Multiple sclerosis (MS) is a chronic and long-lasting autoimmune disease that severely affects the brain and spinal cord (central nervous system). MS is marked by decreased nerve function with initial inflammation of the protective myelin nerve. Medical intervention is required to treat this condition to reduce and slow down disease progression. In this article, we’ll explore everything you need to know about multiple sclerosis.
What is Multiple Sclerosis?
So, what is multiple sclerosis? Multiple sclerosis causes the immune system to target and attack the cells in the myelin sheath (protective layer wrapped around nerve cells), interrupting signals from the brain to other body parts. Various risk factors like age, race, obesity, smoking, and a family history of MS are responsible for causing this disease. There’s no cure for multiple sclerosis, but treatment options are available to help you with speedy recovery from attacks, modifying the course of the disease progression and managing symptoms.
Types and Stages of Multiple Sclerosis
There are four types of multiple sclerosis:
- Clinically isolated syndrome (CIS)
This Clinically Isolated Syndrome (CIS) is the single first episode of neurologic symptoms that lasts about 24 hours. The symptoms of CIS include:
- Vision problems, a condition known as optic neuritis
- Vertigo
- Loss of sensation in the face
- Weakness in the arms and legs
- Difficulty with coordination, balance, and walking
- Difficulty in speaking and swallowing
- Bladder problems
The state of CIS has shifted to relapse-remitting MS if another episode of CIS occurs.
- Relapse-remitting MS (RRMS)
This is the most common type of multiple sclerosis that occurs in almost 85% of people with multiple sclerosis. This type of MS involves episodes of new or increasing neurologic symptoms and may show relapse or exacerbations followed by periods of recovery or remission. In remission cases, either all symptoms disappear, or some symptoms may continue and become permanent.
- Primary progressive MS (PPMS)
Neurologic symptoms worsen progressively without early relapses or disability accumulates due to the appearance of symptoms or remissions. Some people may experience active PPMS with occasional relapse or evidence of new MRI activity.
- Secondary progressive MS (SPMS)
In the case of secondary progressive MS, people will experience an initially relapsing-remitting disease course, with symptom flare-ups where the disease will start to progress steadily, followed by recovery periods.
Symptoms of Multiple Sclerosis
The main multiple sclerosis symptoms are:
People with MS may develop weak muscles due to a lack of stimulation of nerves. Muscle weakness can be managed by stretching, exercising, water therapy, yoga, or physical therapy and medications such as gabapentin or baclofen. People with MS should stay active, as inactivity can contribute to stiffness, weakness, pain, fatigue, and other symptoms.
A pins and needles-type sensation in the face, body, arms, and legs is among the earliest multiple sclerosis symptoms. An affected person can use assistive devices and perform weight exercises to help with these symptoms.
Sometimes, a person may experience electric shocks when they move their neck, a condition called Lhermitte’s sign.
Patients may have problems emptying their bladder or need to urinate frequently due to loss of bladder control. Medical treatments like relieving constipation with the use of laxatives or stool softeners or taking a high-fibre diet can help treat bladder-related problems.
A person with MS has problems with bowel movement, and constipation can worsen this condition.
Fatigue can decrease a person’s physical and cognitive ability to function properly. It is important to join physical activity programmes of mild to moderate intensity to reduce fatigue. Some drugs, including amantadine, methylphenidate, and modafinil, can help to reduce fatigue. Patients can join stress management programmes, relaxation training, and MS support groups to keep nerve stimulation active.
- Dizziness and vertigo: Some people may experience problems with balance and coordination, a condition known as ataxia. This condition occurs when there is damage to the areas of the brain that control Some medications like dalfampridine are used to treat a patient who faces difficulty in walking.
- Sexual dysfunction: Sexual dysfunction can occur when there is damage to nerves running through the spinal cord, and both males and females may lose interest in sexual activity. Along with nerve damage, other problems like fatigue, cramped or spastic muscles, and psychological factors can also cause sexual dysfunction.
- Spasticity and muscle spasms: This is an early symptom of MS that happens when there is damage to the nerve fibres in the patient’s spinal cord and brain, causing muscle spasms
- Vision problems: Some patients may experience double or blurred vision because of multiple sclerosis due to inflammation in the optic nerve.
In the advanced stages of MS, people may experience differences in perception and thinking, as well as sensitivity to heat that worsens with the progression of the disease, and the person may experience emotional, physical and mental stress.
Causes of Multiple Sclerosis
The exact reason behind MS is unknown. Researchers say that since it is an immune-mediated disease, the body’s defence system attacks its healthy tissues and damages the fatty substance that coats and safeguards nerve fibres in the brain and spinal cord, known as the myelin sheath. Scientists say that a combination of genetics and environmental factors appears to be responsible. The risk factors are:
Studies say that MS can occur at any age, but more cases are mainly reported around 20 and 40 years of age.
More cases of MS are reported in women, that is 2 to 3 times as likely as men.
Cases of MS are linked with family history, sometimes seen if any of the parents or siblings have had MS in the past.
Studies have reported cases of MS linked with a variety of viruses, including Epstein-Barr, the virus that causes infectious mononucleosis.
White people are more likely to get this disease, including Northern European descent; Asian, African, or Native American people have the lowest risk.
Cases of MS are far more common in countries with temperate climates, like Canada, the northern United States, New Zealand, southeastern Australia and Europe, where the temperature is either extremely cold or too hot.
People with low levels of vitamin D and less exposure to sunlight are at greater risk of developing MD disease.
A gene on chromosome 6p21 is believed to be associated with multiple sclerosis. People with this gene are at higher risk of developing MS.
The condition of MS mostly develops in women with increased weight, especially true for female childhood and adolescent obesity as compared to low-weight people with a lesser risk of developing MS.
- Certain autoimmune diseases
People living with other autoimmune disorders such as thyroid disease, pernicious anaemia, psoriasis, or type-1 diabetes are at higher risk of developing MS.
Smoking increases the chances of most autoimmune diseases. The symptoms related to MS are more likely than nonsmokers to develop MS disease.
Diagnosis of Multiple Sclerosis
No single test confirms a diagnosis of multiple sclerosis if you have experienced only one attack of MS-like symptoms. Doctors use several strategies to diagnose MS. They may check the patient’s complete medical history and recommend a physical and detailed neurological examination to diagnose the condition.
- Blood Tests: These tests assess the effectiveness of treatment by determining white and red blood cell counts, as well as to help rule out other diseases with symptoms like MS. Blood tests also detect the specific biomarkers associated with MS that may also aid in diagnosing the stage of MS.
- Spinal Tap: In this test, a doctor requires a spinal tap to collect cerebrospinal fluid, which a doctor then analyses to look for abnormalities in antibodies that are associated with MS. They will also check for low sugar levels, elevated white blood cell counts and high protein levels. A spinal tap test can also determine suitable antibiotics for treatment using cerebrospinal fluid. A spinal tap can also help to determine the infections and other stages with neurologic symptoms like MS.
- MRI Test: MRI scans can show characteristic MS lesions on your brain, cervical, and thoracic spinal cord. A doctor will perform an MRI by intravenously injecting a dye or contrast agent to enhance brain images that will indicate the disease in the form of active MS lesions.
- Evoked potential test: This is done to record the electrical signals produced by the nervous system responding to stimulation using electrodes. The electrodes are placed on the skin, and painless electric signals are generated to measure how rapidly and accurately the nervous system responds to stimulation by watching a moving visual pattern on the screen in the form of short electrical impulses that are applied to nerves in your legs or arms. The measured signals tell how quickly the information travels down your nerve pathways. This test is painless and can show how accurately your brain works to receive messages in the form of stimuli from the central nervous system.
Diagnosing MS can be more difficult in cases where there are unusual symptoms of active MS. The doctor may recommend further testing with spinal fluid analysis and additional imaging.
Treatment of Multiple Sclerosis
Since there is no cure for muscular sclerosis, certain treatments focus on managing symptoms, reducing relapses, and slowing the disease’s progression. The treatment plan may include:
- Disease-modifying therapies (DMTs):
Medications like beta-interferon have been approved for long-term treatment of muscular sclerosis. These drugs help reduce the chance of relapse and may decrease inflammation and increase nerve growth by slowing down disease progression and preventing new lesions on the brain and spinal cord.
In severe attacks, a neurologist may recommend a high dose of corticosteroids, which will quickly reduce inflammation and slow damage to the myelin sheath.
- Physical activity and fitness
Muscular sclerosis hinders a patient’s physical activity and fitness. So, it is important to stay physically fit, which will help you maintain your mobility.
Dealing with a diagnosis of muscular sclerosis can be challenging, as it can affect your mood and memory. It’s easy to feel worried, depressed and stressed when dealing with it. Patients should keep in touch with a neuropsychologist about any problems or concerns they may face during treatment.
Prognosis of Multiple Sclerosis
Living with the condition of multiple sclerosis is challenging. The prognosis of multiple sclerosis does not always result in severe paralysis. About two-thirds of people with MS can walk, while some may require assistance with the use of a cane, wheelchair, crutches, or a scooter. It has been studied that the average life expectancy for a person with a condition of multiple sclerosis is generally 5 to 10 years lower than that of the average person.
Thanks to advances in treatment, there has been excellent progress in research areas—especially in the development of new multiple sclerosis treatments to prevent exacerbations of the disease. With appropriate diagnosis and treatment, most people with MS will continue to lead full, active, and productive lives. Discoveries are constantly changing MS treatment options and helping to reduce neurological symptoms of MS that cause disability.
Conclusion
Multiple sclerosis is an autoimmune disorder that needs to be dealt with carefully. MS develops due to various factors like age, race, obesity, smoking, family history and more. It is advisable to talk to your neuropsychologist about therapies and medications available to reduce relapses and flare-up attacks by slowing down the disease progression. There is also hope that researchers will be able to detect what kind of MS a person will develop and establish the most effective mode of treatment right from the time of diagnosis. Having health insurance ensures access to specialized care and advanced treatments, providing essential support for managing conditions like multiple sclerosis.
Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.