Multiple sclerosis is a chronic disease that affects the central nervous system, which is the brain, spinal cord, and optic nerves. This can lead to a wide range of symptoms throughout the body.
It is not possible to predict how multiple sclerosis (MS) will progress in any individual.
Some people have mild symptoms, such as blurred vision and numbness and tingling in the limbs. In severe cases, a person may experience paralysis, vision loss, and mobility problems. However, this is not common.
It is difficult to know precisely how many people have MS. According to the National Institute for Neurological Disorders and Stroke (NINDS), 250,000–350,000 people in the United States are living with MS.
The National Multiple Sclerosis Society estimates the number could be closer to 1 million.
New treatments are proving effective at slowing the disease.
What is MS?
Scientists do not know exactly what causes MS, but they believe it is an autoimmune disorder that affects the central nervous system (CNS). When a person has an autoimmune disease, the immune system attacks healthy tissue, just as it might attack a virus or bacteria.
In the case of MS, the immune system attacks the myelin sheath that surrounds and protects the nerve fibers, causing inflammation. Myelin allows the nerves to conduct electrical signals quickly and efficiently.
Multiple sclerosis means “scar tissue in multiple areas.”
When the myelin sheath disappears or sustains damage in multiple areas, it leaves a scar, or sclerosis. Doctors also call these areas plaques or lesions. They mainly affect:
- the brain stem
- the cerebellum, which coordinates movement and controls balance
- the spinal cord
- the optic nerves
- white matter in some regions of the brain
As more lesions develop, nerve fibers can break or become damaged. As a result, the electrical impulses from the brain do not flow smoothly to the target nerve. This means that the body cannot carry out certain functions.
Types of MS and stages
There are four types of MS:
Clinically isolated syndrome (CIS): This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs at a later date, a doctor might diagnose relapse-remitting MS.
Relapse-remitting MS (RRMS): This is the most common form. Around 85% of people with MS are initially diagnosed with RRMS. RRMS involves episodes of new or increasing symptoms, followed by periods of remission, during which symptoms go away partially or totally.
Primary progressive MS (PPMS): Symptoms worsen progressively, without early relapses or remissions. Some people may experience times of stability and periods when symptoms worsen and then get better. Around 15% of people with MS have PPMS.
Secondary progressive MS (SPMS): At first, people will experience episodes of relapse and remission, but then the disease will start to progress steadily.
Find out more here about the different types and multiple sclerosis stages and what they mean.
Early signs and symptoms
Because MS affects the CNS, which controls all the actions in the body, symptoms can affect any part of the body.
The most common symptoms of MS are:
Muscle weakness: People may develop weak muscles due to lack of use or stimulation due to nerve damage.
Numbness and tingling: A pins and needles-type sensation is one of the earliest symptoms of MS and can affect the face, body, or arms and legs.
Lhermitte’s sign: A person may experience a sensation like an electric shock when they move their neck, known as Lhermitte’s sign.
Bladder problems: A person may have difficulty emptying their bladder or need to urinate frequently or suddenly, known as urge incontinence. Loss of bladder control is an early sign of MS.
Bowel problems: Constipation can cause fecal impaction, which can lead to bowel incontinence.
Fatigue: This can undermine a person’s ability to function at work or at home, and is one of the most common symptoms of MS.
Dizziness and vertigo: These are common problems, along with balance and coordination issues.
Sexual dysfunction: Both males and females may lose interest in sex.
Spasticity and muscle spasms: This is an early sign of MS. Damaged nerve fibers in the spinal cord and brain can cause painful muscle spasms, including in the legs.
Tremor: Some people with MS may experience involuntary quivering movements.
Vision problems: Some people may experience double or blurred vision or a partial or total loss of vision. This usually affects one eye at a time. Inflammation of the optic nerve can result in pain when the eye moves. Vision problems are an early sign of MS.
Gait and mobility changes: MS can change the way people walk due to muscle weakness and problems with balance, dizziness, and fatigue.
Emotional changes and depression: Demyelination and nerve fiber damage in the brain can trigger emotional changes.
Learning and memory problems: These can make it difficult to concentrate, plan, learn, prioritize, and multitask.
Pain: Pain is a common symptom in MS. Neuropathic pain is directly due to MS. Other types of pain occur because of weakness or stiffness of muscles.
Less common symptoms include:
- headache
- hearing loss
- itching
- respiratory or breathing problems
- seizures
- speech disorders
- swallowing problems
There is also a higher risk of urinary tract infections, reduced activity, and loss of mobility. These can impact a person’s work and social life.
In the later stages, people may experience changes in perception and thinking, as well as sensitivity to heat.
MS affects individuals differently. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years. Sometimes, symptoms worsen rapidly, within weeks or months.
A few people will only have mild symptoms, and others will experience significant changes that lead to disability. However, most people will experience times when symptoms worsen and then get better.
Causes and risk factors
MS is an autoimmune condition and like most neurological dysfunctions this too does not have any specific determining factors. In spite of study and research Finding an answer to why the nervous system of an individual behaves the way it does and why it is unable to send the right signals or why it tends to send the wrong signals to various parts of the body remains a challenge to the medical fraternity .
However , research and study do define a few underlying risk factors that might lead to MS – including Genetics ,Immune system , Environment andInfections.Environmental factors such as lack of vitamin and nutrients in the body and also factors such as excessive cigarette smoking have been shown to increase the risk of relapses.
Does MS always cause paralysis? IS it fatal?
Ms does not always lead to paralysis of the body. It is noticed that in most cases people do not become severely disabled. With constant research and development in the field of medicine, life expectancy and quality of life of patients with MS has increased over time. Many of the complications faced during the disease by both- the patient and the doctor, are now manageable
Risk Factor
1. Genetics: While MS is not a hereditary disorder, studies have shown that having immediate relatives such as a parent or siblings with MS may greatly increase a person’s risk of developing the condition.
2. Certain infections: A variety of viruses have been found to increase the risk of developing
MS. There is mounting evidence that some viruses such as Epstein-Barr virus (EBV) and human herpesvirus 6 (HHV-6) may be possible co-factors in MS development.
3. Smoking: Research has shown that smokers are 1.5 times more likely to develop MS tha nonsmokers. It has been found that cigarette smoking not only increases the susceptibility towards MS but may also contribute to rapid disease progression.
4. Obesity: People who are obese are also at an increased risk of developing MS.
5. Environmental factors: Environmental factors such as climate are also believed to be risk factors for MS. For example, people living in countries and regions with climates such as Canada, Northern Europe, New Zealand, and the northern U.S. are more likely to develop the disease.
6. Certain autoimmune diseases: The prevalence of certain autoimmune disorders such as systemic lupus erythematosus (SLE), type 1 diabetes, autoimmune thyroid disease,psoriasis, and rheumatoid arthritis (RA) are known to slightly increase the risk of developing MS.
7. Age, sex, and race: Demographic factors such as age, sex and race may increase anindividual’s risk of developing MS. For example, the risk of developing MS increases with age. In addition, due to genetic variations, women are twice as likely as men to develop the condition. In terms of race, MS is more common in people of Northern European descent than people of Asian, African or Native American descent.
Diagnosis
A doctor will carry out a physical and neurological examination, ask about symptoms, and consider the person’s medical history.
No single test can confirm a diagnosis, so a doctor will use several strategies when deciding whether a person meets the criteria for a diagnosis.
These include:
- MRI scans of the brain and spinal cord, which may reveal lesions
- Spinal Fluid analysis may detect OCB (Oligoclonal band ) Which is consistent with diagnosis of MS.
- An evoked potential test, which measures electrical activity in response to stimuli
Other conditions have symptoms that are similar to those of MS, so a doctor may suggest other tests to assess for other possible causes of the person’s symptoms. Consult best neurologist in Delhi.
If the doctor diagnoses MS, they will need to identify what type it is and whether it is active or not. The person may need more tests in the future to check for further changes.
