What is Multiple Sclerosis? What causes this disease, symptoms and more
Multiple Sclerosis (MS) is a multifactorial, immune-mediated demyelinating disease that is influenced by genetic and environmental factors and one of the leading causes of neurological disability in young adults.
Multiple Sclerosis typically affects young adults between 20-40 years of age and has a higher prevalence in women. Life expectancy is shortened slightly in persons who suffer from MS, and the survival rate is linked to disability. Death usually results from secondary complications, such as pulmonary or renal causes.
So what triggers this disease? Asianet reached out to Dr Santhosh N S, Consultant – Neurology, Manipal Hospitals Whitefield, who explains it. He says, "The global distribution of multiple Sclerosis generally increases with increasing distance from the equator, suggesting sun exposure and vitamin D has some role in prevention. The prevalence is highest in North America, Western Europe, and Australia and lowest in countries centred around the equator".
The three factors that help in developing the disease are genetic (e.g., HLA DRB1*15:01), environmental (e.g., vitamin D), and lifestyle (e.g., cigarette smoking). People who carry the HLA DRB1*15:01 gene are three times more likely than non-carriers to develop Multiple Sclerosis. People who have a first-degree relative with MS (a sibling, parent, or kid) are also at an increased risk.
While talking about symptoms of Multiple Sclerosis, Dr Santhosh N S further said, "MS result from recurrent attacks of inflammation in the central nervous system:
- Sensory loss or paraesthesia (commonly described as numbness, tingling, pins-and-needles feeling, tightness, coldness and/or swelling of the limbs or trunk), girdle like or tight band-like sensation around the abdomen.
- Unilateral painful visual loss (optic neuritis)
- Limb weakness (hyperreflexia, Babinski sign)
- Facial weakness resembling Bell's palsy
- Visual blurring due to diplopia
- Ataxia, Vertigo
- Lhermitte's symptom (electric shock-like sensations evoked by neck flexion)
- Trigeminal neuralgia, hemifacial spasm, and glossopharyngeal neuralgia
- Facial myokymia (rapid flickering contractions of the facial muscles)
- Bladder dysfunction Pain, Cognitive dysfunction, usually mild, "brain fog," difficulty with multitasking, Sexual dysfunction, Fatigue."
While sharing the story, a Multiple Sclerosis patient said, "My both eyes were blurry, had difficulty seeing far off objects and fine prints of newspaper, and there was pain around the eyeballs and sometimes on the movement of eyes. All these symptoms started to happen suddenly, and I was worried about my vision. On taking an MRI scan of my brain, the doctor diagnosed a clinically isolated event of Multiple Sclerosis. However, I was worried and just took steroids as medications rather than undertake a proper multiple sclerosis treatment."
"A year later, my second attack happened, and I experienced weakness in my leg along with a tight band-like sensation in the abdomen. After this, I went on the prescribed medications for Multiple Sclerosis along with a short course of steroids, and now I'm doing great with no recurrence since then. I go for a scan every six months, and I am on oral medicines, and the treatment has helped me lead a smooth and peaceful life," the patient further added.
How to treat this condition? Dr Santosh said, "The main tests used to support diagnoses are MRI and Lumbar puncture and cerebrospinal fluid (CSF) analysis. The timely MRI brain with contrast is important for diagnosis along with a high index of suspicion.
Multiple Sclerosis is seldom fatal, and life expectancy is shortened by only a few months. There have been concerns about prognosis centre primarily on the quality of life and prospects for disability. But, the newer therapies and early diagnosis and treatment has changed the present scenario."
"The most well-established risk factors are Epstein–Barr virus (EBV) infection in adolescence and early adulthood, tobacco exposure through active or passive smoking, a lack of sun exposure, low vitamin D levels and obesity during adolescence. Other less-established risk factors include night work, excessive alcohol or caffeine consumption, and infectious mononucleosis history.
Though there is no comprehensive prevention method, diets, exercises, medications, no smoking, sufficient vitamin D, and early detection can slow its progression. Acute relapses of MS are usually treated with corticosteroids. The newer medications have been promising in preventing relapses and improving the outcome of MS patients, "he further added.