Multiple Sclerosis is a disabling disease that can potentially affect the central nervous system, especially the brain, spinal cord and optic nerves. It is termed as a progressive disease of the nervous system that causes communication problems between the brain and the rest of the body, informs Dr Rahul Bhargava, director, hematology, haemato – oncology and bone marrow transplant, Fortis Memorial Research Institute, Gurugram.
In multiple sclerosis, the immune system affects the protective sheath called myelin which covers the nerve fibres which causes the problem of communication. In due course, the disease can cause damage or deterioration of the nerves which can be permanent in nature.
Symptoms of the condition vary widely and primarily depends upon which nerves are affected and the amount of damage caused. Those who have severe MS may lose the ability to independently walk while others may suffer from remissions for longer periods without showing any new symptoms.
Multiple sclerosis may affect any age group but is primarily seen in the age group of 20 to 40 years of age. It is likely to affect women more than men and smokers tend to have more lesions and brain shrinkage and are thus, more likely to develop the disease.
The symptoms of MS may vary from person to person. People may suffer from following:
*Numbness in one or more limbs. This may typically occur on one side of the body at a time, of the legs, lack of coordination or unsteady gait.
*Electric-shock sensations which may occur from movements in neck, especially in case of bending the neck forward.
*People may witness weak muscles due to nerve damage.
*People may suffer from bladder problems where they may feel the need to urinate or may face difficulty in emptying their bladder.
*People may also suffer from constipation which can lead to bowel incontinence.
*Fatigue or lethargy is one of the common symptoms.
*Muscle spasm and spasticity is an early sign of MS.
*Some people may experience vision problems which may include, double or blurred vision, a partial or total loss of vision.
*It usually affects one eye at first.
*Triggered emotional changes.
*Memory problems can make it difficult for some to concentrate, learn and multitask.
There are no specific tests for diagnosing multiple sclerosis. It often depends upon ruling out other conditions that might produce similar signs and symptoms. Your doctor will first take a thorough medical history and examination and suggest following:
*Blood tests, to help rule out any other diseases which may have similar symptoms to that of MS.
*Spinal tap (lumbar puncture) – It is a simple process in which a small sample is removed from your spinal canal for laboratory analysis. This sample can show abnormalities in antibodies that can be linked with MS. A spinal tap also helps in ruling out diseases which may have similar symptoms to that of MS.
*Getting MRI can reveal areas of MS (lesions) on your spinal cord or brain.
*Evoked potential tests – Through this test, electrical signals are produced by your nervous system in response to stimuli, which is recorded. Electrodes measure the quickness with which the information travels down your nerve pathways.
Although there is no sure cure for multiple sclerosis, the treatment typically focuses on slowing the progression of the disease, speedy recovery from attacks and tremors and managing the symptoms. Some treatment options are:
Corticosteroids is prescribed to reduce nerve inflammation. However, it may also show some side-effects like insomnia, increased blood pressure and mood swings.
Plasma exchange – The liquid portion from part of your blood (plasma) is separated and removed from blood cells in your body. The blood cells are then mixed with albumin which is a protein solution and put back into your body. This plasma exchange treatment is an option when your symptoms are new and severe, and your body has not responded well to the steroids.
Mobility and balance – To treat this, physical therapy may be recommended and drugs like dalfampridine to deal with the problem may be used.
Tremor: To deal with this, assistive devices or attaching weight to the limbs may be recommended to reduce shaking.
Pain: Anticonvulsant or alcohol injections may help to relieve trigeminal neuralgia.
You may experience painful stiffness or spasms, particularly in your legs. Muscle relaxants may help in reducing the pain and stiffness.
Medications to reduce fatigue
Medication to increase walking speed. Some drugs help increase walking speed in some people. Medications also may be prescribed for pain, depression, insomnia, and bladder problems that are associated with MS. Consult your physician before taking such medicines.