Understanding Multiple Sclerosis and the development of this disease

Multiple sclerosis is an autoimmune disease that develops when the immune system of the body attacks the central nervous system, damaging the myelin and nerve fibres that it protects, resulting in inflammation and lesions. As a result, nerve impulses are damaged or disrupted as they travel down the spinal cord. However, the exact cause of this is unknown, but it is thought to be due to an immune system malfunction.¹

Unfortunately, there is no specific test that can be used to diagnose the presence of Multiple Sclerosis. Also, many of the symptoms are indicative of other diseases making the diagnosis difficult. Many tests are conducted to diagnose Multiple Sclerosis and also to rule out other conditions such as CNS infections, CNS inflammatory disorders and genetic disorders.² A neurological examination is conducted to detect reduced nerve function either in one area of the body or over many parts. They include abnormal nerve reflexes, decreased or abnormal sensation and other loss of nervous system functions. An eye examination can be conducted to check abnormal pupil responses, changes in the visual field or eye movements, decreased visual acuity, problems with the inside parts of the eye and rapid eye movements triggered when the eye moves.³ Other tests which can be conducted are lumbar puncture (spinal tap) for cerebrospinal fluid tests, MRI scan of the brain, MRI scan of the spine, nerve function study and many blood tests.

Multiple Sclerosis can affect people in the age group of 15 to 60. Most people affected by this disease are around the age group of 30 but it can occur in people of all age groups with the exception of children, where the occurrence is rare.⁴ Although the occurrence of Multiple Sclerosis is not hereditary, having a first-degree relative with the disease contributes to the risk factor. Also, women are more prone to contracting the disease than men with most women getting the disease before menopause indicating the role of hormones in it. As for men, the severity of the disease is more for them as compared to women.

Multiple Sclerosis symptoms vary depending on the degree of nerve damage and the nerve involved. People with severe cases of Multiple Sclerosis may be unable to walk independently, while others may go into remission for long periods of time without developing new symptoms. Double vision or loss of vision, numbness, tingling, or weakness, paralysis, vertigo or dizziness, erectile dysfunction, pregnancy, walking difficulties, vertigo, vision problems, muscle spasticity, tremor, slurred speech, fatigue, and painful involuntary muscle contractions are all common symptoms of the disease.

There are four types of Multiple Sclerosis. The initial attack where the symptoms may last for a day is a clinically isolated syndrome. The most commonly occurring type is Relapse-Remitting Multiple Sclerosis wherein the symptoms respond to treatment and then resolve. This type is indicated by inflammatory attacks on the myelin and nerve fibres causing the worsening of neurological function. Remission episodes last for weeks to years. The second type is Secondary-Progressive Multiple Sclerosis where symptoms of an exacerbation are not resolved during a remission. Most people having Relapsing-Remitting Multiple Sclerosis transition to Secondary-Progressive Multiple Sclerosis. The third type is Primary Progressive Multiple Sclerosis where the symptoms worsen over a period of time, without remission episodes. It is the least common type of Multiple Sclerosis occurring in only about 5% of the patients. The fourth and last type, which is Progressive-Relapsing Multiple Sclerosis where symptoms escalate over time along with intermittent episodes of remission.

Although there is no cure for Multiple Sclerosis, some conventional treatments can help with symptoms and reduce the frequency and severity of relapses. As a result, medications are used to reduce the severity and frequency of relapses. High doses of corticosteroids, for example, can be used to treat exacerbations or attacks. Rehabilitation can help improve one’s fitness and energy levels. Emotional support for the patient and/or family members can sometimes be beneficial in coping with the disease.