Multiple sclerosis is a medical condition that affects the brain and spinal cord. It is also an autoimmune disease that causes demyelination of the spinal nerve and brain cells. The disease disrupts the communication of the brain with the body. In this condition, the body's immune system attacks the protective sheath (myelin) that covers the nerve fibers resulting in the deterioration or permanent damage of the nerves.
What causes multiple sclerosis?
Multiple sclerosis is a neurological disease that affects the central nervous system. There are millions of nerve cells in the brain that are constantly at work. They send out signals throughout the body and control a person's speech, memory, cognition, movement, and hearing. Every activity undertaken by the human body is controlled by the central nervous system (CNS). The nerve cells carry out the communication process by sending out electric signals through nerve fibers. A protective sheath called myelin covers and guards these fibers and ensures each of the nerve cells reaches its specific target. In the case of multiple sclerosis, the immune cells of the body mistakenly attack the myelin sheath that results in the damage and disruption of nerve signals. Although the exact causes of multiple sclerosis are difficult to diagnose, here are a few factors that can lead to the development of MS:
- Immunologic - this factor is one of the primary causes of multiple sclerosis wherein the immune system malfunctions and attacks its own CNS. Researchers are studying this cause further to determine the probable reasons that trigger these attacks and to learn more about the immune cells that may be responsible for the attack.
- Genetic factors - several genes are known to play a role in the development of this disease. The Multiple Sclerosis Foundation states that the risk of a child to become affected with multiple sclerosis is estimated to be between 2% to 5% if any one of the parents has been diagnosed with multiple sclerosis. According to research, people who are born with a genetic vulnerability to this disease can, upon exposure from an environmental agent, stand at risk of an immune-mediated response causing multiple sclerosis.
- Environment: Epidemiologists have observed an increased pattern of multiple sclerosis instances in countries located away from the equator. This observation is due to a finding that vitamin D may be known to play a role in the occurrence and prevention of multiple sclerosis.
- Infections: Certain bacteria and viruses may also cause multiple sclerosis. Viruses can cause inflammation of the myelin that may, in turn, result in multiple sclerosis.
What are the various signs and symptoms of multiple sclerosis?
Multiple sclerosis symptoms can be difficult to tell. There is no definitive set of symptoms that apply to everyone, and some of the symptoms can be confusing since it overlaps with other diseases, too. In most cases, these symptoms develop over the course of a few days and will last for days to weeks, depending on the patient. Some of the early signs of the disease are:
- Loss of vision - One of the first signs of multiple sclerosis is the weakening of one's eyesight. The impact can be either in one or both the eyes. An ophthalmologist can recommend an MRI scan to confirm if it is multiple sclerosis, which is a condition that results in a quick loss of vision.
- Loss of balance - Often, this symptom of multiple sclerosis goes undiagnosed. A person's balancing problem and dizziness are initially diagnosed as inner ear infections that are easier to treat. If the symptoms persist for a longer duration, one may need to visit a couple of doctors to find out the root cause.
- Numbness and tingling sensation - Frequently, a person with MS experiences tingling or numbness when resting his/her arm or leg in a wrong posture. This sensation goes away for a short while as the blood flow returns to the affected area. In the case of multiple sclerosis, the numbness and tingling sensations are likely to last longer, and in some instances, can even continue to a few days or weeks.
Diagnosing Multiple Sclerosis
Since the symptoms of multiple sclerosis are so varied, they can be easily misdiagnosed. Apart from the above-mentioned symptoms, patients are also likely to have symptoms such as urinary problems, fatigue, pain, speech problems, and depression. If such symptoms persist for over 24 hours, one needs to consult a doctor to do the necessary tests and scans with regards to multiple sclerosis. Typically as a part of the diagnosis procedure, a neurologist will conduct tests including neurological examination, eye function test, and nerve function test. Imaging tests like MRI may be carried out for better examination of the brain. A spinal tap is another testing procedure carried out for diagnosing Multiple Sclerosis where in the spinal cord fluid is tested for diagnostic purpose. Electrical tests known as evoked potentials are also carried out to check if Multiple sclerosis has progressed to damage the nerve pathways.
Typically, as part of the diagnosis procedure, a neurologist will conduct tests including a neurological examination, eye function test, and nerve function test. Imaging tests like MRI may be carried out for a better examination of the brain. A spinal tap is another testing procedure carried out in diagnosing multiple sclerosis wherein the spinal cord fluid is tested for diagnostic purposes. Electrical tests known as evoked potentials (EP) are also carried out to check if multiple sclerosis has progressed to damage the nerve pathways.
What is the treatment course for multiple sclerosis?
Researchers are still finding a definitive cure for multiple sclerosis as there is still no cure found for the disease. The treatment typically works at speedy recovery from the attacks, slower progression, and managing the symptoms. Some symptoms are mild and may not even require any treatment. The following are the stages of treatments involved in addressing multiple sclerosis:
Treating Multiple Sclerosis Attacks
- Corticosteroids - Oral prednisone and intravenous methylprednisolone are suggested by doctors to calm down nerve inflammation. With regards to their side effects, these medications may cause insomnia, increased blood pressure, mood swings, and fluid retention.
- Plasma exchange - This is a medical procedure wherein the liquid portion of the blood (plasma) is removed and separated from the blood cells. The blood cells are then mixed with a protein solution (albumin) and are put back in the body. Plasma exchange is used if the body does not respond to steroids.
Treatments to Modify Progression
There are no therapies yet that are proven to have shown benefits for slowing the progression of multiple sclerosis. Many of the disease-modifying therapies used to treat multiple sclerosis have their associated health risks. Selecting the right therapy depends on multiple factors such as severity of the disease, other health issues, childbearing status, and so on.
Treatment options for a relapsing-remitting multiple sclerosis includes the following:
- Beta interferons: This type of medication is the most commonly prescribed medication for the treatment of multiple sclerosis. These are injected under the skin or into the muscles and can help in reducing the frequency and severity of relapses.
- Glatiramer acetate (Copaxone): This medication is administered to patients to stop the immune system from attacking the myelin and is injected beneath the skin.
- Dimethyl Fumarate (Tecfidera): This oral medication is recommended to patients to help reduce relapses.
- Fingolimod (Gilenya): This medication is given as an oral dose to patients to reduce the relapse rate. However, the heart rate of the patient is monitored for six hours after the first dose because this medicine may slow down the patient's heart rate.
- Teriflunomide (Aubagio): This oral medication is prescribed to be taken orally to reduce the relapse rate. It must not be consumed by a pregnant woman as it is harmful to the developing fetus.
Treatments to Manage the Symptoms
- Physiotherapy: Physical therapy is recommended to patients with symptoms of multiple sclerosis. The patient is taught physical exercises that mainly involve stretching and strengthening of the muscles. Physiotherapy and mobility aids are used to manage leg weakness and other symptoms associated with body movement.
- Muscle relaxants: Muscular spasms and stiffness in the legs are controlled by administering muscle relaxants such as Baclofen (Lioresal) and tizanidine (Zanaflex).
- Medicines that reduce fatigue: Medications that can help in managing fatigue are also prescribed to patients. They also help in dealing with symptoms like pain, depression, sexual dysfunction, and bladder problems often associated with multiple sclerosis.
Although there are no studies that show the efficacy of alternative medicine in managing multiple Sclerosis, patients often complement their treatment with alternative therapies to fight the symptoms. Engaging in activities such as exercise, yoga, meditation, massage, eating healthy and right foods, can help patients manage their symptoms effectively along with their primary treatment.