Multiple Sclerosis

Multiple Sclerosis: When Your Own Immune System Attacks Itself

Multiple sclerosis (MS) is a chronic disease or an autoimmune disorder that affects the central nervous system, which consists of the brain, spinal cord, and optic nerves. It is a potentially disabling disease of the brain and spinal cord (central nervous system) and can lead to a wide range of symptoms throughout the body. 

When a person has an autoimmune disease, the immune system attacks healthy tissue, just as it might attack a virus or bacteria. For MS, the immune system attacks the protective sheath (myelin) that covers nerve fibres and causes communication problems between your brain and the rest of your body. 

Eventually, the disease can cause permanent damage or deterioration of the nerves. It is also not possible to predict how multiple sclerosis (MS) will progress in any individual.

Signs and Symptoms of Multiple Sclerosis

The signs and symptoms of Multiple Sclerosis vary widely and may depend on which nerves are affected, and the amount of nerve damage caused by MS. 

Here are some common early MS symptoms which often affect movement and sometimes vision problems:

  • Blurred vision
  • Difficulty walking 
  • Dizziness
  • Numbness
  • Tingling in limbs
  • Weakness/ Fatigue

Other significant signs include muscle stiffness, speech disorders/ slurred speech, problems with balance and co-ordination, swallowing problems, thinking problems, and bladder (urinary) & bowel problems. 

Some people with severe MS may experience paralysis and mobility problems like losing the ability to walk independently or at all. Some may also include vision loss while others may experience long periods of remission without any new symptoms. However, these severity symptoms are not common. 

The symptoms of MS may look like other health conditions or problems, and it is important to understand that MS affects individuals differently.

Everyone’s experience with MS is different where these losses may be temporary or long lasting. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. For others, the symptoms may worsen rapidly, and it can be within weeks or months.

It is advisable to consult a doctor if you experience any of the above symptoms for unknown reasons.

Types of Multiple Sclerosis

Multiple Sclerosis is unique across individuals, but there are four major types that can be identified:

  • Relapse-remitting Multiple Sclerosis (RRMS): This is the most common form and most people who have MS are initially diagnosed with the RRMS type. It usually starts in the 20s or 30s and involves episodes of new or increasing symptoms. This is followed by periods of remission, during which symptoms may go away partially or totally. 

Relapses often occur without warning, but are sometimes associated with a period of illness or stress.

  • Clinically isolated syndrome (CIS): This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs later, a doctor might diagnose it to be relapse-remitting MS (RRMS).
  • Primary progressive Multiple Sclerosis (PPMS): PPMS is usually diagnosed later in life, where symptoms worsen progressively without early relapses or remissions. This includes trouble with walking and balance. Some people may experience times of stability and then some periods when symptoms worsen and then their condition stabilises and slowly gets better. 
  • Secondary progressive Multiple Sclerosis (SPMS): Before approaching this type, people will experience episodes of relapse and remission (which is the relapsing-remitting multiple sclerosis (RRMS)). However, the disease will start to progress steadily, and symptoms will gradually worsen over time without obvious attacks. Some people continue to have infrequent relapses during this stage.
  • Progressive Relapsing Multiple Sclerosis: The least common type of MS; symptoms vary depending on the area of the brain affected.

Causes of Multiple Sclerosis

The cause of Multiple Sclerosis is unknown, and it is also not clear why it develops in some people and not others. 

Multiple Sclerosis is known as an autoimmune disease in which the body’s immune system attacks its own tissues. The immune system malfunction destroys the fatty substance that coats and protects nerve fibres in the brain and spinal cord (myelin).

There are many possible causes of MS, including:

  • Certain autoimmune disorders
  • Environmental factors
  • Genetic factors
  • Infectious agents, such as viruses

How is Multiple Sclerosis Diagnosed?

Multiple Sclerosis is usually diagnosed when a healthcare professional specialising in the brain – most often a neurologist will perform a neurological exam while enquiring more about your clinical history. This will also lead to different series of tests to determine if you have Multiple Sclerosis.

Diagnostic testing my include:

  • Blood Tests: to help eliminate the possibility of other conditions that have similar symptoms
  • MRI Scan: to detect active and inactive lesions throughout your brain and spinal cord.
  • Optical coherence tomography (OCT): a picture is taken of the nerve layers in the back of your eye to check for thinning around the optic nerve.
  • Spinal Tap (lumbar puncture): To find out abnormalities in the spinal fluid.

Treatment for Multiple Sclerosis

Unfortunately, there is currently no cure for Multiple Sclerosis. However, on the bright side there are several treatments that can assist in controlling the condition like reducing relapses (periods when symptoms worsen) and slowing the disease’s progression.

These treatments also depend on the specific symptoms and difficulties present:

  • Physical rehabilitation to maintain mobility
  • Specific treatments for individual MS symptoms
  • Treating relapses with short courses of steroid medicine to speed up recovery
  • Treatment to reduce the number of relapses using medicines called disease-modifying therapies

Prevention of Relapses for Multiple Sclerosis 

Besides the treatments that the doctors will assist you with, individuals can also carry out lifestyle changes to help slow the disease progression and lessen symptoms to improve quality of life.

Some healthy lifestyles can include:

  1. Eating a healthy diet with lots of fruit and vegetables, whole grains, healthy fats and lean protein. Limiting intake of processed food, added sugars and unhealthy fats. Dietitians can also help with this.
  2. Exercise regularly to keep muscles strong and improve balance.
  3. Stress management for proper mental health care
  4. Quitting smoking and limiting alcohol intake.

Living with Multiple Sclerosis

If you are one experiencing Multiple Sclerosis, or you are living with somebody who has the condition, it is a lifelong condition, and will need a lot of patience in assisting recovery. 

Most people with MS have a relapsing-remitting disease course and they can experience different challenges and various periods of new symptoms or relapses.

Always ensure medication is taken on time and as prescribed to ease with the symptoms, and always communicate concerns with your doctor or assigned healthcare professional. 

There are times we might need to reach out to support groups to assist in the rehabilitation and recovery processes as well. 

You are not alone in this. Check out the neurologists in our WhatsDoc list and enquire away.

References:

https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

https://www.nhs.uk/conditions/multiple-sclerosis/

https://www.nationalmssociety.org/

https://www.webmd.com/multiple-sclerosis/default.htm

https://en.wikipedia.org/wiki/Multiple_sclerosis

https://www.medicalnewstoday.com/articles/37556

https://medlineplus.gov/multiplesclerosis.html

https://www.healthline.com/health/multiple-sclerosis

https://www.mssociety.org.uk/

https://emedicine.medscape.com/article/1146199-overview

https://my.clevelandclinic.org/health/diseases/17248-multiple-sclerosis

https://www.hopkinsmedicine.org/health/conditions-and-diseases/multiple-sclerosis-ms