What is Multiple Sclerosis?

Multiple Sclerosis is a disease is usually present in the form of recurrent attacks of focal or multifocal neurological dysfunction of the brain and the spinal cord. In multiple sclerosis, these messages do not travel through the central nervous system properly and are slowed, distorted or, in some cases, blocked completely due to damage to the nerve tissue. The disease process attacks the myelin sheaths of the nerves and disrupts their function.

Attacks occur, remit and recur randomly over many years. Multiple Sclerosis is a disease begins most commonly in early adult life. A first attack could be followed by another 10-20 years later.

During a typical episode, symptoms worsen over a period of few days to 2-3 weeks and then, remit. Recovery is usually rapid over a period of weeks. Initially recovery is complete, thereafter it is incomplete and as one attack follows another, a stepwise decline commences with permanent
deficits.

Diagnosis of Multiple Sclerosis

Multiple sclerosis should not be diagnosed unless there is evidence that two or more different regions of the central white matter have been affected at different times. A diagnosis of clinically definite disease can be made in patients with a relapsing-remitting course and evidence on examination of at least two lesions involving different regions of the central white matter. The diagnosis is probable in patients with multifocal white matter disease but only one clinical attack, or with a history of at least two clinical attacks but signs of only a single lesion.

Clinical Features of Multiple Sclerosis

Are dependent on the location of the attacks on myelin sheaths within the CNS. The disease usually affects people between the ages of 20 and 50 years, but can also occur before 20 or after 50 years. It is, however, not found for the first time in persons over 55 years, or before adolescence. Women are slightly more affected by this disease than men.

1. Impaired vision.
2. Speech difficulty.
3. Abnormal gait and tremors.
4. Weakness and paralysis of one or more limbs
5. Bladder and bowel difficulties.

Other characteristic changes include the following:

  • ocular dismrbances-optic neuritis, diplopia, ophthalmoplegia, blurred vision, and nystagmus
  • muscle dysfunction – weakness, paralysis ranging from monoplegia to quadriplegia, spasticity, hyperreflexia, intention tremor, and gait ataxia
  • urinary dismrbances – incontinence, frequency, urgency, and frequent infections
  • bowel disturbances – involuntary evacuation or constipation
  • fatigue-often the most debilitating symptom.
    Associated signs and symptoms include poorly articulated or scanning speech and dysphagia. Clinical effects may be so mild that the patient is unaware of them or so intense that they are debilitating.

Multiple Sclerosis Early Symptom – Multiple Sclerosis Sign Symptom

Less commonly, symptoms are steadily progressive from their onset, and disability develops at a relatively early stage (primary progressive disease). The diagnosis cannot be made with confidence unless the total clinical picture indicates involvement of different parts of the central nervous system at different times.

A number of factors (eg, infection, trauma) may precipitate or trigger exacerbations. In most patients, visual problems and sensory impairment, such as burning, pins and needles, and electrical sensations, are the first signs that something may be wrong. Relapses are also more likely during the 2 or 3 months following pregnancy, possibly because of the increased demands and stresses that occur in the postpartum period.

Some of the common symptoms for multiple sclerosis includes :

  • Weakness
  • Dizziness
  • Amnesia
  • Fatigue, tired easily
  • Constipation rarely
  • Hearing loss
  • Loss of ability to think abstractly
  • Pain
  • Depression

 

Management of Multiple Sclerosis

No specific treatment is available as the cause of the disease is yet unknown. Several recent studies have suggested that immunosuppressive therapy with cyclophosphamide, azathioprine, methotrexate, cladribine, or mitoxantrone may help to arrest the course of secondary progressive multiple sclerosis. The evidence of benefit is incomplete, however. There is little evidence that plasmapheresis enhances any beneficial effects of immunosuppression in multiple sclerosis.

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