All about multiple sclerosis

Multiple sclerosis, is an autoimmune disease. The immune system in humans is designed to protect the body from the ill effects of foreign invaders like viruses, bacteria, fungi, and pollens that can cause harm to the body. For some unknown and not fully understood reasons, the immune system becomes hyperactive and attacks one system or the other of the human body. Depending on the system affected, there are different names for the condition. However, all autoimmune diseases have the common trait of periodic flare ups alternating between periods of relative quiets or remittance. There is considerable variation in the symptoms multiple sclerosis and their intensity and is almost specific to each of the patients.

Multiple Sclerosis is an autoimmune disorder with a faulty immune system where the nerves of the central nervous system, the brain and spinal cord are potentially disabled. The protective sheath of the nerves, called as the myelin layer, is attacked and destroyed. This causes problems in the communication between the brain and the rest of the body. As the disease progresses the nerves themselves deteriorate or permanently damaged

The symptoms of multiple sclerosis, as is with autoimmune diseases, vary considerably in patients. The symptoms of multiple sclerosis enumerated below should be viewed with that perspective in mind. Early symptoms of multiple sclerosis can be any or any combination of the following:

• Weakness or numbness in any one or more than limb, characteristically, occurring on one side of the body.
• Prolonged double vision.
• Complete or partial loss of vision in one eye, one at a time, generally with pain on moving the eye.
• Tingling sensation or pain in different parts of the body
• Electric-shock like sensations with neck movements, especially forward bending. (Lhermitte sign)
• Slurring of speech
• Fatigue
• Dizziness
• Tremor, lack of coordination or unsteady gait.
• Difficulties with bladder and bowel functioning.

These early symptoms of multiple sclerosis progress into a cycle of acute exacerbations. Symptoms of multiple sclerosis flare up for a particular period followed by a period of quietude during which the severity of symptoms of multiple sclerosis decrease and sometimes totally disappear. In about 60 to 70% of patients, the symptoms of multiple sclerosis progress to a steady stage of the disease with or without the remittance. This type of disease progression is called secondary progressive MS. There are also times when the early symptoms of multiple sclerosis just steadily become more and more severe and extensive without the periods of remittance. This type is called primary progressive MS.

Risk factors

• Age: Although multiple sclerosis is known to affect all age groups, people in 15 to 60 years are more susceptible.
• Gender: The female gender appears to have double the affinity to multiple sclerosis than the males.
• Family history: A history of the disease in the family increases your risk of developing it.
• Race: Race seems to have some relation with the potential to develop multiple sclerosis. North European descendants have higher risks than people of Asian, Native American or African descendants.
• Infections: Certain viral infections especially Epstein-Barr causing infectious mononucleosis seems to be linked to multiple sclerosis.
• Lifestyle habits: Smokers experiencing an initial event of symptoms of multiple sclerosis are more likely to develop a second event that confirms multiple sclerosis than non-smokers.
• Climate: Climate seems to play a large part in the development of multiple sclerosis. Temperate climates as in Canada, New Zealand, Europe, Northern parts of US and southeastern Australia are more likely to produce multiple sclerosis.
• Other diseases: Certain other autoimmune diseases like thyroid disease, type-1 diabetes or inflammatory bowel diseases increase the risks. Paralysis of the legs, muscle spasms or stiffness, mental changes like forgetfulness or mood swings, problems with bowel, sexual or bladder functions, epilepsy and depression are some of the complications in multiple sclerosis patients.

Multiple Sclerosis is an autoimmune disease and has no known cause. However, a combination of genetics and environmental factors certainly contribute to its development.

Diagnosis and treatment

There are no specific diagnostic tests for MS. Most part of the diagnosis is the symptom picture and history. Some test like blood and spinal fluid tests are used to eliminate diseases with similar symptoms to that of multiple sclerosis. Test for a specific marker in blood is under development. Brain MRI can show lesions on brain and spinal cord. Evoked potential test shows how fast signals produced due to specific stimuli travels down the spinal cord.

In current knowledge, there are avenues available for treatments of multiple sclerosis, though there is no cure. Treatment needs to be fine tuned frequently to suite the conditions of the patient. In the former category are corticosteroids and plasma exchange when steroids have proved ineffective. In the latter category of treatments for multiple sclerosis, there is the drug called ocrelizumab. This medicine is the only one with FDA approval, and is made for treating primary progressive multiple sclerosis, although debilitating a near normal life for long periods is possible now.