It is a chronic condition that affects the brain and spinal cord (central nervous system). This happens due to immune attacks on healthy tissues same as it attacks foreign infections from viruses or bacteria.
Types and stages of multiple sclerosis:
Four types of multiple sclerosis are there:
Clinically isolated syndrome (CIS):
The SINGLE and FIRST EPISODE of this type of multiple sclerosis lasts for twenty-four hours. If a second episode happens it might lead to another type that is relapse-remitting multiple sclerosis.
Relapse-remitting multiple sclerosis (RRMS):
It is the most common type of multiple sclerosis and about eighty-five percent of people have this type of multiple sclerosis. In this type, new episodes of symptoms are seen with several remissions. In the remission phase, symptoms may come and go.
Primary progressive multiple sclerosis (PPMS):
Without any relapse or remission, symptoms get worst progressively. This type of multiple sclerosis is found in around fifteen percent of patients. There is a stability phase in this kind, where symptoms may get worst and then get better slowly.
Secondary progressive multiple sclerosis (SPMS):
In this kind, some patients may undergo many episodes of relapses and remission. At last, this condition began to progress slowly and steadily.
Sign and symptoms of multiple sclerosis: (1)
Symptoms may affect any part of the body because multiple sclerosis damages the central nervous system. Common signs and symptoms of multiple sclerosis are:
- Weakness of muscle:
Due to low stimulation and nerve damage, weakness of muscles is very common among people with multiple sclerosis.
- Numbness and tingling:
Symptoms are felt as needles or pins-type sensations in the body especially the face, legs, or arms.
- Lhermitte’s sign:
A sensation of ELECTRIC SHOCK is felt when you move your neck or turn it. This sensation is called Lhermitte’s sign.
- Bladder problems:
Patients with multiple sclerosis feel difficulty in urinating and emptying their bladder. Sometimes they feel a frequent need to urinate; this condition is known as URGE INCONTINENCE. When a patient loses control of his bladder, it is the earliest sign of multiple sclerosis.
- Bowel problems:
Faecal impaction is caused due to constipation. It sometimes leads to incontinence of the bowel.
- Fatigue:
When a person feel tired to work at home. He is more likely to develop multiple sclerosis. It is one of the earliest signs and symptoms of multiple sclerosis.
- Dizziness and vertigo:
It is the most common problem and it arises due to coordination problems.
- Sexual dysfunction:
The early sign and symptoms of multiple sclerosis are when both males and females start losing their interest in sex.
- Spasticity and muscle spasms:
It is also one of the earliest signs and symptoms of multiple sclerosis in which spasms occurred due to damage of nerve and muscles of the legs felt pain.
- Tremor:
Some patients with multiple sclerosis experience involuntary movements.
- Vision problems:
Double or blurred vision is very common among people with multiple sclerosis. One eye is mostly affected in this case. Pain is felt in the eye due to inflammation of the optic nerve. The problem in vision is also the early sign and symptom of multiple sclerosis.
- Gait and mobility changes:
Due to problems in balance and coordination, people may feel difficulty walking. It also happens due to the weakness of muscles and dizziness.
- Emotional changes and depression:
DEMYELINATION and NERVE FIBER causes deterioration in the CNS that results in a change of emotions and causes depression.
- Learning and memory problems:
People with multiple sclerosis feel difficulty in learning, concentrating, planning and multitasking.
- Pain:
The most common symptom of multiple sclerosis is pain. People feel neuropathic pain due to multiple sclerosis. Some other pains are felt due to stiffness and numbness of muscles.
Some less common signs and symptoms of multiple sclerosis are:
- Seizures
- Loss of hearing
- Headache
- Speech disorders
- Problem in swallowing
- Breathing problems
- Respiratory infections
- Itching
- Sensitivity to heat.
Causes and risk factors of multiple sclerosis:
The exact cause of multiple sclerosis is still unknown to researchers. It is said that multiple sclerosis happens due to an autoimmune attack, when the immune system suddenly attack the healthy tissues. Risk factors associated with multiple sclerosis are:
Age: people are mostly diagnosed with multiple sclerosis at the age of twenty to forty.
Sex: multiple sclerosis can affect both men and women at the same time.
Genetic factors: it is thought that genes play a vital role in developing multiple sclerosis. But scientists believe that environmental factors are responsible to develop multiple sclerosis.
Smoking: if a person smokes he is at higher risk of developing multiple sclerosis. It happens because they have more shrinkage and lesions in the brain as compared to non-smokers.
Infections: there is no definite link between infections and multiple sclerosis but scientists believe that exposure to certain viruses such as EPSTEIN BARR VIRUS, puts the person at risk of developing multiple sclerosis. Herpes virus and mycoplasma also play definite roles in developing multiple sclerosis.
Vitamin D Deficiency: sunlight is necessary to create vitamin D in our bodies. Less exposure to sunlight means a low level of vitamin D in the body. Scientists believe that vitamin deficiency causes multiple sclerosis.
Vitamin B12 deficiency: production of myelin needs vitamin B. If vitamin B is low in the body it causes neurological damage like multiple sclerosis.
What is the treatment of multiple sclerosis? (2)
No specific cure is available for multiple sclerosis. Treatment is given to managing the symptoms of multiple sclerosis.
Treatment for multiple sclerosis attacks:
- Corticosteroids:
Prednisone and methylprednisolone are prescribed to reduce the inflammation of nerves.
- Plasma exchange: plasma is removed from the blood and then it is mixed with the solution of protein and placed back in the body. This procedure works when steroids fail to respond.
Treatment to modify progression:
This treatment includes injectable and oral medications
Injectables:
Injectable treatment includes the following medications:
- Interferon-beta medications
- Glatiramer acetate
Oral medications:
- Fingolimod
- Dimethyl fumarate
- Proximal fumarate
- Teriflunomide
- Siponimod
- Cladribine
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