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WHAT IS MULTIPLE SCLEROSIS

(ALSO KNOWN AS MS) ?

  • A condition that affects the central nervous system, in other words the brain and spinal cord
  • Can also affect optic nerves in the eyes
  • It causes a disruption of the material, myelin, that wrap around the nerve fibres to insulate and protect them
  • This leads to communication problems between the brain and the rest of the body
  • It can occur at any age, but is most commonly found in individuals between the ages of 15 and 60
  • In some cases, symptoms are mild not requiring treatment. Other cases are more severe requiring ongoing treatment and support

TYPES OF MS

There are 4 types of MS, namely:

  1. Relapsing-remitting multiple sclerosis (RRMS)
    – The most common form of MS where the symptoms
    respond to treatment and resolve for weeks to years,
    but relapses may occur
  2. Secondary-progressive multiple sclerosis (SPMS)
    – Signs and symptoms don’t fully disappear during
    remission periods
  3. Primary-progressive multiple sclerosis (PPMS)
    – The signs and symptoms of MS progress over time,
    with no remission periods
  4. Progressive-relapsing multiple sclerosis (PRMS)
    – Although periods of remission occur, the symptoms
    become more severe over time

SIGNS AND SYMPTOMS OF MS

Common signs and symptoms of MS include:

  • Problems with vision
  • Imbalance
  • Loss of muscle control
  • Trouble walking
  • Fatigue/Tiredness
  • Difficulty swallowing
  • Poor control over bladder and/or colon
  • Numbness, tingling or muscle spasms
  • Difficulty concentrating and remembering
  • Dizziness
  • Erectile dysfunction
  • Overall body pain
  • Slurred speech

THE CAUSES OF MS

  • The exact cause is still unknown
  • A combination of genetic and environmental factors may play a role
  • It is considered an auto-immune disease, where the body attacks and destroys its own myelin
  • It is possible that certain viruses that impact the immune system may play a role in developing MS
  • Vitamin D helps strengthen the immune system. Some studies suggest that a vitamin D deficiency may contribute towards developing MS
  • It is not contagious

WHO IS AT RISK OF DEVELOPING MS?

  • Having relatives with MS – in other words, having a genetic predisposition
  • More prevalent amongst females than males
  • Individuals with other auto-immune conditions, such as type 1 diabetes, thyroid disease or inflammatory bowel disease are at higherM risk for developing MS
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HOW IS MS DIAGNOSED?

  • Usually diagnosed by a specialist in the brain and nervous system, called a neurologist
  • Up to date there is no single test available to confirm the diagnosis of MS
  • Evaluation of medical history of signs and symptoms will take place
  • Diagnosis mostly based on eliminating other causes of the presenting signs and symptoms, which may include:
    • Blood tests to rule out conditions that cause similar
      symptoms
    • Magnetic resonance imaging (MRI) of the brain and
      spinal cord is a powerful tool for the early diagnosis
      of multiple sclerosis to detect lesions. It is also used
      to monitor the effectiveness of treatment
    • Analysis of cerebrospinal fluid, that is the fluid around
      the brain and spinal cord
    • Testing the electrical activity in the brain
    • Physical examination, especially of balance and vision

WHAT IS THE EDSS SCORE FOR MS?

As per the National Multiple Sclerosis Society: “The Expanded Disability Status Scale (EDSS) is a method of quantifying disability in multiple sclerosis and monitoring changes in the level of disability over time. It is widely used in clinical trials and in the assessment of people with MS8.”

TREATMENT AND MANAGEMENT OF MS

There is no cure for MS as yet, but treatment can improve the symptoms of MS, slow the progression of the disease and help with the nerve damage.

MEDICATION

There are numerous medication options that the treating doctor or specialist will consider, including, but not limited to:

  • Disease modifying medications
  • Corticosteroids
  • Plasma exchange therapy
  • Muscle relaxants
  • Medication to reduce fatigue
  • Pain medication
  • Antidepressants
  • Medication for sexual dysfunction
  • Medication for bladder and bowel control
  • Medication to help improve memory

PHYSICAL OR OCCUPATIONAL THERAPY

  • Stretching and strengthening exercises
  • Training on devices to utilise for performing daily tasks

WHAT IF I WANT TO START A FAMILY?

  • People with MS are just as likely to conceive and have healthy children as anyone else.
  • In fact, because MS is usually diagnosed between the ages of 20 to 40, plenty of people with MS go on to become parents after their diagnosis.
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COPING AND SUPPORT

  • Follow a healthy diet
  • Get adequate sleep
  • Exercise regularly
  • Build a support structure, including associations or support groups focusing on supporting individuals with MS
  • Avoid exposure to heat, as MS symptoms may worsen when body temperature rises
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1. P & T Journal March 2012, Marvin M. Goldenberg, Multiple Sclerosis
Review

2. British Medical Bulletin, Volume 95, Issue 1, 1 September 2010, Pages 79–104, Konrad Rejdak, Samuel Jackson, Gavin Giovannoni, Multiple sclerosis: a practical overview for clinicians

3. Journal of Multiple Sclerosis ISSN: 2376-0389

4. American Academy of Neurology, March 2018, Helen Tremlett, Feng Zhu, Alberto Ascherio and Kassandra L. Munger, Sun exposure over the life course and associations with multiple sclerosis

5. The Pharmaceutical Journal, 6 MAY 2000, Ahmed Toosy, MRCP,
MA (Cantab) and Alan Thompson, FRCP, FRCPI, Multiple sclerosis: the disease and its treatment

6. The Journal of Clinical Investigation, March 2004, David A. Hafler,
Multiple sclerosis

7. Adv Biomed Res. 2016; 5: 75, Vahid Shaygannejad, Maryam Shirmardi, Leila Dehghani and Helia Maghzi, Co-occurrence of multiple sclerosis and Parkinson disease

8. National Multiple Sclerosis Society, Functional Systems Scores (FSS) and Expanded Disability Status Scale (EDSS)

9. Adv Neurol. 2006;98:125-46, Traboulsee AL, Li DK, The role of MRI in the diagnosis of multiple sclerosis

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