Multiple sclerosis is an autoimmune disease in which the body attacks the protective sheath which covers the nerves. This can interrupt communication between the brain and body and may ultimately result in a deterioration of the nerves which is not reversible.
Symptoms
The symptoms of multiple sclerosis vary widely depending on the nerves that are being attacked. Additionally, it can be difficult to attribute symptoms to multiple sclerosis because they may disappear entirely for months and may reappear seemingly affecting different areas. Symptoms which may indicate multiple sclerosis include:
Changes in vision – this may include blurred vision, double vision, loss of vision, or optic neuritis- Dizziness
- Fatigue
- Lack of coordination
- Numbness or weakness – usually occurs on one side of the body at a time or only in the lower extremities
- Tingling throughout the body
- Tremors
- Unsteady gate
It is important to note that symptoms may be exacerbated with elevated body temperatures.
Causes
The exact cause of multiple sclerosis is unknown, however, research indicates it is an autoimmune disease. The body begins to attack and destroy the myelin which is the coating surrounding the brain, spinal cord, and nerves. It is possible that a combination of factors including previous infections and genetic predispositions may explain why some individuals are more susceptible than others.
Tests
There are no tests that are specifically designed to test for multiple sclerosis. However, there are numerous tests that can rule out other conditions and indicate multiple sclerosis.
• Blood Tests – Blood tests are typically used to rule out other infections or inflammatory diseases that may present with symptoms similar to those of multiple sclerosis.
• Lumbar Puncture – During a lumbar puncture a small sample of cerebrospinal fluid is removed from the spinal canal with a needle and sent for analysis. The sample can show abnormal levels of proteins or white blood cells which are indicative of multiple sclerosis. This test can also be used to rule out other conditions and infections which can have symptoms similar to those found in patients with multiple sclerosis.
• MRI – MRI scans can show lesions on the spinal cord and brain frequently found in patients with multiple sclerosis. These lesions can also be found in patients with Lyme disease and lupus. During the procedure patients lie still while a machine moves around them for about an hour. While the procedure is painless it can be quite confining and does make some people anxious. Prior to the scan patients may be given a dye intravenously to help make lesions more visible.
Treatments
There is currently no cure for multiple sclerosis. Instead, treatment focuses on one of three things; treating attacks, treating symptoms, and modifying disease progression. Research is ongoing to develop treatments to cure the disease.
Attacks
- Corticosteroids are the most common treatment for multiple sclerosis. They are used to reduce inflammation associated with attacks. They can be given orally or intravenously.
- Plasma exchange is similar in form to dialysis. During the process plasma and blood cells are mechanically separated and new plasma is introduced to the body. This treatment is typically only used when the patient is unresponsive to corticosteroids.
Symptoms
- Medications to reduce fatigue and to combat depression, pain, and bowel or bladder problems may be prescribed.
- Muscle relaxants may be necessary for patients who experience severe muscle spasms or stiffness.
- Physical or occupational therapy can give patients necessary training in how to improve flexibility and strength. They may also be able to provide assistive devices to help patients perform routine tasks.
Disease Progression
- Beta interferons slow the rate of progression for some individuals. However, these medications can cause liver damage and liver functions must be monitored closely.
- Glatiramer appears to block the immune system’s ability to attack the myelin. This medication must be injected daily.
- Fingolimod is an oral medication which is taken daily. It works by allowing the lymph nodes to trap immune cells which can reduce attacks.
- Natalizumab works by interfering with movement of immune cells from the blood stream to the spinal cord and brain. This treatment can cause a fatal brain infection and is reserved for patients who have been unresponsive to other treatments.
- Mitoxantrone is an immunosuppressant used in severe cases of multiple sclerosis. It has been associated with an increased risk of developing cancer.
Multiple sclerosis is a chronic condition with limited treatment options. There are, however, things patients can do to improve their quality of life such as getting enough rest and exercise, eating a balanced diet, relieving stress, and staying cool.