Selma Blair is dealing with a surprise medical diagnosis 15 years in the making: As she revealed on Instagram recently, Blair was diagnosed with the neurological condition multiple sclerosis (MS) this past August, after years of dealing with somewhat subtle symptoms of the condition.
"I have #multiplesclerosis . I am in an exacerbation. By the grace of the lord, and will power and the understanding producers at Netflix , I have a job. A wonderful job," she wrote alongside a photo of herself in a dressing room during a fitting for her upcoming Netflix show Another Life.
"I am disabled. I fall sometimes. I drop things. My memory is foggy. And my left side is asking for directions from a broken gps," Blair continued. "But we are doing it . And I laugh and I don’t know exactly what I will do precisely but I will do my best."
Blair also used her post to thank the people who have made up her support system over the past couple months, including costumer Alissa Swanson for helping her change clothes during fittings, as well as the rest of the series' crew and her friends. Blair also expressed gratitude to the friend who prodded her to seek the help that led Blair to get her diagnosis in the first place.
"And the biggest thanks to @elizberkley who forced me to see her brother #drjasonberkley who gave me this diagnosis after finding lesions on that mri," she wrote. "I have had symptoms for years but was never taken seriously until I fell down in front of him trying to sort out what I thought was a pinched nerve. I have probably had this incurable disease for 15 years at least. And I am relieved to at least know. And share."
As SELF wrote previously, MS is a potentially disabling neurological disease that affects the central nervous system.
"MS is a disease where the immune system gets confused and attacks three places in the body: the brain, the spinal cord, and the optic nerve," Robert Fox, M.D., a neurologist at the Mellen Center for Multiple Sclerosis at Cleveland Clinic, tells SELF. The immune systems eats away at the fatty sheathing that covers and protects the nerve fibers in these areas (myelin). When this covering is damaged, it causes communication issues between the brain and the body and can result in damage of the nerve itself, according to the Mayo Clinic.
Although it can develop at any age, people are typically diagnosed between the ages of 15 and 60, per the Mayo Clinic, and it's about twice as common in women than men. Experts aren't sure what causes the disease, but it is thought to be influenced by of a combination of risk factors such as family history, genetics, smoking, exposure to certain infections, and the presence of certain autoimmune conditions.
The symptoms of MS vary from person to person, which makes a diagnosis tricky.
According to the Mayo Clinic, the most common symptoms include fatigue, numbness or tingling in the face or extremities, dizziness, vertigo, balance issues, difficulty walking, weakness, vision issues, and bladder or bowel issues.
Sometimes those symptoms are obvious (e.g. vision problems like blurred or double-vision), which makes diagnosis "relatively easy," Dr. Fox says. But often, the symptoms are harder to notice or definitively attribute to MS.
"There's no hallmark symptom" of MS, which makes it complicated to diagnose, neuroimmunologist Fred Lublin, M.D., director of the Corinne Goldsmith Dickinson Center for Multiple Sclerosis at The Mount Sinai Hospital and the Saunders Family Professor of Neurology at the Icahn School of Medicine at Mount Sinai, tells SELF. "While there are some characteristic features to the illness, it's different in every person, and that’s part of the challenge," Dr. Lublin says.
It can be especially difficult to diagnose when the symptoms are more subtle or nonspecific, such as fatigue, mild weakness, or a barely perceptible loss of balance. Mild cognitive impairments like memory problems, for example, could be attributed to conditions such as depression, anxiety, or insomnia. Even seemingly obvious symptoms, like numbness in one limb, can be tricky—sometimes the sensation is very strong and concentrated in one place, in the body, while other times it can be more diffuse, Dr. Fox explains.
The ebb and flow of these symptoms also makes MS challenging to diagnose.
Additionally, "MS is a relapsing, remitting disease," Jonathan Howard, M.D., a neurologist at NYU Langone’s Multiple Sclerosis Comprehensive Care Center and author of Multiple Sclerosis: Questions and Answers for Patients and Loved Ones, tells SELF.
"It most commonly occurs as episodic attacks," Dr. Lublin explains. Although it is highly variable, Dr. Howard says these episodes typically last anywhere from a couple weeks to a few months, and occur on average about once a year—although the frequency can also be as low as once every 10 years or as high as five times a year. "The symptoms get better if you do nothing," Dr. Howard adds. So if symptoms are relatively mild, you might be tempted to just wait them out and then think they're gone for good.
Even if someone does seek medical attention, there's no guarantee that their passing symptoms will be further investigated, Dr. Howard explains. "Doctors might say, 'If it isn't better in a month, we’ll do something.' And then it goes away before a month."
There's no lab test that can on its own definitively indicate that someone has MS. But, in most cases, an MRI will give enough clues for a diagnosis.
"It's not like swabbing for strep throat," Dr. Fox explains. Rather, arriving at a diagnosis requires taking a thorough medical history, a careful neurological exam, ruling out other illnesses that could be causing the symptoms, and evaluating various lab findings.
The most useful test, Dr. Lublin says, is an MRI to scan for lesions on the brain and spinal cord (which Blair said she received). These lesions are like scars indicating areas of injury where the immune system attacked, Dr. Fox says. Sometimes the brain and spinal cord fully heal after a relapse, Dr. Howard says, but the vast majority of patients will show some scarring or "residual injuries" on their MRI. As this nerve damage accumulates, symptoms can become longer lasting or permanent, he explains, which is how the disease can progress to become much more severe in some people.
Although there is no cure for MS, there are treatments available to manage the disease, including medications to reduce the frequency and severity of relapses and treat them if they do occur, as well as physical therapy to manage symptoms, the Mayo Clinic explains.
The sooner these treatments begin, the more effective they are, Dr. Lublin says. That's why getting diagnosed early early—and taking any new symptoms seriously—is so crucial. "The earlier that we can get to someone, the better," he says.