Have you been observing visual changes, numbness, weakness, signs, and symptoms of vertigo and in-coordination of the muscles in your body? By visiting your doctor, and listening to the signs and symptoms, your doctor will diagnose you with Multiple Sclerosis.
It is a potentially disabling disease of the brain and spinal cord (Central Nervous System).
It attacks the protective sheath (myelin) that covers the nerve fibers and causes communication problems between your brain and the rest of your body.
Multiple Sclerosis (MS)
This is also known as Encephalomyelitis Disseminate, in which the insulating covers of the nerve cells in our body and cause damage to the brain and the spinal cord.
This damage, however, disrupts the ability pats of your nervous system to transmit signals that results in physical, mental, and sometimes psychiatric problems.
It is a long-lasting disease that can affect parts of your brain and spinal cord causing problems with vision, balance, muscle control, and other basic functions of your body.
It happens when the immune system of your body attacks the fatty materials, Myelin, which wraps around the nerve fibers to protect them.
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Types of MS
There is no definite way to predict how an individual’s ms will progress, however, four basic types of MS courses have been defined by the International Advisory Committee on Clinical Trial of MS in 2013.
These are as follows:
Clinically Isolated Syndrome (CIS): It causes first episodes of neurologic signs and symptoms due to inflammation and demyelination in the central nervous system.
Relapsing-Remitting MS (RRMS): This is the most common course of the disease and is defined by attacks of new or increasing neurologic symptoms.
Secondary Progressive MS (SPMS): People who undergo the course of RRMS eventually transition to the secondary progressive course in which there is worsening of neurologic conditions and functions.
Primary Progressive MS (PPMS): In this course, there is worsening of neurologic functions without early relapse or remissions.
Symptoms of Multiple Sclerosis
The signs and symptoms of Multiple Sclerosis (MS) can differ from one person to another. It is also considered an immune-mediated disease.
It also depends on the location of the nerve fibers and their effects. Such as:
- Numbness or weakness in one or more limbs of your body or your legs or trunk
- Electric-shock sensations can occur with certain neck movements, especially bending your neck forward
- tremor, lack of coordination in the body, or unsteady gait
It also affects the optical nerves and can cause:
- Partial or complete loss of vision
- Double Vision
- Blurry Vision
The symptoms might also include slurred speech, fatigue, dizziness or vertigo, tingling or pain in parts of your body, problems with sexual, bowel, and bladder function.
The Course of The Disease
People with MS have a relapsing-remitting disease course. They will experience periods of new symptoms or relapses that will develop over days or week
However, they usually improve partially or completely. These are filled by quiet periods of disease remission that can last for months or even years.
Small increases in the temperature of your body can temporarily worsen the symptoms of MS but these are not the real disease relapse.
50% of the people experience a steady progression of symptoms with or without remission within 10 to 20 years.
This is known as Secondary Progressive MS.
With time as the symptoms worsen, you will notice problems with mobility and gait.
However, the rate of progression of this disease varies from person to person with secondary progressive MS.
Some people might experience a gradual onset and steady progression of signs and symptoms without any relapses.
This is known Known as Primary Progressive MS.
The Causes of Multiple Sclerosis
So far the cause of multiple sclerosis is unknown. It is an auto-immune disease in which your body’s immune system will attack its own tissues.
As a result of this malfunction, it destroys the fatty substances that coat and protects the nerve fibers in your brain and spinal cord.
When there is damage to the protective myelin and the nerve exposes, the messages that travel along that nerve may slow down or block.
The reason for the development of this disease is not yet clear. A combination of Genetic and Environmental factors is somewhat responsible.
There are certain complications of Multiple Sclerosis and they tend to get worse as the disease progress.
People with MS may also develop muscle stiffness or spasm. They might also develop paralysis, in most cases In the lower limbs, problems with bladder, bowel, and sexual functions.
You will observe mental changes such as forgetfulness and mood swings and mental disorders like depression and epilepsy.
Diagnosis of MC
So far there are no tests for Multiple Sclerosis. Diagnosis of this disease depends on ruling out other conditions that might produce similar signs and symptoms.
Your doctor will likely start with medical history and examination. They may also recommend:
Blood Tests: This helps to rule out other diseases with symptoms that are similar to multiple sclerosis.
These tests check for specific markers that develop due to this disease and may also aid in diagnosing the disease.
Spinal Tap: In this test, your doctor will take a sample of spinal fluid and send them for analysis in the lab.
This sample can show certain abnormalities in the antibodies. A spinal tap can also rule out infections and other conditions that are similar to Multiple Sclerosis.
MRI: This can reveal the lesions on your brain and spinal cord. you might receive an IV of a contrast material to highlight the lesions.
This will indicate that the disease is in an active phase.
Evoked Potential Tests: This records the electric signals that our body produces in response to stimuli.
This test uses visual stimuli or electric stimuli and you can watch a moving visual pattern or short electric impulses.
These electrodes measure how quickly the information travels down the nerve pathways in your body.
In most cases, the diagnosis is fairly straightforward and is based on the pattern of symptoms that are consistent with the disease.
Your doctor can confirm it by brain imaging scans like MRI.
However, diagnosis can be fairly difficult in people who do not show symptoms or progressive disease.
In such cases, further testing will find fluid analysis, evoked potential and additional imaging may be required.
There is no cure for Multiple Sclerosis, however, the treatment focuses on speeding recovery from attacks, slowing the progression of the disease, and managing the signs and symptoms of this disease.
Some people have only mild symptoms that require no treatment.
To treat signs and symptoms of MS your doctor may prescribe certain medications.
Treatment for Attacks
Your doctor will prescribe the following in case of attacks:
- Corticosteroids: These reduce nerve inflammation and include oral prednisone and intravenous methylprednisolone. The side effects may include insomnia, varying blood pressure, changing glucose levels, mood swings, and fluid retention.
- Plasma Exchange: This will remove the liquid portion of part of your body i.e. plasma and separates it from blood cells. They are then mixed with a protein solution (albumin) and put back into the body. If your symptoms are new, then your doctor will use this treatment however, severe cases do not respond.
Treatments to Modify Progression of Multiple Sclerosis
Ocrelizumab is the only FDA-approved disease-modifying therapy for primary progressive MS.
People who receive this treatment are less likely to have progression in the disease than those who do not get treatment.
Several disease-modifying therapies are available for people who have relapsing-remitting MS.
Many of these have significant health risks and selecting the right therapy depends on careful consideration of many factors.
These factors are durations and severity of the disease, effectiveness of previous MS treatment, other health issues, cost, and child-bearing status.
Treatment options include injectable and oral medications. The injectable treatments include:
Interferon Beta Medications: Your doctor will inject them under the skin or into your muscles and can reduce the severity and frequency of relapses.
Glatiramer Acetate: This medication stops your immune system from attacking the myelin and your doctor will inject them beneath your skin.
Common side effects are skin irritation at the injection site.
Oral Treatments are:
Fingolimod: This medication reduces the relapse rate and is taken once daily. Side effects are changes in blood pressure, headaches, blurred vision.
Dimethyl Fumarate: This twice-daily medication reduces relapse. Common side effects are flushing, diarrhea, nausea, and low white blood cell count.
Siponimod: Research shows that it can reduce the relapse rate and slow the progression of MS.
It is also approved for secondary progressive MS. However possible side effects are changes in heart rate, viral infections, low white blood cell count.
Treatment for Signs and Symptoms
Your doctor will advise you for physical therapy to build and strengthen the signs and symptoms of Multiple Sclerosis.
Muscle relaxants ease up muscle stiffness and ease pain in your body and muscles.
They will prescribe you medications to reduce fatigue like Amantadine, modafinil, and methylphenidate.
Medications o increase your walking speed however if you have a history of seizures it is not recommended for you.
Many people use alternative or complementary treatments or both of these medications to help manage their symptoms such as fatigue and muscle pain.
Activities such as exercise, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques can help boost overall health and physical well-being.
Some researches strongly indicate that oral cannabis extract (OCE) can help improve muscle spasticity and pain.
A daily intake of Vitamin D3 of 2,000-5,000 can be used as an additional treatment.
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These factors can increase your risk of developing Multiple Sclerosis. These are:
Age: It can occur at any age but usually occurs around 20-40 years of age.
However, any age group can be affected due to it.
Sex: Research suggests that women are more likely than men to develop this disease.
Infections: Certain infections like Epstein-Barr can cause this disease.
Family History: If one or both of your parents suffer from this disease, you have a higher chance of developing this disease.
Autoimmune Disease: Certain autoimmune diseases like anemia, psoriasis, Type 1 diabetes, and inflammatory bowel disease can increase your chances of developing this disease.
With the passage of time and continuous research, doctors are giving better treatment, a better idea of what causes it, and the ability to diagnose it earlier.
Stem cell and genetic research may soon help doctors to repair the damage to the nerves of your body and even to stop the damage before it spreads and causes damage.
In case, you have either one or both of your parents with Multiple Sclerosis and you have developed an autoimmune disease, it is important to consult your doctor as soon as possible and take measures as suggested by your doctor to slow the progression of this disease.