The Patient’s Guide to Multiple Sclerosis (Part 2)

The life expectancy for Multiple Sclerosis (MS) patients is now only 5-10 years lower than average, with the gap steadily closing thanks to vigorous ongoing research and improvement in medicine. A timely diagnosis and adequate treatment, as given below, can help patients overcome the challenges presented by the disease:

Diagnosis:

Due to the lack of specific MS diagnostics and sharing of symptoms with other conditions, the following tests are employed to rule out other conditions and diagnose MS:

• Blood Tests to determine whether the symptoms are related to Lyme disease or AIDS.
• MRIs (Magnetic Resonance Imaging) to help locate exposed nerve endings in the brain and spinal cord.
• Evoked Potential Tests to test the nervous system’s response by using moving visual patterns or short electrical impulses applied to arm and leg nerves.
• Lumbar Puncture to rule out other conditions via the extraction and analysis of spinal fluid.

Treatment:

MS is incurable. However, early-stage treatment can aid in symptom control, attack recovery, and even delaying the condition’s progression in case of relapsing-remitting MS:

1- For Symptom Control:

• Muscle Relaxants such as baclofen and tizanidine for controlling frequent and severe muscle spasms and stiffness.
• Other Medications for correlated symptoms such as depression, anxiety, fatigue, pain, bladder or bowel issues, and sexual dysfunction.
• Physical Therapy, e. exercises for muscular relief and strengthening, and the best ways to use mobility aids like canes, walkers, and wheelchairs can help patients manage MS-caused leg and movement issues

2- For Attacks:

• Corticosteroids to reduce inflammation of exposed nerve endings during attacks. However, side-effects may include mood swings, hypertension, insomnia, and fluid retention.
• Plasmapheresis for new and severe symptoms that are unresponsive towards corticosteroids. The process involves the extraction of a certain amount of blood, from which blood cells are then separated and mixed with albumin (a protein solution), after which the blood sample is re-inserted into the body.

3- For Slowing Symptom Progression:

• Beta Interferons are commonly employed to reduce relapse frequency and severity via under-skin or muscular injections. However, patients require blood tests for liver monitoring to avoid liver damage. Other side-effects include flu-like symptoms and injection-site reactions.
• Ocrelizumab is the only medication that can delay worsening of disability in primary progressive MS via intravenous infusions. However, side-effects include injection-site reactions, fever, nausea, hypotension, and an increased breast cancer risk.
• Glatiramar Acetate is injected in order to prevent further lesions by blocking immune system attacks on myelin, with mild injection-site irritation.
• Teriflunomide also reduces relapses via once-daily oral intake. However, along with liver damage and hair loss, it can damage the fetus, and is, therefore, unsuitable for women who do not use contraception and who are or may become pregnant.
• Natalizumab, protects myelin erosion by blocking the movement of hostile antibodies to the brain and spinal cord in case of severe MS. However, it also increases the risk of ‘Progressive Multifocal Leukoencephalopathy’, a viral brain infection.
• Mitoxantrone, despite being an effective antibody blocker, is a last resort treatment for severe and/or advanced MS, as it can cause numerous blood cancers.

4- Lifestyle Adjustments:

• Low-Impact Exercises such as swimming, walking, stretching, tai chi, and low-impact aerobics can help improve muscular strength, balance and coordination in people with mild-to-moderate MS, as well as relieving stress, a common symptom trigger.
• Avoid Overexposure to Heat as MS symptoms can worsen with rise in body temperature. Also, get plenty of rest.
• Eat A Healthy Diet high in omega-3 fatty acids (salmon, olives, fish oil, etc.) and vitamin D.

Despite being degenerative, an early diagnosis can help ensure an increased lifespan and retention of good life quality. If you or your loved ones observe and signs of MS, contact your doctor without delay. You can also book an appointment with a top Neurologist in Lahore, Karachi and Islamabad through oladoc.com, or call our helpline at 042-3890-0939 for assistance to find the RIGHT Doctor for your neural concerns.