Neurological Conditions

Degenerative Neurological Diseases

Multiple Sclerosis

A potentially disabling disease of the brain and spinal cord (central nervous system).

Multiple sclerosis definition: It is a neurodegenerative autoimmune disorder of the central nervous system – that involves the brain, spinal cord and the optic nerves. It is a chronic disease with a wide range of symptoms that run throughout the body.

It causes potentially disabling symptoms due to the involvement of nerves, spinal cord and central nervous system.

Nerve fibres have a protective covering referred to as myelin sheath. Body’s immune system attacks the cells of the myelin sheath. In this case, the immune system becomes destructive. The destruction of myelin sheath causes communication issues between the brain and the rest of the body.

It is a progressive and degenerative disorder capable of inducing permanent damage and deterioration of the nerves.

What are the Signs and Symptoms of Multiple Sclerosis?

Multiple Sclerosis Symptoms: The signs and symptoms of multiple sclerosis Depends on the extent of the nerve damage and the location of the affected nerves. The symptoms thus very widely from person to person. The disease is progressively deteriorating and thus the course of the disease depends on the location of affected nerves. The disease progresses gradually with intermittent periods of remission – therefore, some people may not develop any new symptoms during the course of the disease owing to long periods of remission.

  • Symptoms are mostly associated with movement as the condition often affect movement.
  • Weakness or numbness in both hands and legs or one hand or one leg may occur.
  • Numbness is experienced on one side of the body or in the legs or trunk.
  • The gait becomes unsteady with lack of coordination and tremor.
  • Pain or tingling sensation in parts of the body.
  • There may be problems with bladder, bowel and sexual functions.

The symptoms or problems associated with vision and eyes include loss of vision in one eye at a time or both the eyes. The vision loss can be partial or complete. Blurred vision, prolonged double vision, and pain during eye movement are the other common symptoms.

The other multiple sclerosis symptoms may include: dizziness, fatigue and slurred speech.

Lhermitte sign is a typical sign of MS. It is associated with neck movements. People having these signs may experience electric-shock sensations when they bend the neck forward.

In some people, severe walking disability occur with chronic MS. They completely lose the ability to walk independently.

What are the causes of Multiple Sclerosis?

Multiple sclerosis is an autoimmune disease. In this condition, body’s own cells (the cells of the immune system) attack its own tissues. In multiple sclerosis, the nerve fibres in the brain and spinal cord get subjected to damage. The exact cause of why this happens is unknown. The consequences of this malfunctioning are quite destructive as there is a progressive destruction of the protective myelin sheath of the nerve fibres. Once the fatty coating of the nerve fibres is subjected to destruction, the nerve fibres get exposed. This coating is similar to the insulation coating (plastic) on electrical wires. As the nerve fibres become naked the messages that transmit through them may become either slow or get blocked.

It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

What are the Complications of Multiple Sclerosis?

Muscle spasm and muscle stiffness may develop in people with multiple sclerosis. People also develop issues with their bladder control, bowel movements, and sexual function. Paralysis can typically occur in legs. Epilepsy develops in some people. Mood swings, forgetfulness and mental changes including anxiety and depression may occur in some people.

What are the risk factors for multiple sclerosis?

  • Family history: This is the most prominent risk factor. The risk increases if one of the parents or siblings has had MS.
  • Age: There is no age bar for this condition – it can occur at any age, but most common around 20s and 40s years of age. Young adults and older people can also get affected.
  • Sex: Women are two to three times more likely than men to develop this condition.
  • Vitamin D: low levels of vitamin D can increase the risk
  • Climate: people living in temperate climatic conditions are at risk. People living in these countries are at risk (Europe, Australia, New Zealand, Northern United States and America).
  • Race: Native American, African and people of Asian origin are at lowest risk compared to people of Northern European and white descent.
  • Autoimmune disease: people with autoimmune diseases such as thyroid disorders, inflammatory bowel disease, type 1 diabetes, psoriasis and pernicious anaemia have a slightly higher risk of developing MS.
  • Infections: Epstein-Barr virus infections have been linked to Multiple sclerosis.

Multiple Sclerosis Diagnosis

Experienced and expert neurologists prefer differential diagnosis to rule out other conditions that may produce similar symptoms. This means the diagnosis relies on ruling out other conditions. In general, there are no specific tests for Multiple sclerosis.

Lumbar puncture (spinal tap): In this procedure, a small sample of cerebrospinal fluid is removed from the spinal cord for laboratory analysis. It helps in detecting abnormal antibodies associated with MS and also ruling out other conditions and infections with similar symptoms.

Evoked potential tests: Nervous system produces electrical signals in response to visual or electrical stimuli. These signals are recorded with the help of evoked potential tests to determine and study the flow of messages down the nerve pathways. In people with unusual symptoms and the progressive disease, diagnosing MS is difficult.

In some people with some unique pattern of symptoms which are consistent with the disease – as seen in relapsing and remitting type of MS, neurologists make the diagnosis and confirm it by imaging tests – such as MRI.

Multiple Sclerosis Radiology

Brain MRI is often used to help diagnose multiple sclerosis.

What is the treatment for Multiple Sclerosis?

Multiple Sclerosis Treatment: in Hyderabad, I have seen many people have lots of concerns regarding the symptoms and treatment of MS. Unfortunately, there is no permanent cure for multiple sclerosis. Treatment is basically help in speeding up the recovery from periodic episodes of symptoms; controlling and managing symptoms and modifying the course of the disease. In some people symptoms are mild and do not require any treatment.

Multiple sclerosis treatment in Hyderabad

Learn More about the Treatment for Multiple Sclerosis – medication, therapies and newer approaches to the management of MS.