An insight into Multiple sclerosis

Multiple Sclerosis is an autoimmune disease in which immune system acts on one’s own central nervous system (brain and spinal cord). It mainly damages the myelin fat sheath around the nerve fibers called axons that decrease the ability to transmit electrical impulses effectively. Later neurons can also be affected.

The presenting symptoms of MS are varied and can range from visual impairment, numbness and or weakness of one or more limbs, unsteadiness while walking to problems in passing urine, stools, memory and language disturbances. The symptoms usually develop over few days to few weeks and minor symptoms may sometimes go unnoticed.

MS can be of relapsing/remitting type in which symptoms come and go with partial or total improvement or progressive type in which symptoms gradually increase over a period of time. There also could be relapses superimposed over a progressive type. Apart from patients history and physical examination investigations like MRI, VEP ,evoked potentials and CSF analysis and blood work up aid in diagnosis of the disease and in differentiating it from other conditions which may have similar manifestations.

Treatment includes IV steroids for acute attacks and disease modifying therapy for prevention of relapses and disability accumulation. Interferons are used as disease modyfying therapy in the form of injections used either once in a week intramuscularly or thrice a week subcutaneously. Oral formulations are also available now which is slowly gaining acceptance over injectons. These are generally given lifelong. Therapy also includes neuropsychological evaluation and counselling as and when necessary.