Nervous System

Multiple Sclerosis (MS)

Multiple sclerosis:

It is an autoimmune disease that affects the central nervous system (the brain and spinal cord). It is a chronic disease that affects people differently. It is the most neurological disease which ends with disabilities among the youth, and the symptoms generally appear between the ages of 20 to 40 years. Females are more likely to suffer from this disease than males.
Types of MS:
There are four main types of MS, named according to the development of symptoms over time:
  • Relapsing-remitting MS: Symptoms of this type come in the form of attacks or seizures, and between attacks people recover or return to their usual level of disability. It may be weeks, months, or even years before another attack occurs, followed again by a period of lethargy. Most people with MS initially have this type of disease.
  • Secondary-advanced multiple sclerosis: People with this type usually have a previous history of attacks, but then symptoms begin to appear gradually and steadily, and there is a deterioration in their functions over time. Most people with this type of disease may continue to develop if it is not treated.
  • Primary MS: This type is less common and is characterized by a gradual worsening of symptoms from the onset with no significant relapses or exacerbations of the disease, although there may be temporary or minor relief of symptoms.
  • Progressive-relapsing MS: It is the rarest type of MS in which there is a continuous worsening of symptoms from the onset with acute relapses that can occur over time in the course of the disease.
Causes of MS:
When a person has multiple sclerosis, immune system cells that protect the body from viruses and bacteria mistakenly attack myelin (a substance that forms the protective sheath that covers nerve fibers) in the central nervous system (the brain and spinal cord), and the cause of this attack is still unknown, but scientists indicate several possible explanations for why the immune system attacks myelin in the central nervous system, and the most common explanation is a viral infection, especially Epstein-Barr virus (EBV), or a genetic defect. Some environmental factors may also play a role.
The natural course of MS varies from person to person, so it would be difficult predict the symptoms. Most sufferers experience short symptoms followed by long periods of relative remission (lethargy), with partial or complete recovery. The onset of symptoms and duration usually depends on the specific type but may start over a few days and disappear quickly or develop slowly and gradually over many years. Early symptoms often include:
  • Vision problems (such as: blurred or double vision or optic neuritis that causes pain during eye movement and rapid vision loss).
  • Muscle weakness, often in the hands and legs, and muscle stiffness with painful muscle spasms.
  • Tingling, numbness, or pain in the arms, legs, trunk, or face
  • Difficulty maintaining balance when walking.
  • Bladder control problems
  • Intermittent or continuous dizziness
MS may cause later symptoms, such as:
  • Mental or physical stress accompanied by early symptoms during a seizure.
  • Mood changes (eg depression, difficulty with expression or emotional control).
  • Problems concentrating, multitasking, thinking, learning, or memory difficulties.
  • Muscle weakness, stiffness, and spasms may be severe enough to affect walking or standing.
  • In some cases, MS leads to partial or complete paralysis and wheelchair use especially in individuals who are not treated or have advanced disease.
  • Many affected people find that weakness and fatigue get worse when they have a high body temperature or when exposed to heat.
Pain is rarely the first symptom of MS, but pain often occurs with optic neuritis and trigeminal neuralgia (a disorder of one of the nerves that supplies sensation to different parts of the face). Inflammation of the legs or around the abdomen is also a symptom of MS.

There is treatment for MS, but there is a possibility to reduce the number and severity of relapses and delay the long-term progression of the disease.

These medications are used to:
  • Slow down and stop the progression of the disease.
An example of these medications: Interferon group, Glatiramer acetate, Fingolimod, Natalizumab.
  • Reduce the severity of attacks.
An example of these medications: Corticosteroid group (Cortisone), which is used for specific periods to reduce the symptoms of attacks.
  • Controlling the symptoms associated with the disease:
Doctors use different medications to treat specific symptoms, such as muscle tension, tingling, fatigue, and depression.​
  • Corticosteroids (taken intravenously) are prescribed as they quickly and effectively suppress the immune system and reduce inflammation. These drugs speed up recovery from flare-ups but do not change the long-term outcome.
  • Plasma exchange: to remove blood from the body and remove components thought to be harmful in the blood plasma, then the remaining blood is returned. This treatment has not been effective in secondary or chronic progressive MS.
  • Disease-modifying treatments, such as injectable drugs (such as beta-interferon drugs, etc.), which prevent inflammatory reactions in the body.
Controlling Symptoms of Multiple Sclerosis:
MS causes a variety of symptoms that can interfere with daily activities but can usually be treated or managed:
  • Eye and vision problems are common in sufferers, but they rarely lead to permanent blindness, so intravenous steroid medications, special glasses, and regular eye rest may be helpful.
  • Muscle weakness and spasticity are common and can be controlled with yoga or physical therapy. It is important to stay physically active because physical inactivity can contribute to weakness, pain, fatigue, and other symptoms.
  • Uncontrollable tremor or shaking develops. In some patients, assistive devices may be used.
  • Walking and balance problems occur in many patients, and the most common walking problem is ataxia (unstable and uncoordinated movements), so in general, a cane, walker, or other assistive device can be used.
  • Patients should avoid excessive physical activity and reduce exposure to hot weather conditions or ambient temperature.
  • Bladder control problems, constipation, frequent or urgent urination, or loss of bladder control can be treated with medical treatments.
  • Impotence can result from damage to the nerves that run through the spinal cord. Some of these problems can be corrected with medication, and psychological counseling may also be helpful.
  • Depression is common among sufferers. It is often treated with cognitive behavioral therapy and antidepressant medications.
  • Conduct a comprehensive review at least once a year.
  • There is no special diet that has been shown to slow the progression of MS, but a generally healthy, well-balanced diet can help manage certain problems (eg: fatigue and constipation).
  • Regular activities and exercises are important for overall health and fitness.
  • stop smoking.
Multiple sclerosis and pregnancy:
For pregnancy planning, Women should talk to your doctor before they start trying to conceive, because some MS medications are not safe during pregnancy.

General advice regarding medications used in cases of multiple sclerosis:
  • You must adhere to using medications in the correct manner and following the instructions of the doctor and pharmacist.
  • To ensure safety and effectiveness of the medications used, you must commit to performing the tests and radiographic examinations requested by the doctor and pharmacist.
  • To ensure effectiveness of the medicine, the medicine must be stored in the correct way. Make sure to read the medicine’s internal leaflet or ask the pharmacist about the storage method.

Last Update : 14 September 2023 12:29 PM
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