Sclerosis means hardening or scaring.
Multiple sclerosis is a chronic, degenerative, typically progressive autoimmune disease causing damage to the sheaths of neurons in the brain and spinal cord.
In multiple sclerosis, multiple scar forms on the covering of neurons (myelin sheath) that affects the ability of neurons to carry signals between brain and body results in,
- Impairment of speech
- Muscular coordination,
- Blurred vision
- Severe fatigue etc.
What is multiple sclerosis? Let’s know
What is nervous system and neuron?
Our body has been gifted with a very intelligent system of communication and processing of information between brain and body i.e. nervous system, by which signals are carried between brain and body. All these signal from brain to the organ or from organ to the brain transferred with the help of wiring system of the body i.e. neurons.
Nervous system is divided into two parts. Central nervous system (CNS) and Peripheral nervous system (PNS). CNS includes brain and spinal cord and PNS includes neurons that connect peripheral organs to the CNS.
Like the normal electric wire, our neuron also have a kind of covering sheath named myelin sheath, layer of fat which protect neurons and helps transferring information from one to another neuron.
What is immune system?
Immune system, a defensive system of the body, protects our body from being ill. Immune system performs its action by killing the harmful agent (Antigen) like bacteria, virus or anything which harm to the body directly or indirectly. For this we have certain specialized cells (immune cells) called T- cells and B- cells, macrophages that recognize the antigen and kill them. This is the phenomenon how body protect itself in healthy state.
What happens in multiple sclerosis?
Multiple sclerosis is kind of an autoimmune disease in which immune system attacks on body’s own tissue by identifying them as antigen.
In multiple sclerosis immune cells crosses the blood brain barrier ( a highly selective semi permeable membrane barrier that separates the circulating blood from the brain, prevents many toxins from entering in brain), attack on the myelin cells of neuron and other cells which help in myelin production. This results in inflammation of myelin sheath and gradually as the disease progress these inflammatory lesions convert into scars. The scar tissue formed in different areas of brain that is why disease named as multiple sclerosis.
Symptom of multiple sclerosis
Symptomatology of the disease depends on the nerve affected, and disease symptoms appear in the area of supply of that particular affected nerve. So the symptom of multiple sclerosis varies from patient to patient. Still there are few common and early signs of multiple sclerosis seen in most of patients.
The most common initial symptoms reported are:
- Changes in sensation in the arms, legs or face
- Complete or partial vision loss
- Double vision
- Unsteadiness when walking
- Balance problems
- Pain (muscular and neurologic)
Symptoms related to particular system
- Vision loss
- “Blind spot” in the centre of the visual field
- Double vision
- Uncontrollable eye movements
- Eye pain
- Difficulty performing multiple tasks at once,
- Difficulty following detailed instructions,
- Loss of short term memory
- Hearing loss
- Problems with balance
- Difficult reasoning and problem solving
- Memory loss
- Poor judgment
- Inability to focus
Movement and coordination
- Abnormal sensation in particular area of the nerve.
- Difficulty moving arms or legs
- Difficulty in walking
- Problems with coordination and fine motor skills (writing, sewing etc.)
- Weakness in arms or legs.
- Tingling, burning or numbness in particular area.
- Painful muscle spasms and twitching
- Facial pain
- Facial weakness
- Problems with erections in men (erectile dysfunction, impotence)
Bladder and bowel
- Difficulty in starting urination (urine hesitancy)
- Frequent, strong or ineffectual urge to urinate
- Dribbling or urine
- Constipation even with loose stool.
- Stool leakage (bowel incontinence)
Speech and swallowing
- Slurred speech
- Difficulty speaking
- Difficulty with chewing and swallowing foods (dysphasia)
Types of multiple sclerosis
It is an autoimmune disease represents itself by variety of symptoms. According to the appearance and progression of symptoms National Multiple Sclerosis Society (NMSS) is divided multiple sclerosis into four forms.
- Relapsing-remitting (RRMS)
- Primary-progressive (PPMS)
- Secondary-progressive (SPMS)
- Progressive-relapsing (PRMS)
Relapsing – remitting
Most common form of multiple sclerosis. As the name introduces relapsing, means symptom appears in episodes, between two episodes patient is nearly asymptomatic due to recovery of the inflammatory lesion. Symptoms usually persist for a short period of time (from a few days to a few months) and afterward may remain symptom-free for periods of months or years. Each episode appears with new and progressive symptomatology. Remitting means complete or partial recovery of the previous symptom. Disease usually does not progress during remitting period.
In this form of multiple sclerosis disease continues to progress since the onset of initial symptoms. There is no relapse and recovery of the symptoms. Symptoms continue to get worse over the period of time. Continue progression of disease without any identifiable attack.
This means disease continues to progress without any phase of improvement in between. This form commonly seen in patients having Relapsing-remitting symptoms initially and gradually disease convert into this form. This form of multiple sclerosis does not have the dramatic variations in symptoms that RRMS does, but rather has a slow, steady progression with or without relapses. If relapses do occur, they usually do not fully remit.
Approximately 5 percent of patients are initially diagnosed with progressive–relapsing. This type of MS steadily worsens from the onset, but symptom flare-ups with or without remissions is also present.
Causes of multiple sclerosis
Multiple sclerosis is an autoimmune disease and there is not a single definitive cause which is responsible for the disease. There are multiple factors like genes, family history, vit-D deficiency, and certain infections which make a person prone to have multiple sclerosis.
Family history- A person with positive family history of multiple sclerosis in parents and sibling are at high risk of having multiple sclerosis.
Vitamin D- Many researchers suggest that vitamin D support and strength immune system and reduce risk of autoimmune disease. People having low vitamin D level are at more risk to develop autoimmune disease.
Environmental factors –Multiple sclerosis is less prevalent in tropical countries, (countries near to equator) which again support the role of vitamin D in multiple sclerosis. People who live closer to the equator are exposed to greater amounts of sunlight year round. As a result, they tend to have higher levels of naturally produced vitamin D
Smoking- There are certain studies that prove a connection between smoking and multiple sclerosis. Smoking increases risk of having multiple sclerosis if a person is genetically predisposed or has positive family history. Fortunately, the evidence also suggests that stopping smoking whether before or after the onset of multiple sclerosis decrease rate of progression of disability.
Infections -Researchers haven’t yet identified any infectious agent that definitely causes MS but there is growing evidence that certain infections could contribute to someone’s risk of developing MS.
People infected with Epistein-barr virus, Human herpes virus 6, Clostridium perfringens type B, Chlamydophila pneumoniae are on higher risk of developing multiple sclerosis than the people never had these infections.
Obesity- Obese people are on higher risk of getting multiple sclerosis if they are genetically predisposed. This might be because obese people are often low in vitamin D. Obesity can also make immune system overactive and cause inflammation in body.
Prognosis of Multiple Sclerosis
Although multiple sclerosis is not the kind of disease that can be treated completely so the prognosis is not very sound. Still there are certain factors that affect the progression and prognosis of disease such as sub type of disease, the individual’s sex , race , age and initial symptoms.
The life expectancy is high due to improved methods of limiting disability like physical therapy, occupational therapy and speech therapy.
Individuals with progressive sub types, particularly primary progressive have a more rapid decline of functions. In the primary progressive subtype, supportive equipment as wheel chair or standing frame is often needed.
The earlier in life multiple sclerosis occurs, rate of disability is slow than the patients who are older than fifty when they diagnosed.
Females generally have better prognosis than males.
Initial MS symptoms of visual loss or sensory problems such as numbness or tingling are markers for a relatively good prognosis but difficult walking and weakness are signs of poor outcome.
Diagnosis of multiple sclerosis
There is not a single test which can give definite diagnosis of multiple sclerosis. Multiple investigations along with clinical history are needed to confirm the diagnosis. Investigations include:
1-History collection – First step in diagnosis is getting history of patient. It includes clinical symptoms, episodes of attack, remission etc.
2-Physical examination- Complete neurological examination.
3-CT scan and MRI- Sclerotic lesion of brain and spinal cord are identified with help CT and MRI.
4-EEG- Electroencephalography (EEG) is an electrophysiological monitoring method to record electrical activity of the brain. Although it is not commonly used as diagnosis tool.
5-EMG Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control the muscle.
6-Lumbar puncture- It is the collection of CSF (a clear, colorless fluid that bathes, nourishes, and protects the brain and spinal cord) for analysis of presence inflammatory cells in CSF.
Treatment for Multiple Sclerosis
There is not a complete cure for multiple sclerosis in conventional medicine. Their aim of treatment includes-
Immunosuppressive therapies– Abnormal sensitivity of immune system is decreased by giving medication that suppresses immune system and decrease level of WBC.
Delay progression – life expectancy is increased by giving certain drug which delays progression of disease.
Treating symptoms in isolation – Medication based on the presenting symptoms such as pain killers for pain, muscle relaxant for muscle spasm, antidepressant for depression etc.
Medication for multiple sclerosis
Interferons are natural body signal protein released by various immune cells in response to antigen and provide signal to initiate defensive immune mechanism. There are different types of interferon of every stage of immune response such as gamma interferon release to initiate immune response, Beta interferon released at the end of an immune attack, blocks the action of gamma interferon and helps to reduce inflammation and the body’s immune reaction. Similarly in the form of medicine beta interferon suppresses body’s immune response and limits the progression of multiple sclerosis.
Commonly used beta interferon:
Other medication includes-
- Teriflunomide (Aubagio)
- Fingolimod (Gilenya)
- Dimethyl fumarate (Tecfidera)
- Fluoxetine (Prozac)
Additional therapies– Multiple sclerosis may affect the patient’s ability to perform self-care and other activities of daily living, treatment may also include
- Physical and occupational therapy
- Various aids — such as foot braces, canes, and walkers— can help them remain independent and mobile.
- Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.
Side effect of conventional medicines
Although conventional medicines limit the progression of disease and somehow increase quantity of life of patient, but Long and continue uses of immunosuppressive drugs, anti-inflammatory medicines, anti-depressant affect other systems of the body. Decrease quality of life by giving another suffering. All these side effects are classified on the basis of their severity and duration.
Mild side effects
The more common side effects, seen in many patients. Lasts for short duration, less harmful.
- Flu-like symptoms, including chills and fever
- Pain in abdomen
- Muscular pains
- upper respiratory tract infection
- Decreased levels of white blood cells
- Hair loss
- Reaction at the injection site
Serious side effects
Serious side effects, due to long and continues use of these medicines. May cause danger to the life.
These side effects can include:
- Heart rhythm problems
- Heart failure
- Anaphylaxis (serious allergic reaction)
- Liver damage
- Increased risk of certain cancers
- Autoimmune disorders
- Clots in small blood vessels (Thrombosis)
- Kidney failure
Homeopathy Treatment & Homeopathic Remedies for Multiple Sclerosis
Aim of homeopathy treatment includes:
- Treatment of a patient without giving him another new suffering (side effects)
- Patients are treated holistically for all presenting symptoms; do not need separate medicine for each set of symptom.
- To improve patients vitality without suppression.
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition.