Eimear Lawlor
eimarlaw@gmail.com
Multiple Sclerosis
What is MS
MS (multiple sclerosis) is a neurological condition which affects the brain, spinal cord and optic nerves. It won’t kill you but the disease is so unpredictable it affects everyone different presenting many difficulties in a person’s life. It is believed that one‘s own body is attacking itself; hence it is classified as an “autoimmune disease”.
The body’s own defence system attacks myelin, the fatty substance that surrounds and protects the nerve fibres in the central nervous system. The nerve fibres themselves can also be damaged. The damaged myelin forms scar tissue (sclerosis), which gives the disease its name. When any part of the myelin sheath or nerve fibres is damaged or destroyed, nerve impulses travelling to and from the brain and spinal cord are distorted or interrupted, producing the variety of symptoms that can occur.
Symptoms of multiple Sclerosis.
Some of the most common symptoms are;
• Fatigue
• Visual problems
• Muscle weakness and spasticity
• Balance problems
• Cognitive problems
Fatigue
The most common complaint of MS patients is fatigue. This occurs in as many as 78% of patients, usually in the late afternoon and usually the fatigue will subside in the early evening. Rest is very important and often people with MS will nap in the afternoon is advised .
Visual Problems
One of most indicative symptom of MS is the eyes in the manifestation of a painful condition called optic neuritis. This is caused by inflammation of the optic nerve affecting the eye. This can result in blurring of vision and tunnel vision.
Muscle spasm and spasticity
Occurs with the initial attack of MS in up to 41% of patients and is present in about 62% of patients with the progressive form of the disease. It occurs when opposing groups of muscles contract and relax at the same time. Spasticity produces a retarded movement where a person will have difficulty moving freely.
Mobility/motor
Gait and balance disturbances are common with MS. Balance problems due to dizziness causes a person to sway or stagger, this will effect walking and if a person is experiencing any type of numbness walking will be impaired as well.
Pain
Pain with MS is classified into neuropathic pain or musculoskeletal pain.
• Burning, aching, or "girdling" around the body. This is called dysesthesia occuring anywhare on the body.
• Lhermitte's sign. A brief, stabbing, electric-shock-like sensation that runs from the back of the head down the spine, brought on by bending the neck forward.
Bladder problems
Increased frequency of urination, urgency, dribbling, hesitancy and incontinence are very common. Urinary tract infections are very common.
Bowel problems
Dysfunction of the bowel occurs in almost two thirds of patients with MS that is why it is very important for people with the disease to eat a high fibre diet.
Tests
It may not always be clear to the physician if a person has MS by a physical exam alone, a MRI (magnetic resonance imaging) or a lumbar puncture will be required. MRI is a type of x-ray that will detect if there are lesions on the brain or spinal cord and a lumbar puncture is where fluid is drawn from the spine to measure oglio bands in the fluid. Two or more bands in the fluid is definitive of MS.
The Four Courses of MS
Since no two people have exactly the same experience of MS, the disease course may look very different from one person to another.
People with MS can typically experience one of four courses of the disease each of which might be mild, moderate, or severe.
Relapsing – Remitting (RR)
People with this type of MS experience clearly defined attacks of worsening neurological function. These attacks are called relapses, flare-ups, or exacerbations which are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Usually an acute attack may result in some deterioration. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
Primary Progressive
This course of MS is characterized by slowly worsening neurological function from the beginning, unfortunately with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
Secondary Progressive.
Following an initial period of relapsing-remitting MS, some people will develop a secondary-progressive disease course. This is where the disease worsens more steadily over time with or without occasional flare-ups, minor recoveries. Before disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years.
Progressive relapsing
In this relatively rare course of MS (5%), people experience steadily worsening symptoms from the beginning with clear attacks of worsening neurological function along the way. They may or may not experience some recovery following each relapse.
Symptoms themselves vary from individual to individual.
Treatments
Currently, there is no cure for MS.. These two drug therapies are the two types of disease modifying drugs available.
These disease modifying drugs will not halt the disease but have been shown to decrease severity of exacerbations and frequency.
• Beta interferons are used for the treatment of relapsing-remitting MS. Betaferon is administered every second day subcutaneously (under the skin) via injection. Avonex is administered via injection intra muscular twice weekly.
• Copaxone also administered by injection is for the treatment of relapsing-remitting MS.
• Fingolimod taken orally for relapsing forms of MS helps reduce the frequency of exacerbations and to delay the accumulation of physical disability.
Alternative therapies
• Positive Attitude. Having a positive will not cure MS but it can reduce your stress helping you feel better.
• Exercise. To some this is very important but someone with MS needs to know when their body has had enough and not to overdo it. Exercise increases endorphins (happy hormones) which will be released and blood flow will improve to all your organs. Before starting an exercise programme a consultation with a doctor or a qualified exercise trainer should be organised.
• Diet. It is important for people with MS to follow a healthy, well-balanced diet. Ask your doctor what diet is right for you.
• Massage. Massage therapy works in a number of ways it can alleviate any pain and also produce a feel good factor.
• Acupuncture. This can help with pain and bladder or constipation.
• Evening primrose oil (linoleic acid). Linoleic acid is also found in sunflower seeds and safflower oil. There is some evidence that taking an oral supplement of linoleic acid may slightly improve MS symptoms.
• Diet. It is believed by some that gluten, milk or legumes are one of the reasons for MS. Some believe people with MS have a leaky gut and molecules from these foods breach the stomach lining got get into the bloodstream which will result in lesions in the brain.
Many of the symptoms of MS can be successfully managed and treated with both alternative and allopathic therapies. There is no cure but with correct medication and use of alternative therapies a person’s life can be helped.
