Multiple sclerosis

Multiple Sclerosis (MS) is an autoimmune disorder in which antibodies are produced against our own nerve cells of the brain and spinal cord, which results in the damage of nerve cells and its associated medical conditions. Multiple sclerosis is a progressive disorder in which the functions of the brain, spinal cord and eye nerves are being damaged. The incidence of multiple sclerosis is more in women, mainly in the age group of 18–45 years, when compared to men. It is a systemic disorder that can affect almost all the important organs such as the eye, upper and lower extremities, urinary and digestive systems and muscular system. According to a recent epidemiological survey, in the United States, approximately 350,000 people are affected by multiple sclerosis.

Types

The main four stages of multiple sclerosis are:

A. Exacerbation Phase: In this stage, a person with multiple sclerosis experiences sudden and severe attack and most of the time it is acute that lasts no more than a day.

B. Relapsing-Remitting Multiple Sclerosis: This stage is the most common phase as the problem persists. There will be a periodical recurrence of symptoms and in the mean time there will be no symptom of the disorder. But again, after a periodical gap, there will be a recurrent attack after the previous attack.

C. Primary Progressive Multiple Sclerosis: In this stage, there will be an irreversible damage to the nervous system and the some of the body functions are gradually disabled.

D. Secondary Progressive Multiple Sclerosis: This is the terminal stage of the disorder and many patients in the treatment conditions can also enter into this stage and there will be a constant progression of the symptom and a decline in the body functions. If it is uncontrolled by medicines, the patient will die eventually due to nervous system damage and its complications.

Causes

The main cause of the onset of multiple sclerosis is the development of autoimmunity against the myelin sheath of the nerve fibers. The damaged nerve fibers in turn affect the neural transmission of the brain. The exact cause for the development of autoimmunity is not determined; however, some causes such as genetic inheritance, environmental factors, smoking, stress-induced factors and viral infections are scientifically proved and documented.

Symptoms of multiple sclerosis

• General Fatigue

• Mood swings

• Diplopia

• Inflammation of optic (eye) nerves

• Slurred Speech

• Abnormal bowel movements

• Profuse weakness

• Diarrhea and fecal incontinence

• Increased urination and urinary incontinence

Diagnosis

• Electrophoresis of CSF shows abnormal Oligoclonal bands of IgG

• Magnetic Resonance Imaging – suggestive of demyelization and lesions with scars.

Treatment Options for multiple sclerosis

The treatment for multiple sclerosis can modify the problem or decrease the incidence of Multiple Sclerosis but not cure the problem. As of now, some of the immuno-modulating biologics are available for treatment, which can decrease the number of episodic attacks and its remissions. Some of them are Interferon B-1a and B-1. Other drugs that are used to treat multiple sclerosis are steroids, immunosuppressive drugs, monoclonal antibodies specific for the auto antibodies and Fingolimod, an FDA-approved new drug for the treatment of Multiple Sclerosis. But all the allopathic drugs and biologics have their own side effects.

Prognosis

The prognosis of multiple sclerosis varies from one person to another and their age and sex. Also the stage of multiple sclerosis is very important to predict its prognosis and the response of the disease to treatment. Usually most of the people with multiple sclerosis cross the age of 60 years but they are affected by permanent disabilities.

Prevention Strategies and Disease Management

As of now, there is no effective preventive measure for multiple sclerosis. Multiple Sclerosis can be managed by the treatment in accordance with the symptoms. The relapses and the remission attacks can be prevented by following the proper medical care, physical therapy and neurorehabilation. Some of the patients claim that alternative medical treatments are useful. But none of these treatments are scientifically validated. However, they can use at their own discretion and risk.

When to see a doctor

If you experience an acute or episodic attack, abnormal symptoms, and sudden disabilities, even when you use medicines, you need to seek medical attention immediately.