The Patient’s Guide to Multiple Sclerosis (Part 1)

Multiple Sclerosis (MS) is a neural and autoimmune condition that damages the brain, spinal cord and optic (eye) nerve, hence causing muscle spasms and gradually reducing mobility. It affects more than 2.3 million people worldwide, usually between the ages of 15 and 60. Those suffering from thyroiditis, inflammatory bowel disease, Type 1 diabetes, or a previous Epstein-Barr virus infection are at a higher risk of developing the condition.

How It Happens:

Due to unknown causes, the immune system mistakenly attacks and damages myelin, the protective covering of the nerve fibers responsible for message transmission, hence damaging brain-body communication. In most cases, the myelin is completely destroyed in some areas, resulting in the formation of scar tissue and ‘lesions’ (aka scleroses, hence the name ‘Multiple Sclerosis’), i.e. exposed nerve fibers that gradually break or become damaged, thereby cutting off message transmission entirely and resulting in the symptoms of MS.

Symptoms:

Symptoms often appear depending on where the affected nerve fibers are located, with some of the common signs being:

• Slurred speech.
• Slowness in movements and impaired balance.
• Pain during eye movement.
• Bowel and bladder dysfunction.
• Prolonged double or blurred vision.
• Dizziness, vertigo, and coordination issues.
• Electric shock-like sensations when bending the neck forward.
• Partial or complete loss of vision in one eye and red-green colour distortion.
• Numbness, weakness, tingling (pins-and-needles), or pain in the arms, legs, and/or trunk, typically on one side of the body.

Types:

First noticeable between 20 and 40?, MS is classified into the following 4 types:

1- Relapsing-Remitting MS:

Observed in almost 85% MS-diagnosed individuals, it is primarily defined by the systematic alternation between relapses (periods when symptoms worsen) that develop over days or weeks, and remissions (periods when symptoms improve) or ‘rest periods’, that may last for weeks, months, or even years at a time. Moreover, while minor body temperature increases may temporarily worsen the symptoms, they aren’t classified as a relapse.

2- Secondary Progressive MS:

For most individuals, relapsing-remitting MS eventually develops into secondary progressive MS, in which symptoms steadily begin worsening with or without remission periods. While usually occurring 10-20 years after the initial diagnosis, those diagnosed at a later age with relapsing-remitting MS often transition quickly into secondary progressive MS.

3- Primary Progressive MS:

In some older people diagnosed with MS, the symptoms appear gradually, but worsen steadily in a non-defined manner, without any relapses. Moreover, people with this type are often less responsive to medication, and lose mobility faster than the above-mentioned types.

4- Progressive Relapsing MS:

Observed in only 5% of individuals diagnosed with MS, this rare type is defined by the gradual worsening instead of improvement of symptoms between relapses, and is also less responsive to medication.

Complications:

MS may also be accompanied by:

• Epilepsy
• Lower body paralysis
• Chronic bowel and bladder issues
• Depression, mood swings, and memory issues

MS and Women:

Pregnancy: MS-diagnosed women can have a normal pregnancy, labour (without requiring a C-section), and can breastfeed. In fact, relapses often reduce during pregnancy, although they may increase following childbirth. And while MS medication must be continued into pregnancy, certain medications may have to be changed due to being unsuitable for pregnant women.

Periods: Symptoms, particularly weakness, fatigue, depression, and balance issues, may worsen before or during periods in some women due to an increase in body temperature. Moreover, certain MS medications may also cause spotting between periods and irregular periods. And while it often stabilizes after a few months, some women may wish to take oral contraceptives or stop their periods altogether.

Recent medical advancement has made it possible to slow down the disease’s progression and drastically improve patients’ quality of life; making an early diagnosis absolutely necessary. If you observe any of the above symptoms, consult your doctor immediately. You can also book an appointment with a top Neurologist in Islamabad, Lahore and Karachi through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your neural concerns.