multiple sclerosis

WHAT IS MULTIPLE SCLEROSIS?

Multiple sclerosis (MS) is an autoimmune disease in which one’s own immune system repeatedly attacks and damages the myelin cover of neural cells within one’s central nervous system. This chronic, potentially disabling condition can lead to difficulties in movement, coordination, respiration, vision and more. 

MULTIPLE SCLEROSIS SIGNS AND SYMPTOMS

Over 90% of people with multiple sclerosis have the relapsing-remitting variety of the disease, while the remaining percentage have other forms such as the primary progressive variety. Those with the relapsing-remitting variety typically present with acute symptoms called relapses. Common symptoms of MS relapse include:

Over 90% of MS patients have the disease’s relapsing-remitting variety. Those with the relapsing-remitting variety typically present with acute symptoms called relapses. Common symptoms of MS relapse include:

• Lhermitte’s sign, which involved electric-shock-like sensations going down the neck and lower back after certain neck movements
• Optic neuritis, which involves sudden, painful partial or total vision across a few days
• Numbness or weakness in the limbs
• Tingling in the face

Most people recover from MS relapses, with some experiencing chronic residual symptoms that can lead to more significant disabilities over time such as:

• Gradual loss of independent ambulation
• Stiffness in the legs and/or arms
• Tremors and unstable gait
• Loss of sphincter control
• Gradual fatigue

MULTIPLE SCLEROSIS RISK FACTORS

The exact cause of multiple sclerosis remains unknown. However, MS experts believe that a combination of genetic susceptibility and environmental factors. Some established risk factors include:

• Family history in first-degree relations
• Race – Caucasian people are at a higher risk
• Low levels of sun exposure
• Low levels of vitamin D
• Living in colder climates
• Age under 40
• Female gender
• Obesity

MULTIPLE SCLEROSIS DIAGNOSIS

Diagnosis of multiple sclerosis often requires ruling out other specific conditions with similar symptoms. This usually requires skilful documentation of medical history and a comprehensive physical examination. This assessment will often be followed by other tests that help to clarify the nature of the underlying diagnosis. Some of these tests include:

BLOOD TESTS: These help rule out other diseases with symptoms similar to MS. This will usually include inflammatory markers, autoimmune antibodies, work-up for vasculitides, etc.

LUMBAR PUNCTURE: During this procedure, a small amount of spinal fluid will be drawn through a needle placed in your lower spinal canal. This fluid will be examined for the presence of special proteins called oligoclonal bands which tends to be positive in up to 90% of MS patients.

MAGNETIC RESONANCE IMAGING (MRI): This is gradually becoming the most important MS diagnosis and monitoring test. It can help identify areas of damage to myelin in the brain and spinal cord.

MULTIPLE SCLEROSIS TREATMENT

While no definitive MS cure has been found, several treatment options for MS relapses and disease progression are available.

TREATMENT FOR MULTIPLE SCLEROSIS RELAPSES/ATTACKS

CORTICOSTEROIDS: Intravenous corticosteroids that are usually administered to reduce inflammation flare-ups that occur during relapses.

PLASMAPHERESIS: During this procedure, your plasma is exchanged in order to remove the inflammation mediators. This treatment is administered in rare cases where relapses do not respond to corticosteroids.

DISEASE-MODIFYING TREATMENTS FOR MULTIPLE SCLEROSIS

These medications are given regularly to help slow the progression of MS, and include:

BETA INTERFERONS: They are one of the first and safest prescribed injectable MS medications. 

GLATIRAMER ACETATE: Needs to be injected beneath the skin.

FINGOLIMOD: A daily oral treatment.

OCRELIZUMAB: This promising new humanized immunoglobulin antibody works for more severe and resistant MS cases, in addition to the progressive form of MS.

NATALIZUMAB: This drug helps block the movement of potentially damaging immune cells from your bloodstream to your nervous system. Usually, it’s used as a second-line treatment option for more aggressive forms of MS.

ALEMTUZUMAB: This medication reduces your immune response to limit the damage caused by the disease.