Selma Blair and MS: Here’s what happens to people with the disease

Actress Selma Blair captivated viewers of Good Morning America this week when she described her life with multiple sclerosis (MS), her voice faltering as a result of the neurological disease.

She was diagnosed with MS in August and went public with it in October, but she thinks it may have begun its course as many as 15 years ago. Blair, 46, said some physicians had not taken her seriously at first when she described exhaustion and other symptoms, so in some ways, the diagnosis was welcome.

“I cried," she told GMA’s Robin Roberts. “They weren’t tears of panic. They were tears of knowing I now had to give in to a body that had loss of control. And there was some relief in that.”

Blair did not reveal the type of multiple sclerosis she has, other than to say it was “aggressive.”

Here are the basics of the disease, courtesy of the National Multiple Sclerosis Society and Clyde E. Markowitz, a neurologist at the Hospital of the University of Pennsylvania and director of Penn Medicine’s Multiple Sclerosis Center.

The disease is characterized by inflammation or breakdown of myelin, the protective “insulation” that coats nerve fibers in the brain and spinal cord. As a result, the body is less able to transmit signals through those nerve cells.

The kinds of symptoms and the speed with which they progress can vary greatly. Some patients experience extreme fatigue and numbness, while others may have vision or memory problems. In the most common form of the disease, called relapsing-remitting MS, symptoms can improve in a matter of weeks or months, though they may flare up again later, Markowitz said.

Blair said her physician told her she might regain 90 percent of her abilities within a year.

In severe cases, patients suffer partial or complete paralysis, but most people with MS do not become severely disabled. Two-thirds of patients remain able to walk, though many need a cane or crutches. Blair sported a stylish cane at Vanity Fair’s Oscars party.

MS is considered to be an auto-immune disease, meaning the immune system is attacking the patient’s healthy tissue. It is not clear what triggers this reaction. Some researchers have explored the possibility that the immune system is responding to a virus and for some reason goes on to attack the myelin sheaths on nerve fibers, Markowitz said.

Symptoms can improve if the immune system manages to readjust itself and tamp down this abnormal response. Even if a patient has suffered permanent lesions on a specific region of nerve cells, another region of the brain or nervous system may be able to compensate by taking on the function of the damaged area, Markowitz said.

Research suggests that on average, the life expectancy for people with MS is seven years less than that of the general population, according to the National Multiple Sclerosis Society. More than 2.3 million people worldwide have the condition, the nonprofit organization says.

Early in the course of the disease, symptoms can resemble those that result from other conditions, said Markowitz. That can result in a delay in diagnosis, especially if the patient does not seek medical attention.

“People may complain of intermittent tingling or numbness that can be mistaken for ‘I slept on my arm funny’ or 'I injured myself’ — things like that,” Markowitz said.

Even if the person seeks medical care, a primary-care physician can mistake the symptoms for something else. And by definition, a conclusive diagnosis of MS cannot be made until a person experiences more than one attack, Markowitz said.

Blair described being so exhausted that after dropping her son off at school, she sometimes had to pull over and take a nap. Feeling despair, sometimes she “self-medicated” with alcohol.

“I was ashamed and I was doing the best I could,” she told Roberts.

At one point, physicians told her she might have a pinched nerve. On Instagram, Blair credited fellow actress Elizabeth Berkley for urging her to see her brother, a neurologist, who made the diagnosis after identifying nervous-system lesions on Blair’s MRI scans.

Most patients are diagnosed between the ages of 20 and 50. Women are more than twice as likely as men to be diagnosed. Certain genetic variations may predispose a person to develop MS, but more research is needed.

No, but more than a dozen medications are available that can reduce the severity and frequency of symptoms in patients with the relapsing-remitting variety of MS, Markowitz said.

The relapsing-remitting variety accounts for 85 percent of cases. The remainder of cases are described as “primary progressive,” meaning the symptoms grow steadily worse after the initial onset of the disease.

Some patients with relapsing-remitting MS shift to a progressive form of the disease, referred to as “secondary progressive" — a shift that is more likely if they do not seek treatment.