What is multiple sclerosis ?
Multiple sclerosis is said to be a condition where the brain and spinal cord is affected which results in the loss of muscle control, sensation, vision, balance. In multiple sclerosis, the body’s own immune system somehow damages the nerves of the brain and spinal cord. Thus, multiple sclerosis is also called an autoimmune disease.
In an autoimmune disease the body’s own immune system somehow gets abnormal and starts attacking the components of the body itself. The work of the immune system is to protect against foreign substances like microbes but in multiple sclerosis the immune system attacks then nerves of the brain and spinal cord. These are the vital components of the central nervous system.
The central nervous system and the nerves are responsible for carrying messages all across the body. It helps in an organised functioning of the body. The nerves are covered by a fatty substance. These are called myelin sheath. This helps in the insulation of the nerve as well as carrying messages and impulses from the brain to other parts. Nerves help in every simple and complex day to day activity.
The pathophysiology of multiple sclerosis:
Sclerosis is the build up of scar tissues. In this disease, scar tissues are found to form in the brain. The autoimmune disease destroys the myelin covering of the nerves. It is then that the scar tissues or plaques are formed. The destruction of the myelin sheaths causes improper transmission the nerve impulses. As a result the functioning of the body also gets disrupted. The brain can’t govern the body functions properly. This is when the symptoms arise due to improper functioning.
The nerves have the property of regaining the myelin back. But in multiple sclerosis the rate of destruction is faster than the rate of repairing. The symptoms and their severity depend on the severity of the destruction of the myelin and also on the location of the damage.
Occurrence of the disease:
The National Multiple Sclerosis Society found out that the condition usually affects 400,000 Americans approximately. This non traumatic disease is also found to be the most common neurological disorder which affects the middle aged persons.
The female to male ratio of occurrence of the disease is 2:3. It occurs generally in middle aged adults. It is unlikely to see the disease in the adolescents. But risks gradually develops after the teens.
Multiple Sclerosis Causes
Multiple sclerosis is generally a neurological disorder where the immune system attacks the body’s nerves. It is said to be an autoimmune disorder. The immune system destroys the myelin sheaths of nerves thus resulting in improper functioning of the body.
Doctors are yet to understand the exact cause of the disease. But it has been found out that probably a virus, genetic factors or environmental factors might play a role.
It has been found out that there is a difference in the presence of multiple sclerosis in various population and ethnic groups. Epidemiological study suggests that the disease is commonly seen in the population of Scandinavia, Scotland and the whole of northern Europe. In the United States the disease is commonly seen in whites than other groups.
Multiple sclerosis is seen commonly in certain parts of the world. It is said to be the disease of the temperate regions. The further you move out from the equator the greater risks you are in. if you are in a higher risk zone and then if you move to a lower risk zone, it is possible that you also carry the risk factor with you.
Researchers have come up with the finding that multiple sclerosis might be inherited. This is a probable cause. Genetics is found to contribute somehow to the occurrence of the disease. Relatives of the first, second and third degree are said to be in greater risk of getting the disease.
Researchers also found out that there may be the presence of more than one gene which contributes to the disease. It may be due to the fact that some persons are born with that particular gene. They were meant to react to some particular environmental factors which would eventually trigger the autoimmune response.
Role of viruses:
Viruses may also play a role in the development of the disease, Although this reason has not been confirmed yet. Some viruses like varicella zoster, Epstein-Barr may have a role in causing multiple sclerosis.
It has also been found out that body hormones may have a link to causing multiple sclerosis. Both male and female hormone such as testosterone, estrogen and progesterone are found to suppress the body’s immune system. It has been seen that women with multiple sclerosis show less severity when they get pregnant. This is because pregnancy produces high levels of estrogen and progesterone.
Symptoms of Multiple Sclerosis
The symptoms of multiple sclerosis usually appear between the ages of 20 and 40. Generally a person is supposed to develop two or more distinct symptoms that are consistent with multiple sclerosis to identify the disease.
Some of the symptoms of the disease
- Tingling sensation.
- Loss of sensation.
- Impaired balance.
- Weakness in the extremities.
- Blurred vision or diplopia.
- Slurring of speech.
- Paralysis which appears suddenly.
- Co-ordination gets affected.
- Cognitive difficulties
With the progression of the disease other symptoms are visible too. Let us look through those symptoms and what they mean.
Patients complain of high levels of fatigue. This is due to increased muscle weakness. The patients also complain of drowsiness, mental fatigue, sleepiness. It is not due to any stressful physical activity because some patients are seen to complain of fatigue even after a long and relaxed sleep.
When exposed to heat the patients are found to go for the worse. They show increased symptoms due to heat sensitivity.
Spasticity is usually the increased tone of the muscle. In patients with multiple sclerosis spasticity is noticed in the muscles of arms and legs. The limbs appear to be very stiff due to the high contracted state of the muscle. This is a very common symptom of the disease. The patient finds it difficult to move the muscles freely.
It is seen that the patients lose balance. They complain of vertigo. This means they feel their surroundings to be spinning. This is due to the damage done to complex nerve pathways that control vision and other senses that help in maintaining balance.
Problems arise with thinking. The patient loses concentration, slowly they start losing memory. This affects the daily activities of the patients.
Vision problems are quite common in patients with MS. In fact, a problem in vision, called optic neuritis is seen to occur in 55% of people with the disease. This usually results in blurring or doubling of vision or even blindness in one eye. But generally blindness doesn’t occur in most cases.
Speech and swallowing problems
Multiple sclerosis patients have bulbar problems. This means they face difficulty while swallowing and speech. The muscles of the tongue and the palate go for weakness. The nerves supplying these regions probably get affected.
Multiple Sclerosis Treatment
Multiple Sclerosis Treatment Drugs
Multiple sclerosis can be treated in a lot of ways. One of the most preferred way of treating multiple sclerosis is by drug therapy. Nowadays a number of drugs have come up. They have been successful in slowing the progression of multiple sclerosis. So these are aptly named as disease modifying drugs. They include Betaseron(interferon beta 1b), Avonex (interferon beta 1a), Copaxone (glatiramer acetate), Novantrone (mitoxantrone), Refib(interferon beta 1a), Gilenya(fingolimod), Tysabri (natalizumab).
These drugs work in a way which suppresses or alters our immune system. These drugs therefore work on the theory that multiple sclerosis is caused due to an abnormal immune system. So it is because of that abnormality the body’s own myelin sheaths are attacked probably. Nowadays most doctors use these drugs in the treatment of multiple sclerosis as these drugs are proved to reduce to the frequency of the myelin sheath attacks. They also reduce the occurrence of brain lesions. They are known to suppress the effect of multiple sclerosis and they also improve the quality of life. No doubt these are called disease modifying drugs and are the preferred choice of treatment by the doctors.
Treatment for bladder and bowel:
This is a matter of concern. Most people suffering from multiple sclerosis lose their control bladder and bowel functions. Some of the common problems faced by the patients are:
- Incontinence- multiple sclerosis may affect the nerves that control the bladder functions. If this happens the person is found to pass urine involuntarily.
- Urinary hesitancy- some people finds it difficult to initiate urine. This is due to the fact that the nerves related to the urination process get damaged.
- Nocturia- due to multiple sclerosis damaging some nerves which control the urination, the affected person will find himself waking up a number of times in the night feeling the need to pass urine.
Bladder training is quite an effective way in treating incontinence. People suffering from incontinence find it difficult to hold back urine. They pass their urine involuntarily. So these people are handed a time schedule for voiding urine. The persons are told to hold back the urge to pass urine until that scheduled time. Once they get better at it the time period between consecutive voiding is increased. This is continued until they can hold their urine for long duration. This method of treating incontinence is found to be quite effective.
Multiple Sclerosis and Exercise
Multiple sclerosis is an autoimmune disease. The myelin sheaths of nerves get damaged by the body’s own immune system. Although myelin sheaths do regenerate but the rate destruction is much faster. Exercise can increase the rate of regeneration. Repeated activity retrains the nerve. Also it is proved that exercises when done regularly increases stress and helps in co-ordination. But exercises should be done carefully. Multiple sclerosis patients already suffer from muscle weakness and fatigue, If they over train or overwork then symptoms might worsen.
It is better to consult with your doctor before you start exercising to know thoroughly what you need to do exactly.
You should know what exercises will suit you and what you should not do.
• Know the duration of your workout.
• Know about the intensity with which you will be exercising.
• Try consulting a physical therapist. He will arrange a proper workout schedule following which you might find the symptoms of the disease decreasing.
• The physical therapist might show you free range exercises or he might help you with passive exercises, assisted exercises and then gradually shifting to resisted exercises.
• When you find trouble maintain balance your physical therapist will assist you in balance training. These are simple tilt board or wobble board exercises.
• Gait training may be necessary for those who find difficulty in walking.
Maintain a positive attitude:
Multiple sclerosis can affect your confidence. Patients get depressed due to the disease. But it is necessary to keep a positive attitude. You have to keep in mind that you are the same person that you were before diagnosing the disease. It is just the fact that you have to push yourself towards getting better.
Ask for help
It would of no use to think that you can manage everything by yourself even when you find it difficult to cope up with the disease. So get help when you need it. This would probably prevent the symptoms from going to worse. You should learn to control stress level. Consult with a mental health care provider and the person will train you live life positively with a better emotional and spiritual outlook.
it is good to get related with a support group. It is always a nice experience to share your experiences with the disease. People come together and they share their experiences and also try to talk about new ways of controlling the disease.
If you have further questions or comments, please leave it below. I would love to hear from you. Please let me know about the parts that you think is missing and incorrect.
Wishing you joy and healing.