Nerve cells are composed of cell bodies and axons. Demyelination is the term used for a loss of myelin, a substance in the white matter that insulates nerve endings. The axons can be large myelinated, small myelinated or small unmyelinated.
Myelin helps the nerves receive and interpret messages from the brain at maximum speed. When nerve endings lose this substance they can not function properly, leading to patches of scarring, or ‘sclerosis’, occurring where nerve endings have lost myelin.
  • Autoimmune disease
  • Genetics
  • Infections
  • Low oxygen levels from disorders such as carbon monoxide toxicity.
  • Nutritional deficiencies
  • Organophosphates (class of chemicals), which are the active ingredients in  commercial insecticides and flea treatment preparations for pets
 Symptoms And Signs
  • Anxiety,fear,worry
  • Blurriness in the central visual field that affects only one eye; may be accompanied by pain upon eye movement;
  • Cognitive disruption(speech impairment and memory loss)
  • Constipation
  • Difficulty controlling bowel movements or urination
  • Difficulty coordinating movement
  • Double vision
  • Dry/rough skin
  • Fatigue
  • Headaches
  • Heat sensitivity (symptoms worsen, reappear upon exposure to heat such as a hot shower);
  • Increased sensitivity
  • Insomnia
  • Loss of dexterity
  • Odd sensation in legs, arms, chest, or face, such as tingling or numbness (neuropathy);
  • Pain
  • Paralysis
  • Poor digestion
  • Seizures
  • Underweight

Diagnosis of demyelination diseases depend on the specific disease.

MRI can often diagnose plaques or scarring caused by multiple sclerosis, but a normal MRI occurs in 5 percent of people with MS in early stages, the National Multiple Sclerosis Society states, and doesn’t rule out MS or other demyelinating diseases.

                No cures exist for demyelinating diseases as their progression, and symptoms are different for everyone. Getting treatment early is important. Treatment focuses on:
  • Minimizing the effects of the attacks
  • Modifying the course of the disease
  • Managing the symptoms
A variety of drug therapies are recommended depending on specific disorder. These may include medications that decrease the frequency of new lesion formation. Strategies to treat symptoms include physical therapy, muscle relaxing drugs, and medications to reduce pain and fatigue.
Management of Acute attacks–
During symptomatic attacks, patients may be hospitalized. administration of high doses of intravenous corticosteroids, such as methylprednisolone is the routine therapy for acute relapses. This is administered over a period of three to five days, and has a well-established efficacy in promoting a better recovery from disability. Steroids produce a rapid improvement from disability, but this improvement only lasts up to thirty days following a clinical attack.
Potential side effects include osteoporosis  and impaired memory, the latter being reversible.
Approved Drugs —–
The six drugs are
i. Interferon beta-1a—- injected weekly
ii. Interferon beta-1b——- injected every second day
iii. Glatiramer acetate—– injected daily
iv. Mitoxantrone ———— most effective in the short term,use limited by
severe cardiotoxicity
v. Natalizumab————- most effective
vi. Fingolimod
Most of these drugs are approved only for the Relapsing-Remitting course. Not all the patients are responsive to all these therapies.
Even with appropriate use of medication, to varying degrees most patients with relapsing-remitting MS still suffer from some attacks and many suffer subsequent disability. Treatments only reduce the progression rate of the disease but do not stop it. As multiple sclerosis progresses, the symptoms tend to increase. The disease is associated with a variety of symptoms and functional deficits that result in a range of progressive impairments. Management of these deficits is therefore very important.
Multidisciplinary approach
As for any patient with neurologic deficits, a multidisciplinary approach is key to limiting and overcoming disability.People with MS may need help from almost any health profession or service at some point.

·  Neurologists

·  Physiatrists.

·  Physiotherapy

·  Speech and language therapy

·  Occupational therapy

·  Psychologists, and psychiatrists

·  Neuropsychologists

Multidisciplinary approaches have been shown to be effective in increasing activity levels and participation in multiple sclerosis
Ayurvedic Management——-

Ayurvedic treatment of MS is aimed at arresting the progress of the illness and helping alleviate the symptoms. Almost all cases showed positive response to the Ayurvedic approach to varying extents. The major aspects of an Ayurvedic treatment for MS include diet, healing supplements, yoga and Ayurvedic therapies that nourish and empower the nervous system.

There are many herbal medicines currently in use for the treatment of MS related symptoms. Specific herbal and mineral preparations are carefully gathered and prepared which improve both nervous and muscular function according to Ayurvedic tradition.

General guidelines—
  • Avoid caffeine, alcohol and smoking.
  • Avoid gluten rigidly. Instead have Indian basmati rice
  • Cut out all refined  sugar and dairy products
  • Eat fresh food and lots of fresh fruits.
  • Eat lots of dark green leafy salads, legumes, nuts and seeds.
  • Eat raw vegetables, such as shredded cabbage, raw grated carrots and beetroot.
  • Increase use of fish and sea foods.
  • Use olive oil or coconut oil for cooking and salads.
  • Practice Pranayama or breathing exercises daily.
  • Meditation is a way to achieve integration and balance.
Managing symptoms–
For each symptom there are different treatment options. Treatments should therefore be individualized depending both on the patient and the physician.
  • Bladder
    Pelvic floor muscle training, stimulation, biofeedback.
  • Bowel— Pain or problems with defecation can be helped with a diet change, oral laxatives or suppositories and enemas.
  • Cognitive and emotional—–Depression, anxiety and euphoria can be treated with a variety of Ayurvedic antidepressants. Psychological interventions are also useful in the treatment of cognitive and emotional deficits.
  • Dysphagia and dysarthria—-A speech and language therapist may give advice on specific swallowing techniques, on adapting food consistencies and dietary intake, on techniques to improve and maintain speech production and clarity.
  • Fatigue——-Patients should be evaluated for depression before other therapeutic approaches are used. Disturbed sleep, chronic pain, poor nutrition, or even some medications can contribute to fatigue. Fatigue is a very difficult symptom to manage for which specific drugs are recommended.
  • Pain—Acute pain is mainly due to optic neuritis, trigeminal neuralgia, Lhermitte’s sign, or dysesthesias. Subacute pain is usually secondary to the disease and can be a consequence of spending too long in the same position, urinary retention, and infected skin ulcers, amongst others. Treatment will depend on cause. Chronic pain is very common and harder to treat as its most common cause is dysesthesias.
  • Spasticity: A physiotherapist can help to reduce spasticity and avoid the development of contractures with techniques such as passive stretching. There are also palliative measures like castings, splints or customized seatings.
  • Vision: different Ayurvedic medicines and formulations are given to improve the symptoms of nystagmus or diplopia.
  • Walking capacity: Classical Ayurvedic medicines improves walking ability.
Ayurveda hold promise in the management of Demyelination. The proven medicines and various methods used in the treatment controls the progress of disease and helps in curing the disease. The therapy improves course of life definitely.
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