Multiple Sclerosis – Causes, Symptoms and Treatment

Multiple sclerosis is a chronic disorder affecting the central nervous system. It affects the brain and the spinal cord and can cause permanent nerve damage.

What Is Multiple Sclerosis?

In multiple sclerosis, the immune system attacks the myelin sheath that covers and secures the nerve fibers. Myelin sheath helps nerves to conduct electrical signals quickly and efficiently. When the myelin sheath gets damaged, it creates a scar or sclerosis. With progressive lesions and injuries, the nerve fibers get damaged. It causes inflammation and swelling, hindering the normal functioning of the body. 

Types of Multiple Sclerosis

Multiple sclerosis is of four types. It also defines the stages. They are:

• Clinically isolated syndrome: The first and single episode of multiple sclerosis is where the symptoms last for approximately 24 hours. 
• Relapsing  remitting multiple sclerosis: Almost 85% of people are diagnosed with this type. After relapse, the new symptoms might disappear without adding to the level of disability, or the new symptoms might disappear partially, but might still result in an increase in the disability.
• Primary progressive multiple sclerosis: PPMS is characterized by deteriorating neurologic function (accumulation of disability) from the onset of the symptoms, without early remissions or relapses. 
• Secondary progressive multiple sclerosis: SPMS follows an initial relapsing-remitting course but the transition to an advanced secondary course wherein there’s a progressive worsening of neurologic function.

Symptoms of Multiple Sclerosis

Symptoms vary from individual to individual. 

• Weakness or numbness in one/more limbs which typically happens on one side of the body at a time, or the trunk and legs 
• Tremor, lack of coordination or unsteady gait
• Sensations of electric shock that occur with some neck movements (Lhermitte sign)

Vision problems are also common, such as:

• Blurry vision
• Prolonged double vision
• Partial or complete vision loss, generally in one eye at a time, often accompanied by pain during eye movement

Multiple sclerosis symptoms may also include:

• Fatigue
• Slurred speech
• Dizziness
• Problems with bladder, bowel and sexual function
• Tingling or pain in parts of the body

When Should You See A Doctor For Multiple Sclerosis

If you have a few of the abovementioned signs and symptoms, you must get diagnosed with multiple sclerosis. There is no permanent cure for this disorder. An early diagnosis and treatment can aid in fast recovery from immune attacks, alter the course and control the symptoms.

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Diagnosis of Multiple Sclerosis

There are no specific diagnostic tests for Multiple Sclerosis. Meanwhile, a diagnosis often depends upon ruling out other conditions. Your doctor my probably start with a thorough examination and medical history. Your doctor may then suggest:

Blood tests: to exclude other diseases with symptoms similar to Multiple Sclerosis. 

Spinal tap (lumbar puncture): in which a small cerebrospinal fluid’s sample is removed as it can show in antibodies that are linked to Multiple Sclerosis and rule out other conditions.

MRI: which many reveal areas of Multiple Sclerosis (lesions) on your spinal cord and brain. 

Evoked potential tests: in which an electrical signals produced by your nervous system are record in response to stimuli. 

Treatment of Multiple Sclerosis

Multiple sclerosis cannot be cured. The treatments get done to reduce the symptoms and slow down the progression of the disease. Also, mild symptoms do not need any treatment. 

To treat attacks, the doctor may suggest corticosteroids or plasma exchange. Corticosteroids involve oral and intravenous medications. Plasma exchange is also known as plasmapheresis. In this method, plasma are removed from the blood cells. These blood cells are then  mixed with albumin before putting it back into the body.

For primary progression type of  multiple sclerosis, Ocrelizumab is the only FDA-approved disease-modifying therapy (DMT). Treatment options for relapsing-remitting multiple sclerosis include oral and injectable medications. The oral medications include Dimethyl fumarate, Diroximel fumarate, Fingolimod, Cladribine, Siponimod, and Teriflunomide. The injectable medications include Glatiramer acetate and Interferon-beta medications. There are also infusion treatments available to treat multiple sclerosis-like Natalizumab, Ocrelizumab, and Alemtuzumab. Other than medications, physical therapy, and muscle relaxants have proved to be helpful for the treatment. 

The type of treatment to opt for depends upon the stage, and your doctor may suggest the best option as per your stage or type of MS. 

Conclusion

The life expectancy of patients with multiple sclerosis has improved over the years. It has happened due to novel treatment approaches, better healthcare facilities, and lifestyle changes. It can even turn out to be life-threatening. Although, this happens very rarely. 

Frequently Asked Questions (FAQs)

Who is at risk of multiple sclerosis?

The risk factors include the family history of multiple sclerosis, low vitamin D levels, female gender, certain viral infections, smoking, and autoimmune disorders. 

What complications may arise along with multiple sclerosis?

Complications like depression, paralysis of legs, epilepsy, muscle spasms, mood swings, and problems with bladder, bowel and sexual function may arise due to multiple sclerosis. 

Is multiple sclerosis curable?

Multiple sclerosis does not have a permanent cure, but the symptoms and problems arising may be managed by early diagnosis and proper treatment.