Multiple Sclerosis is an inflammatory disease of the Central Nervous System (brain and spinal cord). It is a demyelinating disease.
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Causes
Environmental factor
Low prevalence in the tropics and high prevalence in the temperate zones of both northern and southern hemispheres. Migration to high prevalence areas before the age of 15 is a risk factor for the development of the disease.
Genetic factor
Risk is high in first relatives and monozygotic twins
Immunological factor
Increased levels of activated T lymphocytes in the CSF and increased immunoglobulin synthesis within the CNS.
Classification
Relapsing-remitting Multiple Sclerosis (RRMS)
- Recurrent attacks
- Neurologic deficits appear in different parts of the nervous system
- Resolve completely or almost completely over a short period of time
Secondary progressive MS (SPMS)
- Continued progression over the years
- Increasing disability
Primary progressive MS (PPMS)
Function declines steadily without relapses
Progressive-relapsing MS (PRMS)
Occasional relapses superimposed on progressive disease
Symptoms and signs of Multiple Sclerosis
- Constipation and stool leakage
- Decreased attention span
- Depression
- Difficulty beginning to urinate
- Difficulty in reasoning
- Dizziness
- Double vision
- Erectile problems
- Facial pain
- Fatigue
- Hearing loss
- Incontinence
- Loss of balance
- Memory loss
- Muscle spasms
- Slurred speech
- Strong urge to urinate
- Tingling, crawling, or burning feeling in the arms and legs
- Uncontrollable rapid eye movements
- Vision loss (usually affects one eye at a time)
- Weakness/tremor in one or more arms or legs
Investigations
- Neurological exam
- Eye examination
- Lumbar puncture
- MRI scan of the brain and spine
- Nerve function study
Treatment
- Ayurvedic Medicines
- Panchkarma
- General measures
- Physiotherapy
- Speech therapy
- Occupational therapy
- Support groups
- Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
- A planned exercise program
- A nutritious diet, enough rest and relaxation
- Avoiding fatigue, stress, temperature extremes, and illness
Complications
- Spasticity
- Ataxia
- Dysaesthesia
- Failure to store urine
- Failure to empty bladder
- Osteoporosis
- Pressure sores