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Living with Multiple Sclerosis (MS): Types, Causes, Symptoms & Management

About 2 to 2.5 lac Multiple Sclerosis patients are under treatment in India. Unfortunately, the majority of them receive either inadequate or incorrect diagnoses.

What is Multiple Sclerosis?

First things first, MS is a neurological condition that affects the central nervous system, which includes the brain and spinal cord. It's like a mix-up in the body's messaging system. Instead of smooth communication, there are glitches and hiccups along the way.

In a more technical explanation, Multiple Sclerosis is a chronic neurological illness. Sclerosis literally means ‘abnormal hardening of a body tissue’. It causes damage to the brain, spinal cord, and optic nerves that form the central nervous system (CNS) of our body. The condition is autoimmune where one's immune system attacks the healthy cells by mistake. If you are curious, they are called Myelin, the protective covering of the nerves.

Did you know Multiple Sclerosis (MS) affects about 5-10 individuals per lac in India? The number began at as low as 1.33 in 1985. By 2015, it drastically rose to 20–25. While India seems to be doing better at it, the world is struggling. Canada, for example, reports more than 10 daily cases on average, making it 1 patient in every 400 people.

So the risk is always there, especially when we know that the disorder strikes both the aged and the young.

So, let’s dig deep and first understand Multiple Sclerosis better.

Types of Multiple Sclerosis

MS is majorly divided into four types :

- Relapsing-remitting MS (RRMS)

In most scenarios, the disorder follows a relapsing-remitting path. Patients develop relapses (new symptoms) in days or weeks. These might or might not go completely. Post that, there is a phase of recovery. Meaning the symptoms disappear for months or even years.

Your situation may not deteriorate in between relapses. But each relapse can be more traumatic than the one before.

- Secondary Progressive MS (SPMS)

20-40% of patients with RRMS face a steady worsening of signs within 10-20 years of the onset. This happens both with or without episodes of remission.

- Primary Progressive MS (PPMS)

In this case, the condition is progressive from the beginning with a gradual worsening of symptoms. It usually takes place around 40 years.

Progressive-relapsing MS (PRMS)

This one is like a mix of SPMS and RRMS. There's a steady decline in symptoms, but you may also experience occasional relapses.

Multiple Sclerosis Symptoms

MS is a pretty unpredictable disease. For most Multiple Sclerosis patients, the signs remain absent most of their lives. While for some, it is severe and everlasting.

Here are common MS symptoms to watch out for.

  • Numbness in the arms/ legs (mostly on one side)

  • Tingling sensation

  • Neck movements giving electric-shock sensations

  • Walking difficulties (unsteadiness)

  • Lack of coordination

  • Partial/ complete vision loss

  • Long-term Diplopia (double vision)

  • Blurry vision

  • Vertigo

  • Fatigue

  • Mood swings

  • Trouble speaking (slow/ garbled words)

  • Cognitive issues

  • Sex, bowel, and bladder-related concerns

Some patients may also experience more complicated Multiple Sclerosis symptoms like:

  • Stiff muscles

  • Paralysis in the legs

  • Depression

  • Seizures

Multiple Sclerosis Causes

Unfortunately, the exact causes behind the development of MS are still unknown. However, as per scientists, the condition may be a result of a varied mix of factors. Like specific gene combinations when exposed to environmental triggers.

Geography does play a role in it. That’s because MS disease is more prevalent in the Northern and the Southern Latitudes. This includes Canada, Europe, New Zealand, the Northern US, and Australia (southeast).

But, as far as causal factors go, there’s more to the MS story.

Who is At More Risk of Developing MS?

Here are some factors that can influence Multiple Sclerosis occurrence.

  1. Age - The condition can take place at any age with 20 and 40 years being the most common.

  2. Sex - Women, in general, are 2-3 times more prone to having this CNS disorder than men.

  3. Genetics- A family history of MS makes you vulnerable.

  4. Climate- Temperate climatic conditions have been linked with Multiple Sclerosis autoimmune disease. Together with less sun exposure.

  5. Infections- Viral Infections may be one of the Multiple Sclerosis causes. The Epstein-Barr virus, for instance.

  6. Vitamin D- Vitamin D deficiencies have been associated with MS.

  7. Obesity- Being severely overweight can trigger the condition.

  8. Autoimmune diseases - Other autoimmune conditions can influence the development of MS. Thyroid disease, Type 1 Diabetes, and others.

  9. Smoking- Smoking may be a factor in having Multiple Sclerosis.

How is Multiple Sclerosis Diagnosed?

There are no particular evaluation tests for Multiple Sclerosis diagnosis. Conclusions are drawn by ruling out diseases that have similar symptoms.

The process usually involves checking your medical history and the following examinations:

  • Blood tests

  • Spinal Tap (It involves the removal of some cerebrospinal fluid from the spinal canal for lab analysis)

  • MRI

  • Evoked potential tests (this is used to see the electrical responses by your CNS to stimuli)

Multiple Sclerosis Treatment

There is no specific medication/ therapy to cure the condition. But Multiple Sclerosis management is very much possible. They depend on the patient's situation and the purpose that needs to be served.

For MS Attacks

  • Corticosteroids- They ease inflammation in nerves.

  • Plasma Exchange - They are used in severe situations when steroids fail.

For modifying the progression of Multiple Sclerosis disease

  • Injectable treatments

  • Interferon Beta Medications - They lessen the seriousness/ frequency of relapses.

  • Glatiramer Acetate - They prevent attacks on myelin.

  • Monoclonal Antibodies - They target cells that affect your CNS.

  • Oral treatments

  • Teriflunomide - This Multiple Sclerosis medication decreases relapse rates.

  • Dimethyl Fumarate - They are taken twice daily and help with less relapses.

  • Diroximel Fumarate - They have similar boons just like Dimethyl. But with fewer side effects.

  • Monomethyl Fumarate - They exhibit slow but steady results.

  • Fingolimod - They are effective in reducing relapses.

  • Siponimod - They slow the advancement of the signs.

  • Ozanimod - They reduce relapse frequency.

  • Ponesimod - They aid in less brain damage.

  • Cladribine - They are a second-line treatment for RRMS.

  • Infusion Treatments

  • Natalizumab - They reduce relapse rates and slow disability.

  • Ocrelizumab - Effective for PPMS.

  • Alemtuzumab - They come with MRI boons.

Please note that the above-mentioned Multiple Sclerosis treatments are not entirely risk-free. So, detailed consultation with your doctor is a must.

For reducing MS Symptoms

  • Stretching/ strengthening workouts

  • Muscle relaxants to reduce stiffness (Baclofen)

  • Pills to lessen exhaustion (Amantadine)

  • Drugs to help you walk faster (Dalfampridine)

Doctors can prescribe other medications too depending on the problem you are facing.

Final Thoughts - Can Multiple Sclerosis Be Cured?

The medical world has not been able to find a permanent cure for Multiple Sclerosis yet. But you can ease your troubles by reducing relapses and slowing the progression of MS.

Positive lifestyle changes are also a part of Multiple Sclerosis management. So, quit smoking, exercise daily, and eat healthy. And on top of everything, be happy.

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