Unfolding Multiple Sclerosis: From Causes To Management Strategies

Unfolding Multiple Sclerosis: From Causes To Management Strategies

World Multiple Sclerosis (MS) Day is observed on 30th May every year. The theme for this year is connections, which means building community connections, self-connection and connections to quality care.

Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the central nervous system which is known to affect around 2.5 million adults across the globe[1]. According to a 2015 study published in PLoS One[2], the prevalence of MS in India is likely to be around 8 per 100,000. The condition is seen to affect the young population (preferably in the age group of 25 to 30 years) and is seen more commonly in women as compared to men.

So on this World MS day, let’s understand the basics of this condition and its management for quality care and life.

What is multiple sclerosis?

Multiple sclerosis is a chronic, typically progressive disease which affects your spinal cord, brain, and the optic nerves present in your eyes. It is an autoimmune disease, which means the immune cells in the body attack its own cells causing an inflammatory response.

In this, the immune system attacks the myelin sheath (which is the protective covering of the nerves) resulting in nerve damage. This causes a disruption in the communication between the brain and the body.

What causes multiple sclerosis?

The exact cause underlying multiple sclerosis is unknown. However, extensive research has shown that both environmental and genetic factors play a significant role. Studies[3]  have shown that genetic factors such as alterations in the HLA-DRB1 and IL7R genes potentially increase the risk of MS. 

Certain environmental factors also play a major role in its pathogenesis. Some of them are listed below:

– Smoking

– Exposure to certain viruses (especially Epstein-Barr virus, or human herpesvirus 6)

– Low levels of Vitamin D

– Excessive salt intake in the diet

What are the symptoms of multiple sclerosis?

People with multiple sclerosis can experience a wide range of symptoms from fatigue and weakness to physical disability. Also, the symptoms and the severity of the disease can vary from one person to another. In severe cases, it can impair your vision, and interfere with muscle control and other basic body functions. 

Following are the common symptoms observed during the course of MS:

– Numbness or weakness in limbs particularly felt on one side of your body at a time, or the legs and trunk

– Partial or complete vision loss, often associated with pain during eye movement

– Prolonged double vision

– Tingling or pain in the body

– Electric-shock sensations occurring with neck movements, mainly while bending the neck forward

– Lack of coordination or unsteady posture

– Slurred speech

– Fatigue

– Dizziness

– Altered bowel and bladder function

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How to confirm if you have multiple sclerosis?

There’s no single test to confirm the diagnosis of multiple sclerosis; however, a combination of physical examination and diagnostic tests can help reach a diagnosis. A relevant medical history along with key signs of nerve damage in your brain, spinal cord, and optic nerves may be helpful for a physician in ruling out MS. Blood tests also help in differentiating multiple sclerosis from similar diseases such as Lyme disease and acquired immunodeficiency disease (AIDS). Magnetic resonance imaging (MRI), visual evoked potentials (examination for analysis of electrical activity of the brain) and spinal fluid analysis are a few other investigations that can aid in the diagnosis of MS.

How to manage multiple sclerosis?

There is no cure for MS. The treatment is aimed at alleviating the symptoms with the use of medications like corticosteroids. However, these drugs do not stop the neurodegeneration but improve the severity of the symptoms and quality of life. 

Although multiple sclerosis cannot be completely cured, several management strategies can improve the symptoms and keep the body working well. Doctors usually prescribe 

– Steroids or interferon beta-1α that make multiple sclerosis attacks less severe

– Muscle relaxants that help ease out muscle spasms.

Physiotherapy as well as other physical activities such as regular exercises can help in reducing fatigue and pain and also improve control over the symptoms related to coordination and posture.

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If MS is due to underlying autoimmune disorders, specific therapies should be undertaken to modify the disease process. Managing MS is an ongoing process that involves high quality, comprehensive, interdisciplinary care. It is always advisable to start with the very first symptoms and continue throughout the disease course.

Multiple sclerosis can be managed with the right treatment and therapy. So this world MS day, let’s spread proper awareness about this condition and help everyone know about it. Also, share the article with as many people as you can to do your bit in spreading awareness about the condition.

Recommended Reads:

Feel Tired All The Time? It Could Be Chronic Fatigue Syndrome

World Multiple Sclerosis (MS) Day: 5 Facts Everyone Must Know!

References:

1. Surya N. Rehabilitation of multiple sclerosis patients in India. Ann Indian Acad Neurol. 2015 Sep;18(Suppl 1):S43-7. https://www.ncbi.nlm.nih.gov/pmc/articl es/PMC4604697/

2. Malli C, Pandit L, D’Cunha A, Mustafa S. Environmental factors related to multiple sclerosis in Indian population. PLoS One. 2015 Apr 22;10(4):e0124064. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4406747/   

3. Singhal BS, Advani H. Multiple sclerosis in India: An overview. Ann Indian Acad Neurol. 2015 Sep;18(Suppl 1):S2-5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604693/

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