Types of Multiple Sclerosis (MS)
Multiple sclerosis, or MS, is a tough disease that progressively worsens, causing increasing disability and loss of function.
The journey with MS often begins with a first neurological event known as Clinically Isolated Syndrome (CIS), which lasts for at least a day. Symptoms can vary from single to multiple lesions, resulting in monofocal or multifocal MS. MS is categorized into four types based on how symptoms appear:
1. **Primary Progressive MS:** This type is less common, affecting about 10% of people with MS. It involves steadily worsening symptoms without relapses or remissions.
2. **Relapsing Remitting MS:** This is the most prevalent form, affecting up to 85% of individuals with MS. It features phases called relapse flare-ups or exacerbations, where new symptoms appear.
3. **Secondary Progressive MS:** Symptoms gradually worsen over time, with or without relapses or remissions. Most people with relapsing-remitting MS (RRMS) eventually develop this type.
4. **Progressive Relapsing MS:** A rare form, affecting less than 5% of MS patients, where symptoms steadily worsen with acute relapses and no significant recovery.
Once diagnosed with MS or after experiencing an MS-related event, it’s crucial to start treatment promptly, as the first year can cause more significant damage than later years.
**Symptoms**
MS symptoms commonly arise between the ages of 20 and 40. They can worsen or reappear over time, although some may improve.
**Early Signs of MS:**
– Lack of coordination or clumsiness
– Weakness in an arm or leg
– Tingling or numbness
– Loss of balance
– Double vision
– Mental confusion
These symptoms might resolve over months or years, or they might come and go, becoming more intense over time.
**Common Symptoms:**
– Unusual sensations like pins and needles, numbness, burning, itching, or pain
– Bladder issues, frequent urination, or trouble emptying the bladder, along with constipation
– Balance, movement, or walking difficulties
– Dizziness or lightheadedness
– Fatigue and exhaustion
– Muscle spasms, particularly in the legs
– Sexual dysfunction, including vaginal dryness in women and erectile issues in men
– Speech difficulties such as slurred or nasal speech and pauses between words; swallowing problems in advanced stages
– Concentration or focus problems
– Tremors, vision issues, and rarely, seizures
**Causes of MS**
MS symptoms are grouped into primary, secondary, and tertiary categories. Primary symptoms are due to damage to the myelin sheath, which protects nerves in the brain and spine. This damage leads to scarring, disrupting signal transmission between the brain and body.
The exact cause of MS is unknown. It’s an autoimmune disorder where the immune system attacks its own tissues, specifically the myelin that insulates nerve fibers in the brain and spinal cord. Several factors may increase MS risk:
– Age, particularly between 15 and 60
– Gender, with women being twice as likely to develop MS
– Family history, especially if a parent or sibling has MS
– Infection with the Epstein-Barr virus
– Higher risk among Caucasians, and those in temperate climates like North America and Europe
– Conditions like thyroid dysfunction, type 1 diabetes, or inflammatory bowel disease
– Smoking
**Treatment of MS**
Diagnosing MS can be challenging, particularly in those with progressive disease or unusual symptoms. While there is no cure, treatment can reduce relapse frequency and slow disease progression.
**Tests and Diagnosis**
Doctors use differential diagnosis techniques, examining patients physically and recommending tests like spinal taps, MRI scans, blood tests, and more to check for lesions or indications of active disease.
**Managing MS**
Treatment options include:
– Injections: Subcutaneous (under the skin) or intramuscular (into the muscle)
– Medication: Intravenous (through infusion) or oral (by mouth)
– Injectable medicines like beta interferons or glatiramer acetate
– Oral capsules include fingolimod, teriflunomide, and dimethyl fumarate
– Chemotherapeutic agents like mitoxantrone, and natalizumab (an intravenous medication)
– Corticosteroids, such as oral prednisone and intravenous methylprednisolone
**Physical Therapy**
Physiotherapy helps regain motor control and manage balance and coordination loss. Muscle relaxants can alleviate tightness and coordination issues.
**Counseling**
Given that MS is a long-term disease, counseling and therapy are essential for supporting patients and their families and friends.
Even though MS is a challenging condition, ongoing research may one day lead to a cure, thanks to advances in medical science.