Multiple Sclerosis

MULTIPLE SCLEROSIS wheelchair

Last Updated December 20th, 2021

Overview

Multiple sclerosis is a potentially debilitating disease that directly affects the brain and spinal cord. Normal nervous communication becomes disrupted as a result of erosion of the protective covering of the nerves. Depending on which nerves are affected and to what extent, the manifestations of multiple sclerosis often vary appreciably from one individual to the next.

This disease is not contagious, nor is it hereditary. However, research has established that a combination of environmental, genetic and lifestyle factors renders some individuals more susceptible than others. MS is a lifelong condition that normally strikes between the ages of 20 and 50.

 

Definition

MULTIPLE SCLEROSISMultiple sclerosis (MS) is a neurological disorder involving demyelination of nerves of the brain and spinal cord. In other words, it involves damage and erosion of the myelin sheath that forms an insulating layer around nerve cells. This occurs as a result of the abnormal behavior of the immune system, causing it to attack healthy nerve cells, producing patches of inflammation along the myelin sheath. This is responsible for the symptoms. No two attacks may be the same.

Typically, patients with MS experience alternating episodes of relapses (appearance of symptoms) and remission (subsiding of symptoms). This coincides with periods of inflammation followed by healing. Hence, symptoms come and go intermittently and may or may not repeat in subsequent episodes. Disruption in normal nerve activity and communication manifests in the form of unusual sensations, gradual loss of bladder control, inability to think clearly and disturbance in vision. Eventually, the nerves can become permanently damaged and leave the patient severely disabled.

 

Causes

MULTIPLE SCLEROSIS wheelchairThe symptoms of MS are generally attributed to an autoimmune disorder. A misdirected immune response attacks healthy nerve cells of the central nervous system instead of targeting foreign matter and pathogens. The result is the formation of lesions or areas of inflammation along the nerve sheath giving rise to various neurological symptoms. As the inflammation heals, symptoms subside and the myelin sheath develops scars. The presence of such scarring or sclerosis is what gives the disease its name.

This is the mechanism underlying the intermittent relapses and remissions that characterize MS. Over time, the myelin sheath may become completely eroded, exposing nerve fibers to permanent damage and causing severe neurological symptoms.

While it is believed that some individuals may be inherently genetically susceptible to this disease, the risk of actually developing MS can be compounded by a number of other factors such as:

  • Being female. Women are up to 2 to 3 times more likely to be affected than men.
  • Having a close family member with the disease increases one’s own chances by about 3-4%. However, MS is not a hereditary condition.
  • Smoking significantly increases the likelihood of developing MS.
  • The incidence of MS is lower in areas closer to the equator. Hence, it is more common among Caucasians, particularly Nordic populations, and markedly lower in Asian, African and Polynesian populations.
  • Research also shows a correlation between MS and certain viral infections. For instance, infection with the Epstein-Barr virus might trigger onset in those who are already genetically susceptible.

 

Symptoms

Some individuals may only suffer mild symptoms intermittently over the course of their lifetime while others might experience a progressive deterioration into a debilitating state where they might lose the faculty of autonomous movement or focused thought. Any part of the body can be affected.

However, patients usually experience problems with mobility, vision, abnormal sensation, bladder control and thinking ability. Severe exhaustion is typical and symptoms are found to worsen with rising temperature. In the initial stages, symptoms may appear for a short while after which the patient may remain asymptomatic for a considerable length of time. The following is a more comprehensive (although not exhaustive) list of probable symptoms:

  • Abnormal sensation, such as tingling, numbness or burning sensations in different parts of the body. Patients also complain of sharp pains.
  • Weakness in a limb.
  • Loss of coordination and balance.
  • Muscle spasms and stiffness.
  • Inability to think clearly or concentrate. Reduced attention span.
  • A difficulty with reasoning, logic, and problem solving as a result of being unable to effectively process information.
  • Double vision or blurring of vision.
  • Heat intolerance.
  • Tremors.
  • Fatigue.
  • Dizziness.
  • Bladder-related symptoms include incontinence, frequently feeling the urge to urinate and inability to empty the bladder completely.
  • Constipation.
  • Sexual dysfunction.
  • Changes in speech patterns. Speech may become slow, slurred or incoherent.
  • Difficulty in swallowing.
  • Backaches.
  • Joint pain.
  • Progressive loss of vision. Typically one eye is affected and then the other follows.

 

Types of Multiple Sclerosis

There are a number of different types of MS:

  • Relapse Remitting Multiple Sclerosis (RRMS) – This type accounts for a majority of MS cases; approximately 85%. It is characterized by relapses separated by periods of remission. Symptoms may differ between one episode and the next.
  • Secondary Progressive MS (SPMS): Some patients with RRMS progress to the next stage known as secondary progressive MS. This type does not follow the relapse and remission pattern. Instead, the patient deteriorates progressively.
  • Primary Progressive MS (PPMS): This type is relatively less common. In such instances, the patient shows a steady decline right from its onset. Relapses and remissions do not occur.
  • Progressive-Relapsing MS (PRMS): This affects only about 5% of those with MS. Some patients with PPMS transition into PRMS when they begin experiencing acute relapses. However, remission phases are absent and the disease worsens progressively.
  • Malignant or Fulminant MS: Normally, the course of MS is gradual. Despite significant impairment of important functions such as vision, speech, and mobility, the disease does not shorten life expectancy if treatment is provided. However, malignant MS shows a rapid escalation of neurological symptoms causing significant disability within a short period of time following onset of the disease. It may even lead to death.

 

Clinical Complications

Those suffering from multiple sclerosis often experience depression, anxiety and mood swings. They are also more prone to developing infections. For instance, those with existing bladder-related symptoms are at a higher risk of suffering repeated episodes of urinary tract infections.

In severe instances of MS, mobility may be affected to such an extent that the patient loses the ability to move without assistance. This leads to isolation and increases the risk of suffering depression and mood disorders. Housebound patients can end up becoming obese or develop osteoporosis. Those with difficulty in swallowing are prone to developing pneumonia as a result of food or liquid finding its way into the lungs. MS can also cause significant vision and speech impairment. Contracting severe infections or having malignant MS can lead to death.

 

Diagnosis

Multiple sclerosis physioOften the symptoms are vague and may be mistaken for another disorder of the nervous system. Hence, making a definitive diagnosis lies in the domain of a neurologist. The patient’s neurological function is carefully evaluated. Speech, vision, mobility, and response to sensory stimuli are tested.

The patient’s blood and cerebrospinal fluid may be tested for signs of infection that may implicate other diseases. These samples may also show the presence of certain markers that can help make a positive diagnosis of MS.

Usually, magnetic resonance imaging (MRI) is the most effective diagnostic tool for detecting MS. It can reveal areas of scarring on the myelin sheath in the central nervous system. Following this, an evoked potentials test measures electrical responses generated in the central nervous system in response to sensory stimuli. This test is able to detect even subtle damage or disruption in nerve circuits. While a positive finding in this test can support a diagnosis of MS, it cannot be taken as conclusive without considering other diagnostic results and laboratory findings.

Further tests may be required depending on the extent of the disease.

 

Treatment & Prevention

There is no definitive cure for MS but there are treatment methods that can help you achieve relief from the symptoms. These include:

  • Disease-modifying drugs ( such as Beta Interferons) can help in slowing down the progress of the disease and to minimize the risk of future flare-ups. These work by suppressing the immune system’s response so that it doesn’t attack the myelin (protective covering) that surrounds the nerves.
  • Some of these medicines can have evident side-effects such as fevers, chills, and increased susceptibility to diseases, but these tend to fade over time.
  • Episodes of flare-ups can be treated with the help of steroid medications such as prednisone or ACTH. These are administered intravenously.
  • Plasma exchange procedure is carried out when the above method fails to improve the conditions.
  • Physiotherapy is an integral part of the treatment procedure as it helps the patients regain physical strength and flexibility.
  • Medicines are also prescribed to help with other associated symptoms of MS such as muscular spasms, fatigue, and depression.

Facts

  • Multiple Sclerosis or MS is prevalent in almost 2 million people across the globe, with almost 350,000 cases diagnosed in the USA alone.
  • The most common MS triggers identified by doctors are vitamin D deficiency, certain viral infections, and decreased exposure to natural sunlight.

Facts

  • The most debilitating symptom of MS is severe fatigue, which is observed in 75% to 90% of all cases.
  • Depression, anxiety, mood swings, and stress are commonly observed in patients diagnosed with MS. Stress is both a trigger and side-effect of MS.

Facts

  • Having a family history of MS or any other immune disease increases your risk of developing MS. Being a Caucasian of Northern European descent is also a risk factor.

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Dos and Don'ts

Dos
  • Start the treatment of MS as soon as possible since it can cause serious and irreversible damage to your central nervous system.
  • Take medicines as prescribed and be in constant touch with your doctor regarding the onset of symptoms.
  • Maintain a systematic record of your complete medical history and always produce it before any doctor you consult.
Don'ts
  • Become impatient with the treatment course or change the treatment method just because it’s not leading to immediate positive results.
  • Completely depend on your medications to attain relief from the symptoms. Dietary regulation and stress management are equally important.
  • Indulge in alcohol consumption as the intoxication could worsen the symptoms of MS.

 

 

 

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apolipoprotein a1 test
Apolipoprotein -A1 (APO-A1) Test Apolipoprotein A-I (Apo-A1) constitutes 70% of protein content in high-density lipoprotein (HDL) and helps in lipid metabolism.
lipase test
Lipase Test A lipase test is a blood test performed to quantitatively measure the level of the enzyme lipase in…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
Hepatitis A virus infected liver
Hepatitis A Virus (HAV) Total Blood test to look for IgM antibodies to know if you are infected with Hepatitis A virus (HAV),…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
nutritional yeast bread
Nutritional Yeast : How can a fungi culture be good for your body? Nutritional yeast: How a simple culture of fungi can transform your skin, digestion, immunity , and much more.…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
Bubble Tea: Bubbling with nutrition or a hidden sugar mine? The tapioca pearls present in the tea looks like bubbles and hence the name bubble tea became popular.…
EEG
Electroencephalogram – EEG EEG or electroencephalogram is a diagnostic tool used to access the functioning of neurons and brain activity to…
LFT-test
Liver Function Test – LFT LFT or Liver Function Test is a blood test used to determine the levels of hepatic enzymes which…
anoscopy
Anoscopy Anoscopy is an invasive diagnostic procedure where a small device known as anoscope will be inserted in the…
Rubella IgM test
Rubella IgM Test The Rubella IgM test is a blood test that is performed to diagnose the presence of the rubella…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
Isagenix diet weight loss
How are BMI and BMR different and what do these numbers mean? BMI and BMR are two important metrics that provide a clear picture of your body's metabolism and also…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
sleep deprivation
Don’t let your sleep deficit grow into memory loss or heart attack Why is sleep important for us? How could sleep deprivation harm you? We bet you didn't know about…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
Cottage cheese: What can you find in this healthy chunk of fresh milk cheese? Love cheese but scared of putting on extra pounds? With cottage cheese, you can get the best of…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
Inversion Therapy: The anti-gravity way of healing chronic back pain Inversion therapy involves suspending a person upside dow using different types of equipment. This works by taking the…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
CEA_test
Carcinoembryonic antigen (CEA) test CEA or carcinoembryonic test detects the presence of CEA antigen in your blood mainly & determines the effectiveness…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
Squid-ink-spaghetti
Squid Ink: A unique food coloring and flavoring agent Want to add a unique black color to your pasta, noodles and ice-creams? How can you use squid…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
Tight phimosis ring
Phimosis Read to know everything about phimosis, types, symptoms, treatment, risks and prognosis for patients with this condition.
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…