Multiple Sclerosis: An autoimmune condition that affects brain and spinal cord

Typically, nerves and blood vessels are separate. Nerves, encased in a layer called myelin, lie deep inside the body and are invisible. Just like how a copper wire is wrapped in rubber insulation, every nerve is protected by a sheath, which is what the myelin layer is. Damage to this myelin layer is called demyelination. Multiple sclerosis (MS) occurs due to demyelination.

The prevalence of multiple sclerosis is increasing in India. Previously, it was believed to be found only in foreign countries. However, due to advancements in medical technology, this problem has become more noticeable in our country too. Typically, multiple sclerosis is more common among young women aged 15 to 40 years which causes some women to worry about pregnancy. However, women with multiple sclerosis can conceive while undergoing treatment under medical supervision. Nowadays, various medications can be offered even for pregnant women.

Multiple sclerosis progresses through two stages: relapsing multiple sclerosis and progressive multiple sclerosis.

In relapsing multiple sclerosis, the disease typically comes as recurrent attacks at multiple areas across the central nervous system which includes the brain, spinal cord and the optic nerves. For instance, if there is swelling in the eye or blurred vision, treatment leads to recovery, but after some time, another area might be affected. This means that demyelination plaques can form on nerve cells in the brain or spinal cord, affecting the leg or arm. In some cases, the patient may recover without any treatment. However, there is a risk of no recovery or partial recovery with persisting disability and always a risk of recurrence.

To book your appointment for the related treatment, visit Star Hospitals Website or call 07969250194

This disease can be diagnosed through MRI and medical tests such as cerebrospinal fluid (CSF) analysis for OCBs and visual or auditory evoked potentials. Aggressiveness of the disease can also be estimated through MRIs. Until 1995, no medications were available for this condition. Now, several types of medications are accessible. If detected in time and treated, relapsing multiple sclerosis can be managed to prevent further progression, allowing the patient to lead a normal life. Failing to treat the disease in the relapsing stage leads to cumulative disability or a switch to progressive form with stiffness in limbs or cognitive disturbances. Thus, relapsing can progressively advance into progressive multiple sclerosis. In the progressive stage, the patient’s walking, balance, and cognition slowly deteriorate. If the problem reaches the progressive stage, providing treatment becomes very challenging.

In truth, if adequate treatment is not provided during the relapsing stage, the patient may become confined to a wheelchair within ten to fifteen years. However, medications for progressive multiple sclerosis are also available now. When infections attack, they battle with our immune system, leading to the production of certain cells and antibodies within our body, which impede the infections attacking the body. Sometimes, these molecules on infective agents closely resemble self-neuronal molecules, triggering these body-produced immune cells to attack our neural tissue. This means our immune system starts attacking our own body, referred to as an autoimmune condition. When this condition occurs, the protective myelin sheath on the nerves is damaged, resulting in demyelination, thus causing multiple sclerosis.

Symptoms:

• Blurred vision
• Difficulty recognizing colours, brightness, contrast
• The sensation of electric shocks/ lancinating pain on one half of the face
• Electric shocks down the body with neck movements
• Lack of sensation or numbness, tingling in the arms and legs
• Weakness in one leg or arm or both legs or both arms and legs
• Loss of balance while walking, falls because of imbalance
• Fatigue
• Lack of urinary control/bowel urgency
• Tremors in arms and legs, muscle tightness and stiffness in limbs
• Cognitive slowing
• Eye movement abnormalities, double vision, speech disturbances
• Rarely giddiness, seizures

Diagnosis and Treatment:

The earlier the disease is identified, the better the treatment can be provided. Medical professionals determine the severity of the disease through MRI, previous relapses and clinical examination. For milder disease, basic DMTs will work. For high-activity disease, aggressive therapy will be offered. Hitting hard from the beginning if the disease is highly active will help to a great extent. Both pills and injections are available.

Multiple sclerosis patients will undergo two primary types of treatment: acute relapse treatment and relapse prevention treatment. In acute treatment methods, steroids, plasmapheresis, and immunoglobulin injections are used singly or in combination. In relapse prevention (DMT treatment), both injections and pills are accessible. If necessary, some may undergo hematopoietic stem cell transplant treatment, which will be offered to eligible candidates.

To book your appointment for the related treatment, visit Star Hospitals Website or call 07969250194