Multiple Sclerosis (MS) is a chronic autoimmune disease that involves the destruction of the myelin sheaths that protect the nerve fibers by the body’s immune system. This break down leaves the nerves covered in scar tissue or completely damaged and unable to function properly.
Nerves in the human body are wrapped by a protective, insulating layer that ensures that electrical signals are transmitted effectively throughout the body. Damage to this protective covering is called demyelination and it’s a significant part of the disease. Worldwide, approximately 2.1 million people are affected by MS.
Types of Multiple Sclerosis
Multiple sclerosis can be grouped into four main types:
- Relapsing-Remitting MS (RRMS)
- Secondary Progressive MS (SPMS)
- Primary Progressive MS (PPMS)
- Progressive-Relapsing MS (PRMS)
RRMS is the most common type, occurring in around 85% of patients with an onset of symptoms starting in a person’s 20s or 30s. Neurologic deficit symptoms tend to appear (relapse) and resolve without reappearing for some time (remission).
It is important to note that there can also be a single incidence of an autoimmune attack on the nervous system called Clinically Isolated Syndrome. A diagnosis of MS is considered when these attacks happen frequently.
Signs And Symptoms
Of all of the symptoms that people experience, fatigue is the most common. Debilitating tiredness that interferes with productivity and the completion of even simple daily tasks is experienced by at least 75% of patients.
Other common symptoms of MS include:
- Loss of vision, blurriness, and pain behind the eyes
- Double vision
- Primary pain from the demyelinating process; described as burning, gnawing, or shooting
- Secondary pain from muscle spasticity
- Cognitive difficulties including those with attention span, concentration, memory, problem-solving, and comprehension
- Heat intolerance
- Bilateral facial weakness
- Irregular twitching of facial muscles
- Paresthesia
- Depression
- Muscle cramping and spasms
- Bowel, bladder, and sexual dysfunction
- Poor balance and impaired coordination
Causes And Risk Factors
There is no known cause of MS, however there are various genetic and environmental risk factors associated with the disease. Most forms of MS are two to three times more common in women than in men. The reason for this is mostly unknown, but there is evidence pointing to hormones, body fat, and obesity. Other risk factors for MS include Vitamin D deficiency, viral infections (Epstein Barr virus), and geographical location (incidence is lower in equatorial regions).
Treatment Options
MS currently has no known cure, but there are treatment options that can slow the progression of the disease and the damage to the nerves, as well as reduce symptoms.
The drugs used in Immunomodulatory Therapy are called Disease-Modifying Agents for MS (DMAMS). They include, but aren’t limited to:
- Interferons e.g., IFN beta-1a (Avonex or Rebif)
- Sphingosine 1-phosphate receptor modulators e.g., Siponimod, Ozanimod
- Monoclonal Antibodies e.g., Natalizumab, Alemtuzumab
- Miscellaneous immunomodulators e.g., Glatiramer.
For the mitigation of acute symptoms and the reduction of inflammation, corticosteroids can be used to speed up recovery after a relapse. Muscle relaxants are also often prescribed to help with pain, spasms, and fatigue.
Supportive and supplemental treatment options include:
- Eating a healthy, balanced diet
- Exercise
- Stretching
- Physical therapy
- Oleic acid, according to recent studies
If you believe your symptoms match those of MS, it is critical that you talk to your doctor to establish a diagnosis and start treatment as soon as possible. While the disease may not have a cure, there are many forms of treatment available and more becoming known through research to help patients with MS live a long, productive life.