MULTIPLE SCLEROSIS

Multiple sclerosis (MS) is a potentially disabling disease of the brain and spinal cord (central nervous system).

In MS, the immune system attacks the protective sheath (myelin) that covers nerve fibers and causes communication problems between your brain and the rest of your body. Eventually, the disease can cause permanent damage or deterioration of the nerve fibers.

Signs and symptoms of MS vary widely between patients and depend on the location and severity of nerve fiber damage in the central nevous system. Some people with severe MS may lose the ability to walk independently or ambulate at all. Other individuals may experience long periods of remission without any new symptoms depending on the type of MS they have.

SYMPTOMS: -

MS-related nervous system damage

Myelin damage and the nervous systemOpen pop-up dialog box

Multiple sclerosis signs and symptoms may differ greatly from person to person and over the course of the disease depending on the location of affected nerve fibers.

COMMON SYMPTOMS INCLUDE:

• Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time.
• Tingling.
• Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign).
• Lack of coordination.
• Unsteady gait or inability to walk.
• Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement.
• Prolonged double vision.
• Blurry vision.
• Vertigo.
• Problems with sexual, bowel and bladder function.
• Fatigue.
• Slurred speech.
• Cognitive problems.
• Mood disturbances.

DISEASE COURSE: -

Most people with MS have a relapsing-remitting disease course. They experience periods of new symptoms or relapses that develop over days or weeks and usually improve partially or completely. These relapses are followed by quiet periods of disease remission that can last months or even years.

Small increases in body temperature can temporarily worsen signs and symptoms of MS. These aren't considered true disease relapses but pseudorelapses.

At least 20% to 40% of those with relapsing-remitting MS can eventually develop a steady progression of symptoms, with or without periods of remission, within 10 to 20 years from disease onset. This is known as secondary-progressive MS.

The worsening of symptoms usually includes problems with mobility and gait. The rate of disease progression varies greatly among people with secondary-progressive MS.

Some people with MS experience a gradual onset and steady progression of signs and symptoms without any relapses, known as primary-progressive MS.

CAUSES: -

The cause of multiple sclerosis is unknown. It's considered an immune mediated disease in which the body's immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys the fatty substance that coats and protects nerve fibers in the brain and spinal cord (myelin).

Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and the nerve fiber is exposed, the messages that travel along that nerve fiber may be slowed or blocked.

It isn't clear why MS develops in some people and not others. A combination of genetics and environmental factors appears to be responsible.

RISK FACTORS: -

These factors may increase your risk of developing multiple sclerosis:

Age: MS can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.

Sex: Women are more than 2 to 3 times as likely as men are to have relapsing-remitting MS.

Family history. If one of your parents or siblings has had MS, you are at higher risk of developing the disease.

Certain infections: A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis Race. White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk. A recent study suggests that the number of Black and Hispanic young adults with multiple sclerosis may be greater than previously thought Climate. MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe. Your birth month may also affect the chances of developing multiple sclerosis, since exposure to the sun when a mother is pregnant seems to decrease later development of multiple sclerosis in these children.

Vitamin D: Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of MS.

Your genes. A gene on chromosome 6p21 has been found to be associated with multiple sclerosis.

Obesity: An association with obesity and multiple sclerosis has been found in females. This is especially true for female childhood and adolescent obesity.

Certain autoimmune diseases: You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.

Smoking: Smokers who experience an initial symptom that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

COMPLICATIONS: -

People with multiple sclerosis may also develop:

• Muscle stiffness or spasms
• Severe weakness or paralysis, typically in the legs
• Problems with bladder, bowel or sexual function
• Cognitive problems, like forgetfulness or word finding difficulties
• Mood problems, such as depression, anxiety or mood swings
• Seizures, though very rare.

EXAMS AND TESTS: -

Symptoms of MS may mimic those of many other nervous system problems. MS is diagnosed by determining if there are signs of more than one attack on the brain or spinal cord and by ruling out ther conditions.

People who have a form of MS called relapsing-remitting MS have evidence of at least two attacks separated by a remission.

In other people, the disease may slowly get worse in between clear attacks. This form is called secondary progressive MS. A form with gradual progression, but no clear attacks is called primary progressive MS.

The health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.

An exam of the nervous system may show reduced nerve function in one area of the body. Or the reduced nerve function may be spread over many parts of the body.

This may include:

• Abnormal nerve reflexes
• Decreased ability to move a part of the body
• Decreased or abnormal sensation
• Other loss of nervous system functions, such as vision
• An eye exam may show
• Abnormal pupil responses
• Changes in the visual fields or eye movements
• Decreased visual acuity
• Problems with the inside parts of the eye
• Rapid eye movements triggered when the eye moves.

TYPES OF MS AND STAGES: -

There are four types of MS: -

Clinically isolated syndrome (CIS): This is a single, first episode, with symptoms lasting at least 24 hours. If another episode occurs at a later date, a doctor might diagnose relapse-remitting MS.

Relapse-remitting MS (RRMS): This is the most common form. Around 85% of people with MS are initially diagnosed with RRMS. RRMS involves episodes of new or increasing symptoms, followed by periods of remission, during which symptoms go away partially or totally.

Primary progressive MS (PPMS): Symptoms worsen progressively, without early relapses or remissions. Some people may experience times of stability and periods when symptoms worsen and then get better. Around 15% of people with MS have PPMS.

Secondary progressive MS (SPMS): At first, people will experience episodes of relapse and remission, but then the disease will start to progress steadily.

TESTS TO DIAGNOSE MS INCLUDE: -

Blood tests to rule out other conditions that are similar to MS.

Lumbar puncture (spinal tap) for cerebrospinal fluid (CSF) tests, including CSF oligoclonal banding may be needed.

MRI scan of the brain or the spine, or both are important to help diagnose and follow MS.

Nerve function study (evoked potential test, such as visual evoked response) is less often used.

PROGNOSIS: -

The outcome varies, and is hard to predict. Although the disorder is life-long (chronic) and incurable, life expectancy can be normal or almost normal. Most people with MS are active and function at work with little disability.

Those who usually have the best outlook are:

• Females
• People who were young (less than 30 years old) when the disease started
• People with infrequent attacks.
• People with a relapsing-remitting pattern.
• People who have limited disease on imaging studies.
• The amount of disability and discomfort depends on how often and severe the attacks are.
• The part of the central nervous system that is affected by each attack
• Most people return to normal or near-normal function between attacks. Over time, there is greater loss of function with less improvement between attacks.

COMPLEMENTARY AND ALTERNATIVE THERAPIES: -

The following may help with different aspects of MS:

heat and massage. treatment for pain.

acupuncture for pain and gait.

stress management to boost mood.

exercise to maintain strength and flexibility, reduce stiffness, and boost mood

a healthful diet with plenty of fresh fruits, vegetables, and fiber quitting or avoiding smoking.

REHABILITATION AND PHYSICAL THERAPY: -

Rehabilitation can help improve or maintain a person’s ability to perform effectively at home and work.

Programs generally include:

Physical therapy: This aims to provide the skills to maintain and restore maximum movement and functional ability.

Occupational therapy: The therapeutic use of work, self-care, and play may help maintain mental and physical function.

Speech and swallowing therapy: A speech and language therapist will carry out specialized training for those who need it.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.

Vocational rehabilitation: This helps a person whose life has changed with MS make career plans, learn job skills, and get and keep a job.

APPROACH OF HOMOEOPATHIC MEDICINES FOR MANAGING MULTIPLE SCLEROSIS:-

When Multiple Sclerosis is concerned there are many effective medicines available in homoeopathy, but the selection depends upon the individuality of the patient, considering mental and physical symptoms.

Alumina:- One of the best remedy for multiple Sclerosis with lack of muscular coordination. Locomotor ataxia. Staggers on walking. Spinal degeneration and paralysis of lower limbs. Inability to walk, except when eyes are open or in day time. Legs feel numb. Constipation.

Argentum nit:- Where the person feels great weakness of lower limbs, with softening of the spinal cord. Weakness, rigidity, or twisting in calf muscles. Legs feel as if made of wood or there is trembling and numbness of limbs.

Causticum:- For multiple Sclerosis associated with urinary incontinence. Weakness and progressive loss of muscular strength, causing paralysis of single organs or parts.

Conium Mac:- For multiple Sclerosis with muscular weakness, especially lower limbs. Sudden loss of strength while walking. Can walk straight and steadily with closed eyes,but staggers , becomes giddy and is nauseated while walking with open eyes. Numbness of fingers and toes.

Gelsemium:- One of the top remedies for multiple Sclerosis with double vision and lack of muscular coordination. Vision blurred and smoky. Blurring and discomfort in eyes even after accurately adjusted glasses.

Lathyrus sativus:- Used in multiple Sclerosis with spastic paralysis of lower limbs. Reflexes are increased. Tremulous tottering gait. Excessive rigidity of legs, spastic gait. Gluteal muscles and muscles of lower limbs are emaciated.

Oxalic acid:- Numbness and tingling in the limbs. Numbness extends from shoulders to finger tips. Pain starting from spine and extend to the limbs.