Introduction

It is a disease of potentially disabling the brain and spinal cord that is the central nervous system. Communication dysfunction is caused when the immune system attacks the myelin that is the protective sheath that covers the nerve fibers. Communication problems take place between the brain and the rest of the body parts. In short, this disease can cause permanent and complete damage to the nerves. Depending upon the amount of nerve damage and type of nerve that is damaged, multiple sclerosis varies in sign and symptoms.

No complete cure is identified for multiple sclerosis but, treatments given for MS can help recovery from attacks, manage the symptoms and can also modify the disease course. In multiple sclerosis, the life expectancy of a patient is reduced slightly.

Mostly this disease is identified in people with the age groups of 20 and 30 but this is not the limit as it can develop at any age. Multiple sclerosis is more common 2 to 3 times in women as compared to men. Disability in young adults is mostly due to Multiple sclerosis. Multiple sclerosis is a lifelong condition that causes severe problems but in some cases, it can be mild too.

What causes Multiple Sclerosis (MS)?

Causes of multiple sclerosis are identified as when the immune system mistakenly attacks the healthy part of the body and in this case, the healthy part is the brain and spinal cord. Thus, multiple sclerosis is an autoimmune condition. Attack on the layer that covers the nerve commonly known as myelin sheaths is happened by the immune system. When the sheath gets damaged and underlying nerves are also damaged then the traveling of the message gets slowed and disrupted. But the exact cause of the immune system is still unclear but according to experts, the cause is a combination of environmental and genetic factors.

Symptoms of Multiple Sclerosis:

A wide range of symptoms is experienced by people with multiple sclerosis. Symptoms vary from person to person due to the nature of the disease. Severity may change from one year to another, month to month, and also day by day. The most two common symptoms are difficulty in walking and fatigue.

Fatigue:

People with multiple sclerosis report fatigue about 80%. Fatigue becomes debilitating mostly with people with MS that affects the daily routine and ability to do work properly.

Difficulty Walking:

A number of reasons involved in difficulty waking are:

Numbness feeling in legs and feet
Difficulty in balancing
Weakness in muscle
Spasticity in muscle
Problem in vision
Difficulty in walking can lead to many injuries because of falling

Other symptoms:

Some other symptoms that are involved in multiple sclerosis are:

Chronic or acute pain
Tremor
Issues in cognitive like concentration, difficulty in word-finding, and memory.
Speech disorders is linked with multiple sclerosis.
Tingling
Numbness
The problem in learning and thinking
Anxiety and depression
Sexual problems
Bladder issues
Bowel problems
Difficulty in swallowing.

Diagnosis of Multiple sclerosis(1):

If you or your general practitioner thinks that you might have multiple sclerosis then he would suggest you to the neurologist who is the specialist in this condition for diagnosis.

Tests for Multiple Sclerosis:

A single test cannot detect Multiple sclerosis so diagnosing is very complicated. When there is evidence of 2 attacks separately. MRI scan is also done on the signs of attacks. Some tests are performed to confirm the diagnosis.

Neurological Examination:

The neurologist will check for abnormalities, eye movements, the strength of legs and hands, co-ordination and balance, reflexes and speech, and weakness in vision. This will show that your nerves are damaged or not.

MRI

A painless scan MRI is done for diagnosis in which magnetic field and radio waves are generated that will make an image of the body’s inside parts. It will identify if any damage is there in the myelin sheath of the brain or spinal cord.

Evoked potential Test

Many evoked potential tests are performed to assess how your eye works. Brainwaves are monitored with the help of sticky small patches that are called electrodes by showing light patterns to the eyes. It shows whether your brain is working properly or not.

Lumbar puncture:

This is the procedure in which a sample is removed from the spinal fluid by injecting a needle into your lower back. If changes in a fluid are identified that shows the problem in the nervous system. The sample drawn is then tested for antibodies and immune cells that show that the immune system has the fighting capability with the disease or not.

Blood tests

To check for other causes of symptoms, blood tests are performed, such as to check for vitamin deficiency and in rare cases for conditions called neuromyelitis opica.

Treatment for Multiple Sclerosis

No cure is available currently for the treatment of multiple sclerosis, but multiple options exist for treating multiple sclerosis.

Disease-modifying therapies (DMTs)

To slow the progression of the disease and reduce the rate of relapse, Disease-modifying therapies are introduced.

Self- injectables: Medication for the treatment are glatiramer acetate and beta interferons like:

Avonex
Betaseron
Extavia
Plegridy
Rebif

Oral medications: medications for RRMS that are given orally includes:

Dimethyl fumarate
Fingolimod
Teriflunomide
Cladribine
Diroximel
Siponimod

Intravenous infusions: treating RRMS intravenous infusions include:

Alemtuzumab
Natalizumab
Mitoxantrone
Ocrelizumab

Food and drug administration approved the first disease-modifying therapy in 2017 for PPMS patients. That drug is ocrelizumab and given through infusion, also this drug is used to treat patients with RRMS

Ozanimod is another drug that has been approved for the treatment of CIS, SPMS, and RRMS patients. But this drug is not available in the market yet due to the current situation of a pandemic.

All the drugs are not appropriate for every patient with multiple sclerosis. You must discuss with your doctor or pharmacist about the drug and ask for the best suitable drug for you with fewer risks and more benefits.

Other drugs for multiple sclerosis(2)

Corticosteroids like methylprednisolone or acthar gel are also prescribed by the doctor to reduce or treat relapses. Such treatments can lessen your symptoms and improve the quality of living for patients. Multiple sclerosis is different for every person and treatment is also different depending upon the symptoms. So you must discuss with your doctor in detail before taking any medication.

References:

Overview of Multiple Sclerosis