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Multiple Sclerosis

Definition


Disease: Multiple Sclerosis Multiple Sclerosis
Category: Neurological diseases
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Disease Definition:

A potentially debilitating disease in which the body's immune system eats away at the protective sheath that covers the nerves is called multiple sclerosis (MS). This condition interferes with the communication between the body and the brain. In a process that's not reversible, deterioration of the nerves themselves may be ultimately the result of this.

Depending on which particular nerves are affected and the amount of damage, symptoms vary widely. The ability to speak or walk may be lost in people with severe cases of multiple sclerosis. Because symptoms often come and go, sometimes disappearing for months, multiple sclerosis can be difficult to diagnose early in its course.

Multiple sclerosis most often begins in people between the ages of 20 and 40, although it can occur at any age. This condition is more likely to develop in women than in men.

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Depending on the location of affected nerve fibers, signs and symptoms of multiple sclerosis vary widely. The following are included in the signs and symptoms of multiple sclerosis:

 

  • Lack of coordination, tremor or unsteady gait
  • Often with pain during eye movement (optic neuritis) and usually in one eye at a time, partial or complete loss of vision
  • Dizziness
  • Blurring of vision or double vision
  • Numbness or weakness in one or more limbs, which typically occurs on one side of the body at a time or the bottom half of the body
  • Tingling or pain in parts of the body
  • Fatigue
  • Electric-shock sensations that occur with certain head movements


Relapses of symptoms, which are followed by periods of complete or partial remission, may be experienced by most people with multiple sclerosis, particularly in the beginning stages of the disease. An increase in body temperature often worsens or triggers the signs and symptoms of multiple sclerosis.

Causes:

The autoimmune disease in which the body's immune system attacks its own tissues is called multiple sclerosis. This process destroys myelin, which is the fatty substance that coats and protects nerve fibers in the brain and spinal cord.

The messages that travel along that nerve may be slowed or blocked when myelin is damaged. This means that myelin can be compared to the insulation on electrical wires.

Why multiple sclerosis occurs in some people and not others is not really understood. Ranging from genetics to childhood infections, a combination of factors may play a role.

Some of the factors that may increase a person’s risk of developing multiple sclerosis include:

Heredity:
The risk of developing multiple sclerosis is higher for people who have a family history of the disease. For instance, a person has a 1 to 3% chance of developing the disease if one of his/her parents or siblings has had multiple sclerosis, as compared with the risk in the general population, which is just a tenth of 1%.  

However, the fact that heredity can't be the only factor involved was proved by the experiences of identical twins. Identical twins would have identical risks if multiple sclerosis was determined solely by genetics, but this is not what happens. There is only a 30% chance of developing multiple sclerosis in an identical twin if his/her twin already has the disease.

Race:
The risk of developing multiple sclerosis in white people, those whose families originated in northern Europe in particular, is very high; while the lowest risk is in people of African, Asian or Native American descent.

Infections:
A variety of viruses have been linked to multiple sclerosis. The greatest interest is currently in the association of multiple sclerosis with Epstein-Barr virus, which is the virus that causes infectious mononucleosis. However, It's still not clear how Epstein-Barr virus might result in a higher rate of MS.

Geographical factors:
In countries with temperate climates such as southeastern Australia, Europe, New Zealand, southern Canada and northern United States, multiple sclerosis is far more common. With latitude, the risk seems to increase.

The child who moves from a high-risk area to a low-risk area or vice versa tends to have the risk level associated with his/her new home area. However, the young adult usually retains the risk level associated with his or her first home, if the move occurs after puberty.

Other diseases:
When having one of the following autoimmune disorders, people are very slightly more likely to develop multiple sclerosis:

 

  • Thyroid disease
  • Type 1 diabetes
  • Inflammatory bowel disease

Complications

Complications:

People with multiple sclerosis may develop the following complications:

 

  • Depression
  • Problems with bladder, bowel or sexual function
  • Mental changes, such as forgetfulness or difficulties with concentration
  • Muscle stiffness or spasms
  • Epilepsy
  • Paralysis, most typically in the legs

Treatments:

Multiple sclerosis has no cure. Managing the symptoms and combating the autoimmune response are the things that treatment typically focuses on. In some cases, no treatment is necessary when people have such mild symptoms.

MEDICATIONS:
The following are the drugs that are commonly used for multiple sclerosis:

Glatiramer:
It is believed that glatiramer works by blocking one's immune system's attack on myelin. This drug must be injected subcutaneously once daily. Shortness of breath and flushing after injection may be some of its side effects.

Corticosteroids:
The inflammation that spikes during a relapse can be reduced by corticosteroids, the most common treatment for multiple sclerosis. Intravenous methylprednisolone and oral prednisone are some examples.

Interferons:
It appears that the rate at which multiple sclerosis symptoms worsen over time is slowed by these types of drugs, such as Rebif, Betaseron and Avonex. However, serious liver damage can be caused by interferons.

Mitoxantrone:
This immunosuppressant drug is usually used only in people who have advanced multiple sclerosis, as it can be harmful to the heart.

Natalizumab:
This drug interfers with the movement of potentially damaging immune cells from the bloodstream to the brain and spinal cord. This medication is reserved for people who can't tolerate or see no result from other types of treatments because it increases the risk of progressive multifocal leukoencephalopathy, a brain infection that is usually fatal.  

THERAPIES:
A physical or occupational therapist can show the patient how to use devices that can make it easier to perform daily tasks, and can teach him/her stretching and strengthening exercises.

PROCEDURES:
Because plasma exchange (plasmapheresis) separates the blood cells from the plasma, which is the liquid part of the blood, it looks a little like dialysis. To help combat severe symptoms of multiple sclerosis relapses, especially in people who are not responding to intravenous steroids, plasma exchange is sometimes used.

Prognosis:

Not Available

Expert's opinion

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