All about Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that causes the destruction of myelin, the protective covering of nerves in the spinal cord and brain. When myelin is damaged, it disrupts nerve signaling, leading to neurological problems. The immune system mistakenly attacks the myelin, resulting in symptoms like muscle weakness, coordination issues, and sensory problems.

The symptoms ofMS depend on the person's immune response, the location, and severity of nerve damage. The progression of the disease varies based on the type of MS. While there is no cure, treatments are available to help speed up recovery, modify the disease's course, and manage symptoms.

The average age of onset for MS is 27, with the disease most commonly affecting individuals between 20 and 40 years of age. MS is 2 to 3 times more likely to occur in women and is one of the most common and debilitating neurological conditions in young people.

Risk factors for MS include genetics, lack of sun exposure or vitamin D deficiency, childhood obesity, and smoking.

Relapsing-remitting multiple sclerosis (RRMS) is the most common form of MS, affecting about 85% of those diagnosed. In this from of MS, people experience episodes of new symptoms or relapses that develop over days or weeks, followed by periods of partial or complete improvement. These relapses are then followed by periods of disease remission, which can last for months or even years.

Secondary progressive multiple sclerosis (SPMS) can develop in some people (20-40%) with relapsing-remitting MS. In this form of MS, the nerve damage gradually accumulates over time, and symptoms worsen progressively. There are fewer or no periods of remission, and the disease continues to advance, often without the typical flare-remission cycles seen in relapsing-remitting MS.

Primary progressive multiple sclerosis (PPMS)is a form of MS where symptoms begin slowly and worsen gradually over time, without episodes of relapse or remission. In this type, there is continuous progression of disability from the onset, with no clear periods of improvement.

Common symptoms of multiple sclerosis  include:

• Numbness and tingling
• Fatigue
• Weakness
• Partial or complete loss of vision (often with pain during eye movement)
• Double vision
• Dizziness
• Mood changes
• Clumsiness
• Difficulty with bladder control
• Loss of balance and coordination
• Imapired cognitive function (trouble with thinking, memory, and focus)Muscle stiffness and spasms
• Small increases in body temperature can temporarily worsen symptoms ofMS, also known as Uhthoff's phenomenon, where even a slight rise in temperature, such as from exercise, hot weather, or fever, can lead to a temporary flare-up or worsening of symptoms like fatigue, weakness, and vision problems
• Sudden, brief sensations of electric shock-like pain that runs down the back and into the limbs

The diagnosis of MS is primarily based on clinical evaluation and imaging techniques, such as MRI, which can detect lesions in the brain and spinal cord. In some cases, a lumbar puncture (spinal tap) may be performed to analyze cerebrospinal fluid for specific markers, helping to confirm the diagnosis.

Treatment strategies include:

1. Medications
• Disease-modifying therapies (DMTs) to slow disease progression.
• Symptom management medications to address issues like fatigue, muscle spasms, and pain.
2. Physical, Occupational, and Speech Therapy
• These therapies help improve mobility, coordination, and communication while maintaining independence.
3. Mental Health Counseling
• Provides support for managing emotional challenges such as depression and anxiety.
4. Lifestyle Modifications
• Adequate Sleep: Ensuring enough rest to help manage fatigue and support overall health.
• Regular Physical Activity: Staying active to improve strength, balance, and mobility.
• Avoiding Tobacco and Alcohol: Reducing these habits can help slow disease progression.
• Eating Nutritional Meals: A healthy diet supports overall well-being and may help manage MS symptoms.

These combined approaches can significantly improve one’s quality of life and help slow the progression of multiple sclerosis.

Dr. Mohammad Ghatali - Mubadala Health Dubai, UAE