Multiple sclerosis

Last updated date: 12-May-2023

Originally Written in English

Multiple sclerosis

Multiple sclerosis (MS) is a condition associated with the disabling of the spinal cord and the brain. With the disorder, the body's immune system fights healthy cells by accident. Also, the immune system destroys cells in the myelin sheath that protects nerves within the brain and spinal cord in individuals with MS. 

Nerve signals from your brain to other areas of your body are disrupted when the myelin sheath is damaged. Symptoms that affect the spinal cord, brain, and eyes are possible as a result of the damage. Other people with chronic cases might lose their capability to walk independently. 

 

Types of Multiple Sclerosis 

The four types of multiple sclerosis include; 

Clinically isolated syndrome (CIS): This is a term that healthcare providers use to describe a person's first episode of multiple sclerosis symptoms. However, multiple sclerosis does not develop in everyone who has CIS.

Relapsing-remitting MS (RRMS): The most common type of multiple sclerosis is RRMS. Flare-ups with new or aggravating symptoms, also known as relapse or exacerbation, occur in patients with RRMS. There are remission periods that follow after that, a situation where the symptoms stabilize or disappear. 

Secondary progressive MS (SPMS): This is a form of MS that develops after someone has been diagnosed with RRMS. You will keep on accumulating nerve damage if you have secondary progressive multiple sclerosis while the symptoms intensify over time. Though you can still have relapses or flares (when the symptoms worsen), you won’t experience remission periods after that. 

Primary progressive MS (PPMS): This is a form of MS in which symptoms progressively intensify over time with no periods of remission or relapse

 

Signs and Symptoms of Multiple Sclerosis 

Signs and Symptoms of Multiple Sclerosis 

Based on the location of the damaged nerve fibers, multiple sclerosis signs and symptoms can vary widely from one person to another and throughout the disorder. 

Movement difficulty:

Some of the MS symptoms that can affect mobility include; 

  • Weakness or numbness in one or more limbs, usually on one part of the body at a time, or in the legs and trunk
  • Certain neck movements, particularly when bending your neck forward, cause electric shock sensations 
  • Tremor, a shaky gait, or a loss of control

Vision problems:

Vision issues are also widespread and include; 

  • Partially or completely lost vision, normally in one eye at a time, and often accompanied by discomfort when moving the eyes.
  • Long-term double vision
  • A blurry vision.

Multiple sclerosis may also be associated with the following symptoms; 

  • Fatigue 
  • Slurry speech 
  • Pain or tingling in some areas of the body 
  • Dizziness 
  • Sexual problems, including bladder and bladder dysfunction 

 

Causes of Multiple Sclerosis 

Multiple sclerosis has no known cause. It's classified as an autoimmune condition because the immune system fights the body's tissues. This malfunction of the immune system in MS destroys the fatty substance that covers and shields the nerve fibers in the brain and spinal cord (myelin). 

Myelin is similar to the insulation that protects electrical wires. The messages that pass through the nerve fiber can be delayed or blocked. This happens if the protective myelin is destroyed while the nerve fiber is exposed. 

In addition, it is unclear why some people get MS and others do not. According to studies, it seems that a mixture of environmental factors and genetics is to blame.

 

Risk Factors of Multiple Sclerosis 

The following factors can increase your chances of getting multiple sclerosis; 

  • Age: MS can strike at any age, but it mostly develops between the ages of 20 and 40. Young and older adults, also, might be affected on rare occasions. 
  • Gender: Relapsing-remitting MS affects more than two to three times as many women as it does in men. 
  • Family history: You have a high chance of developing MS if one of your siblings or parents has had the disease.
  • Vitamin D deficiency and lack of sun exposure are linked to an increased risk of multiple sclerosis.
  • Some autoimmune diseases: If you have thyroid disease, psoriasis, pernicious anemia, inflammatory bowel disease, or type 1 diabetes, you're at a significantly high risk of getting MS. 
  • Smoking: Regular smokers, unlike nonsmokers, are most likely to have a second event that proves relapsing-remitting MS. This is after experiencing an early event with symptoms that could indicate MS. 
  • Infections: MS has been related to a number of viruses, such as Epstein-Barr, the virus that triggers infectious mononucleosis.

 

Complications of Multiple Sclerosis 

Patients with multiple sclerosis can develop some related complications such as; 

  • Paralysis usually in both legs 
  • Spasms or stiffness of the muscles 
  • Issues with the bowel and bladder or sexual dysfunction 
  • Epilepsy 
  • Depression 
  • Mental changes, including mood swings or forgetfulness 

 

Multiple Sclerosis Diagnosis 

MS does not have any specific examinations. Instead, a differential diagnosis, or rule out other disorders that may cause the same signs and symptoms, is often applied. This is to confirm a diagnosis of multiple sclerosis

A detailed medical history, as well as examination, is likely to be the first steps your doctor takes. After that, your doctor can suggest any of the following; 

Blood tests: Doctors can use this to rule out other disorders that have symptoms that are the same as MS. Tests to look for certain biomarkers linked to MS are being developed, and they could help with diagnosis. 

Magnetic resonance imaging (MRI) scans: Doctors can use this imaging test to check the brain and spinal cord areas for MS or lesions. An intravenous injection of contrast material may be given to highlight lesions that suggest your disease is active.

Spinal tap (lumbar puncture): A small sample of cerebrospinal fluid is taken from the spinal canal for lab examination during this procedure. With the sample, antibody abnormalities linked to MS can be detected. The doctor can also use a spinal tap to rule out some infections and other illnesses with symptoms similar to multiple sclerosis. 

Visual evoked potentials (VEP) test: The stimulation of nerve pathways is necessary during this test, which examines electrical activity in the brain. Earlier, auditory-evoked and sensory-evoked potential tests on the brain stem were used to detect multiple sclerosis. 

Optical coherence tomography (OCT): This test involves taking a picture of the nerve layers located at the back of the eye. This is to see whether the optic nerve is thinning. 

 

Most patients with relapsing-remitting multiple sclerosis undergoes a simple diagnosis based on a history of symptoms that are consistent with the disorder. The diagnosis is then verified with brain imaging scans like MRI. When people have irregular symptoms and a progressive illness, diagnosing MS may be more difficult. 

 

Multiple Sclerosis Treatment 

Multiple sclerosis has no known treatment solution. Treatment usually focuses on reducing the time it takes to heal from attacks, minimizing the disease's progression, and controlling MS symptoms. Nonetheless, other people's symptoms are so minor that no cure is needed. 

The comprehensive cure plan for MS can include; 

  • Managing multiple sclerosis attacks medications

Corticosteroids: To treat nerve inflammation, corticosteroids including intravenous methylprednisolone and oral prednisone are usually administered. High blood pressure, insomnia, high blood glucose, fluid retention, and mood swings are possible side effects.

Exchange of plasma (plasmapheresis): Plasma is the liquid component of your blood that is isolated from the blood cells. After that, the blood cells are combined with a protein content (albumin) and reintroduced into the body. If the symptoms are recent, intense, and have failed to react to steroids, plasma exchange can be used. 

  • Disease-modifying therapies (DMTs)

The FDA has approved several drugs for long-term multiple sclerosis treatment. These medications aid in the prevention of relapse (also known as attacks or flare-ups). They help to delay the progression of the disease. They also have the ability to stop new lesions from developing on the brain or the spinal cord. 

  • Physical therapy

Physical therapy

Physical therapy is a type of treatment performed by physical or occupational therapists. They can help teach you how to stretch and strengthen your muscles, as well as how to use some tools to make everyday activities easier. Physical therapy, combined with the use of a mobility aid, can help treat leg instability and other gait issues common in MS patients.

  • Mental health counseling

Living or coping with a serious illness can be emotionally draining. MS may also have an effect on your mood as well as memory. Therefore, talking to a neuropsychologist or receiving other forms of therapeutic support is an important part of coping with the disorder. 

 

Conclusion 

Multiple sclerosis is an autoimmune disease that affects the central nervous system, including the brain, spinal cord, and optic nerves. It's whereby your immune cells destroy your healthy nerve cells by mistake. Inflammation and damage to the myelin sheath that coats and protects the nerve cells result from these attacks.

Neurological symptoms include loss of balance, muscle weakness, and vision issues resulting from this damage. There are a number of successful MS therapies available. The drugs help to prevent relapses and delay the disease's progression. Luckily, most MS patients can control their symptoms and live healthy, productive lives.