Multiple Sclerosis

1 What is Multiple Sclerosis?

A potentially disabling disease of the spinal cord (central nervous system) and brain is called multiple sclerosis (MS). In this disease it causes communication problems between your brain and the rest of your body because the immune system attacks the protective sheath (myelin) that covers nerve fibers. The nerves will soon deteriorate or damaged permanently.

MS

The symptoms of MS depend on the amount of nerve damage and which nerves are affected. Some people with MS experience long periods of remission and some lose the ability to walk independently.

There is no cure for MS, the treatments can only help in recovery from attacks and manage symptoms.

2 Symptoms

The signs and symptoms of multiple sclerosis differ from one person to another and it depends where the affected nerve fibers.

MultipleSclerosis

It includes:

  • weakness of the limbs, legs and trunk,
  • prolonged double vision; partial or complete loss of vision,
  • pain or tingling in parts of your body,
  • slurred speech, dizziness,
  • electric-shock sensations with neck movements (Lhermitte sign),
  • fatigue,
  • lack of coordination,
  • unsteady gait,
  • problems with bladder and bowel function.

Some people with this disease will have relapsing-remitting disease course. They will have new symptoms or relapses over a few weeks and sometimes may improve partially or completely. This will be followed by quiet periods of remission that may last up to years.

Secondary-progressive MS is a steady progression of symptoms that can occur to about 60 to 70 percent of people with relapsing-remitting MS.

Primary-progressive MS is a gradual onset and steady progression of signs without any relapses.

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3 Causes

There is no known cause of multiple sclerosis and is considered as an autoimmune disease.

The body’s tissue will be attacked by the body’s immune system. In MS, it destroys the fatty substance that protects and coats nerve fibers in the spinal cord and brain (myelin). The nerve fiber will be exposed if the myelin is damaged, the messages that travel along that nerve might be blocked, slowed or damaged.

A combination of environmental and genetics factors might be responsible.

4 Making a Diagnosis

Your physician may recommend you to a neurologist that specializes in brain and nervous system disorders to receive a diagnosis of multiple sclerosis. Your doctor may recommend a neurological exam and may ask your medical history. There are no specific tests for MS. A differential diagnosis that often relies on ruling out other conditions that might produce similar symptoms might be recommended. Some of these include:

  • Blood test – to check for specific biomarkers associated with MS and rule out other diseases.
  • Lumbar puncture or spinal tap – your doctor will remove a small sample of fluid in your spinal canal and this will abnormalities in antibodies that are associated with MS, this can also rule out other conditions and infections.
  • MRI – that can reveal areas of lesions on your spinal cord and brain.
  • Evoked potential tests – your nervous system in response to stimuli will record the electrical signals, the electrodes will measure how quickly the information will travel down your nerve.

A person with unusual symptoms or progressive disease is difficult to diagnose, more testing may be recommended.

5 Treatment

There is no known cure for MS. The treatment for multiple sclerosis will focus on the recovery from attacks and managing symptoms. Some of the treatments for MS attacks include:

  • Corticosteroids – prednisone and intravenous methylprednisolone to reduce nerve inflammation and side effects are increased in blood pressure, insomnia, fluid retention and mood swings.
  • Plasma exchange (plasmapheresis) – your plasma will be separated from your blood cells and then mixed with albumin, this may be used if steroids are not effective.

If you have early treatment, it can slow the formation of lesions and lower the relapse rate. Treatments for relapsing-remitting MS include:

  • Fingolimod (Gilenya) – to reduce relapse rate. Your heart rate will be monitored for 6 hours after the first dose and side effects are high blood pressure, blurred vision and headache.
  • Teriflunomide (Aubagio) – side effects are hair loss and liver damage and cannot be used by pregnant women because it can be harmful to the unborn baby.
  • Glatiramer acetate (Copaxone) – to prevent blocking of immune system’s attacks on myelin.
  • Dimethyl fumarate (Tecfidera) – twice a day oral medication to reduce relapses and side effects are diarrhea, flushing, nausea, lower white blood cell count.
  • Beta interferons – can reduce the severity and frequency of relapses, side effect is flu-like symptoms.
  • Natalizumab (Tysabri) – to block the movement of damaging immune cells in your spinal cord and brain and this may increase the risk of a viral infection called progressive multifocal leukoencephalopathy.
  • Mitoxantrone – immunosuppressant to treat only severe advance MS because it can be harmful to the heart and you may develop blood cancer.
  • Alemtuzumab (Lemtrada) – to reduce relapses but have a risk of infections and autoimmune diseases.

The treatments for MS symptoms include:

  • physical therapy that involves strengthening and stretching exercises so you can do your daily tasks,
  • medication to reduce fatigue,
  • muscle relaxants such as baclofen (Lioresal) and tizanidine (Zanaflex),
  • other medications for pain, depression, bladder and bowel control and sexual dysfunction.

6 Prevention

There is no way to prevent multiple sclerosis but these tips may help relieve the signs and symptoms such as:

  • get plenty of rest,
  • exercise regularly to improve balance and coordination, stretching, walking, yoga and Tai chi,
  • eta a healthy and balanced diet, low in saturated fat abut high in omega-3 fatty acids,
  • avoid heat,
  • do meditation and breathing problems to relieve stress.

7 Alternative and Homeopathic Remedies

Some people with multiple sclerosis use alternative remedies to help relieve the symptoms.

Activities like massage, yoga, exercise, meditation, eat a balance and healthy diet and relaxation techniques can be helpful.

The use of oral cannabis extract for muscle spasticity and pain is recommended by the American Academy of Neurology, but they do not cannabis in any other form of MS symptoms because of lack of evidence. Ginkgo biloba and bee venom and magnetic therapy are not recommended too.

8 Lifestyle and Coping

Consider these suggestions to cope with multiple sclerosis:

  • stay connected to family and friends,
  • maintain normal activities,
  • you can talk to a counselor about your feelings,
  • continue your hobbies and interests,
  • find a support group in your area to help you cope with MS.
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9 Risks and Complications

There are several risks and complications associated with multiple sclerosis.

The risk factors that may increase developing multiple sclerosis include:

  • Age, most common in between the ages of 15 to 60 but can occur at any age,
  • Sex, women are twice as likely as men to develop this disease,
  • Race, white people in Northern Europe descent, the lower risk are Asian, Native American and African descent,
  • Family history; Climate, in countries with temperate climates like New Zealand, Canada, northern United States, Europe and southeastern Australia,
  • Smokers are most likely to develop this,
  • Certain infections including Epstein-Barr,
  • Certain autoimmune diseases, if you have type 1 diabetes, inflammatory bowel disease and thyroid disease.

People who have multiple sclerosis may have complications such as:

  • depression, paralysis mostly in legs,
  • muscle stiffness or spasms,
  • bladder, bowel and sexual function problems,
  • mood swings or forgetfulness,
  • epilepsy.
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