people with multiple sclerosis are able to go to work, raise families and travel, Abuaf said.

“I always like to tell people I’m cautiously optimistic that they can have an excellent quality of life and hopefully live a life that is relatively unaffected by this disease,” Abuaf said.

Luzzio said many people with multiple sclerosis are very willing to talk about their diagnosis. He has patients who are artists and avid travelers who are quite open about their condition. But, some people are careful about talking about their multiple sclerosis diagnosis because they don’t want their employer to know.

Some people with multiple sclerosis need some kind of accommodation at work, such as part-time hours or different equipment. Luzzio said there are many local businesses that are very understanding of this need.

Abuaf said people with multiple sclerosis experience an ‘invisible disability.’ On the outside they may look good, but they’re actually experiencing the symptoms of multiple sclerosis, like pain, spasms or tingling.

“I think just offer understanding and compassion and accept what they can easily do except if they find a limit,” Abuaf said.

If experiencing any of the symptoms of multiple sclerosis, it’s important to see a neurologist early. Multiple sclerosis is easiest to treat when people seek out medical care early on, so awareness is incredibly crucial, Abuaf said.