About Multiple sclerosis
Multiple sclerosis(MS) is a chronic disease of the central nervous system whose onset generally occurs in adults between 20 to 40 years old. It is usually seen as an autoimmune disorder in which your body starts to attack itself by mistake.
Multiple sclerosis can affect people differently and is an unpredictable disease. In some cases, the symptoms of MS are only mild, while others may lose their ability to perform many tasks. For example, the ability to see, speak, write or walk. These complications appear when the communication between the brain and other body parts becomes disrupted.
The condition appears when myelin gets destroyed in many areas of your body. Myelin is a fatty tissue that surrounds and protects nerve fibres, and the loss of myelin causes scar tissue, known as sclerosis. The areas with the loss of myelin are also called lesions or plaques.
This way, the damaged nerves can't conduct electrical impulses to and from the brain, which leads to the complications listed.
Causes of Multiple Sclerosis
The cause of Multiple sclerosis is unknown, but some conditions that may lead to MS are-
- Genetic factors
- Autoimmune disorders
- Environmental factors
- Infectious agents, for example viruses
Symptoms of Multiple sclerosis
Multiple sclerosis symptoms can vary in severity, duration, and unpredictability. They can be mild or severe, short-term or long-lasting. Depending on the area of the nervous system affected, there can be different combinations of symptoms. Here are the most common symptoms of Multiple sclerosis-
Initial symptoms of Multiple sclerosis
These common symptoms often appear in the initial stages of MS.
- Double or blurred vision
- Trouble walking
- An abnormal feeling or pain causing numbness, prickling, or pins and needles (paresthesia)
- Red-green color distortion
- Swelling of the optic nerve(optic neuritis) causes pain and also cause loss of vision
Other symptoms of Multiple sclerosis
- Speech problems
- Weakness of muscle in the arms and legs
- Spasticity
- Loss of sensation
- Having trouble with coordination
- Dizziness
- Fatigue
- Bowel and bladder problems
- Tremor
- Hearing loss
- Depression
- Changes in sexual function
Almost 50% of people with Multiple sclerosis deal with thinking(cognitive) problems. These problems are linked to this disease, and their effects can be mild. If you suspect the following problems, you should consult your healthcare provider. They include problems or difficulties in functions and tasks like:
- Focusing(concentration)
- Poor judgment
- Attention
- Memory
Risk factors for Multiple sclerosis
These are the risk factors that may increase the chances of developing multiple sclerosis-
Age
Multiple sclerosis can occur at any age, usually around 20 and 40. Younger and older people are likely to get affected by MS.
Family history
If any person like your parents or sibling has had MS, you are at higher risk of developing it.
Sex
Women are 2 to 3 times more likely to develop MS, and men are likely to have relapsing-remitting MS.
Certain infections
Researchers have found a link between MS and various viruses. People affected by Epstein-Barr, the virus that causes infectious mononucleosis, are at risk of MS.
Race
People of Northern European descent, particularly white people, are at higher risk of MS. But comparatively to these people, people of Asian, African or Native American descent are at the lowest risk of MS. According to a new study, there will be more black and Hispanic young adults dealing with Multiple Sclerosis than we first believed.
Climate
The disease is more common in temperate climates, especially in countries like Canada, the northern United States, Southeastern Australia, New Zealand and Europe. The month in which you were born can impact the chances of getting MS. If a pregnant woman has exposure to the sun, then it seems to lower the risk of Multiple sclerosis in her child.
Vitamin D
Low vitamin D levels and low exposure to sunlight may increase the risk of Multiple sclerosis.
Genes
Researchers have found a link between Multiple sclerosis and a gene on chromosome 6p21. So, people with this gene are at higher risk for MS.
Obesity
A link has been found between obesity and Multiple sclerosis in females. They are most likely to have a risk of MS during childhood and adolescent obesity.
Certain autoimmune diseases:
Certain autoimmune disorders have a higher risk of developing MS. These disorders include-
- Pernicious anemia
- Thyroid disease
- Psoriasis
- Inflammatory bowel disease
- Type 1 Diabetes
Smoking
It can also be a risk factor for MS. If you are a smoker and experience initial symptoms of MS. It can signal MS. Smokers are more likely to develop it than nonsmokers and develop a second event that confirms relapsing-remitting MS.
Complications due to Multiple sclerosis
People with Multiple sclerosis can suffer from complications like
- Problems with bladder control, bowel or sexual function problems
- Muscle spasms and stiffness
- Cognitive issues like forgetfulness or difficulty finding words
- Severe weakness or paralysis in the legs
- Behavioural problems, mood swings, depression and anxiety
- Rare seizures
Diagnosis of Multiple sclerosis
There is no specific test available to diagnose Multiple sclerosis. However, a doctor can diagnose by following a process to rule out other possible causes and diseases carefully. Two things must be done to make a diagnosis of Multiple sclerosis.
You must have had 2 attacks of MS that were at least one month apart. A seizure occurs when any MS symptoms appear suddenly and if any symptoms get worse for at least 24 hours.
Also, you must have more than one damage to the area of the central nervous system myelin. Myelin is the sheath which surrounds and protects nerve fibres in our body. The caused damage must be at more than 1 point in time, and any other disease did not cause it.
Also, if you have Multiple sclerosis, a single attack and specific changes in your brain tissue on an MRI can indicate it. An MS evaluation includes a check on your health status and a neurological exam for
- Language functions
- Mental functions
- Balance, Movement and coordination
- Emotional functions
- Functions of the 5 senses
- Vision
These are some methods that may help in evaluating a person for Multiple sclerosis-
MRI
An MRI scan can help find plaques or scarring caused by Multiple sclerosis. It is a diagnostic test through a machine that uses large magnets, sound waves, and computers to create detailed pictures of organs and structures in the body.
Cerebral spinal fluid analysis
Also called a lumbar puncture or a spinal tap. It examines the fluid taken from the spinal column to provide an evaluation or diagnosis. The test looks for the cellular and chemical abnormalities that may appear with MS.
Evoked potentials
These tests record your brain's electrical response. It notes the responses to visual, auditory and sensory stimuli. These tests detect if you have a slowing of messages in the different areas of your brain.
Blood tests
These tests may help determine other causes of a patient's neurological symptoms.
These tests and methods may help evaluate and diagnose MS and Also help rule out other possible disorders and confirm the diagnosis if it is positive for MS.
Treatment and management of Multiple sclerosis
Currently, there is no cure for this disease. A doctor can suggest a treatment plan depending on factors like-
- Your age, overall health and past medical history
- The severity of the condition
- How well you can handle or tolerate certain medications, treatments or therapies
- How long does your situation last
- Your preference and opinion
Also, the treatment focuses on managing symptoms, reducing the periods when symptoms worsen and slowing down the disease progression. The comprehensive treatment plan may include the following treatment methods-
Disease-modifying therapies(DMTs)
These types of therapies include treatment with several medications approved by the FDA for long-term treatment of MS. These medications may help to reduce the flare-ups or attacks and slow down the progression of the disease. Also, they can help by preventing new lesions from developing on the brain and spinal cord.
Relapse management medications
A neurologist may prescribe high-dose corticosteroids for severe attacks as part of relapse management. The drug can quickly reduce the inflammation and slow down the damage to the myelin sheath.
Physical rehabilitation
Your physical function may be affected by Multiple sclerosis. So, staying physically fit and strong can help you maintain your mobility.
Mental health counselling
Dealing with a chronic condition that may also affect your mood and memory can be challenging. You can take counselling sessions and work with a neuropsychologist, or get emotional support can help you manage the disease more easily.
