Multiple sclerosis (MS) is a condition related to the Central Nervous System and occurs as a result of immune-mediated process against the CNS. In multiple sclerosis, the immune system of the body causes inflammation within the CNS which causes damage to the myelin sheath. Myelin sheath is a layer of fatty tissue surrounding and insulating the nerve fibers. This leads to the following consequences,
The signals in the CNS are either changed or stopped.
Damage to the areas of CNS leading to several neurological symptoms.
Development of scar tissue in multiple areas
Signs and symptoms
The symptoms of multiple sclerosis may greatly vary depending upon the areas where there have been nerve damage and severity of the damage. Some of the most common signs and symptoms include:
Numbness or weakness in the limbs, more often at the sides
Lhermitte sign - shock like sensations while doing certain neck movements like bending forward
Partial or complete vision loss and pain during eye movement.
Double vision and blurred vision
Altered sexual behavior
Changes in bowel and bladder function
Risk factors for Multiple sclerosis
People aging between 16 to 55 years are more prone to having multiple sclerosis.
Women are 2-3 times at more risk than men to suffer from this condition.
Family history is another factor that increases the risk of having the disease.
Certain viral infections such as Epstein-Barr virus infection also increases the risk.
Northern European people are at high risk whereas Asian, African or Native American people are at lower risk to have the disease.
Low levels of vitamin D and lesser exposure to sunlight is another risk factor.
Patients having thyroid disease, type 1 diabetes and inflammatory bowel diseases are more prone to have Multiple sclerosis.
Lastly, smokers are at more risk of having the disease than non-smokers.
How is it diagnosed?
The diagnostic tests to detect Multiple Sclerosis are not very specific. Instead, a combination of tests is conducted to rule out other conditions of similar signs and symptoms. After taking a detailed case history to know any past medical illness and family history, and conducting a detailed examination, the following tests are recommended:
Blood sample tests - Certain tests to detect some particular biomarkers related to Multiple Sclerosis that aid to give the final diagnosis.
Spinal tap test or lumbar puncture - A sample of fluid is taken from the spinal canal for laboratory analysis. This helps in ruling out infections or any other abnormalities having similar symptoms like MS. This also detects certain abnormalities in the antibodies associated with MS.
Radiological examination - Imaging tests such as MRI are done to detect the areas in the brain and the spinal cord which are affected. A contrast material is injected in the veins to reveal the active phase of the disease.
Potential tests - These tests help in recording the electrical signals created by the nervous system to respond to the stimuli. The electrodes are used to measure the speed at which the information travels along the nerve pathways.
There is no permanent cure for the condition. The objective is to speed up the recovery from attacks and slow down the progression of disease along with the management of the symptoms. The top neurosurgeons in India, mostly choose the following forms of treatment:
Corticosteroids - These include prednisone and intravenous methylprednisolone, used to reduce nerve inflammation. The side effects may include insomnia, increased blood pressure, mood swings and fluid retention.
Plasma exchange - Plasma is a part of the blood, which is removed and separated from the blood cells. The blood cells are mixed with albumin and then inserted back into the body. This is used if the symptoms are new, severe and did not respond to steroids.