Multiple Sclerosis (MS) is an inflammatory immunological disease that targets myelinated axons in the central nervous system, thereby destroying them in varying degrees in more than 30 percent of individuals and causes substantial physical impairment within 20 to 25 years. MS is characterized by symptomatic events occurring months or years apart and affecting distinct anatomical sites.

Multiple sclerosis (MS) can damage the brain and backbone and cause a range of possible symptoms including issues of vision, arm or leg motion, feeling or balance. The disease can cause many more symptoms. This can sometimes produce a significant impairment, however occasionally it might be moderate. This is a lifelong disease. It is usually diagnosed in early 20s and 30s and is comparatively more common in women than men.

Types

There are mainly 4 types of multiple sclerosis named as:

  1. Relapsing-remitting MS (RRMS)
  2. Primary-progressive MS (PPMS)
  3. Secondary-progressive MS (SPMS)

Relapsing-remitting MS (RRMS)

It is the most common type of MS. When you have RRMS you may experience:

  • Clearly identifiable recurrences or flare-ups leading to intensive deterioration of your neurological function
  • partial or full remissions or healing periods between episodes following recurrence and when disease ends
  • mild to severe symptoms with relapses and remissions of longer days

Primary-progressive MS (PPMS)

Slowly yet steadily, this kind of MS advances from its inception. There are no times of remission and symptoms remain at the same degree of severity without diminishing. Essentially, PPMS patients have a very constant deterioration.

Secondary-progressive MS (SPMS)

It may initially entail a reappearance-sending stage with symptomatic outbreaks followed by intervals of recuperation. Persons with SPMS may have mild symptoms, although this is not always the case.

Causes

There is no specific cause but multiple theories show that:

  • Geography – people who live in colder parts tend to catch the disease more likely than people living in warmer regions
  • Smoking – tobacco can be a cause to increase the risk
  • Genetics – genes do play a vital role. Siblings have a 3% to 5% chance if a brother or sister has it
  • Vaccines –researches tell vaccines maybe a cause too
  • Lack of sunlight or vitamin D deficiency
  • Teenage obesity
  • Viral infections

 

 

 

Signs and symptoms

Symptoms of MS vary and cannot be predicted. There are no two persons with exactly the same symptoms, and throughout time, the symptoms of each person may alter or vary. One person may have only one or two of the potential symptoms, while another may have many more.

  • MS hug (Dysesthesia) – A MS hug is a squeezing feeling around the torso, often the initial sign of MS or a relapse, which feels as though it tightens a blood pressure cuff
  • Fatigue – mostly occurs in around 80% of people, thus causing difficulty in working
  • Walking difficulties – weakness, loss of balance, sensory deficit are included in it
  • Numbness or tingling – face, body, hands or arms face numbness
  • Spasticity – muscle spasms, especially in legs
  • Weakness – overall weakness in the body due to unused muscles of the body
  • Feeling of lethargy
  • Vision problems – blurred vision, optic neuritis, neuromyelitis optica, and pain on eye movement can be terrifying
  • Vertigo and dizziness – lightheadedness, feeling of balancing off, and having the sensation that their surrounding is spinning
  • Bladder problems – bladder dysfunction can occur in 80% of the people that can be treated easily
  • Sexual problems – Very prevalent among the public, including MS individuals. The impairment in the central nervous system and the symptoms such as tiredness, stiffness and psychological issues might influence sexual responses.
  • Bowel problems – constipation is the main concern as is loss of control of bowels
  • Pain and itching – pain syndromes are common in MS with clinically significant pain while others have chronic one
  • Cognitive changes – Refer to a variety of high brain features in more than 50 percent of MS patients that include processing incoming information, learning and remembering new knowledge, organizing and resolving problems, focusing attention on the environment and seeing the world properly.
  • Depression – It is more prevalent for those with MS than for those with many other chronic and disabled illnesses in the general population. Depression may be both primary and/or caused by the disease’s own difficulties.

Diagnosis and Treatment

A doctor medically investigates by taking medical history and by conducting some tests that include:

  • Blood tests – can help exclude other symptom-like illnesses like MS. Tests are being development on certain MS-related biomarkers and may possibly help diagnose the illness
  • Spinal tap (lumbar puncture) – For laboratory analysis, a tiny cerebrospinal fluid sample is taken from your spinal canal. Antibodies that are linked with MS may present abnormalities in this sample. A spinal tap can also help exclude MS-like infections and other illnesses.
  • MRI – that can reveal your brain and spinal cord regions
  • Evoked potential Tests – which record in reaction to stimuli electrical impulses generated by your neurological system. A potentially reminiscent test can employ visual stimuli or electric stimuli.

Treatment/Medication

  • Corticosteroids – Nerve inflammation reduction is advised to include oral prednisone and intravenous methylprednisolone. In addition, sleeplessness, blood pressure, blood glucose, mood and retention of fluid might have side effects.
  • Plasmapheresis (plasma exchange) – The fluid portion of the blood (plasma) is extracted from your blood cells. The blood cells are then blended with an albumin solution and returned to the body.

Injectable treatments include;

  • Interferon beta medications: they are injected in the muscle or under the skin and can reduce the severity of relapses
  • Glatiramer acetate (Copaxone): This can help prevent myelin assault from your immune system and must be administered under the skin

Oral treatments include;

  • Dimethyl fumarate
  • Diroximel fumarate
  • Siponimod
  • Cladribine

Physical therapy is prescribed for the people with multiple sclerosis. Muscle relaxants are also prescribed for uncontrollable muscle stiffness. Dalfampridine can assist to speed up in certain persons marginally (walk speed). This drug must not be used in anyone with a history of seizures or renal problems.

 

References

 

[i] https://www.healthline.com/health/multiple-sclerosis/types-of-ms#secondaryprogressive

[ii] https://www.nhs.uk/conditions/multiple-sclerosis/causes/