Multiple Sclerosis: Inflammatory Autoimmune Disorder



To minimise the debilitating effects of the chronic neurological disease,
it is imperative to diagnose and treat the ailment well in time



It was difficult for 40-year-old Nayana Vaidya to digest the fact that she was suffering from a chronic neurological disorder Multiple Sclerosis (MS). On hearing the doctor’s diagnosis, she was overcome with anxiety. Being a working woman, she found it extremely difficult to concentrate on her work. Commuting also became tiresome. The real trauma unfolded when Nayana developed vision problems and a burning sensation in the neck.


One day, however, her right side was paralysed. MRI scan later confirmed the doctor’s diagnosis of MS. The disorder is usually diagnosed between the ages of 20 and 40 years, considered the most productive period of a person’s life. While other people may be building their careers, getting married, or enjoying life in general, MS patients undergo undue hardships in dealing with the disease symptoms. Moreover, an MS patient has to avoid heat and high temperatures, which aggravate symptoms and the patient’s general condition.    


An autoimmune disorder that directly affects the central nervous system (the brain and spinal cord), Multiple Sclerosis generally occurs when the immune system attacks and destroys healthy body tissues, thereby damaging the myelin sheath – the protective covering surrounding nerve cells. With the nerve covering damaged, nerve impulses slow down or stop. Such nerve damage is mainly caused by repeated episodes of inflammation when the body’s immune cells attack the nervous system. This inflammation can be triggered by a virus, genetic defects or environmental factors.


Although Nayana initially found it difficult to cope with the disease, she gradually took it in her stride and began going to office regularly, despite debilitating symptoms. With the help of proper medication and treatment, she is now able to do her daily chores. Awareness and proper attention to the disease have also made her deal with the symptoms more effectively.


Some major MS symptoms include: impaired or double vision, vertigo, facial pain, loss of balance, problems in making minor movements, numbness, tingling or weakness in the limbs, difficulty in passing or holding urine, constipation and other bowel problems, muscle spasms, excessive fatigue, decreased attention span, poor judgment, memory loss and emotional fluctuations leading to depression.


Since the symptoms depend on the site of inflammation in the central nervous system, the location and severity of each attack can vary. Each episode could last for days, weeks or months, with incomplete recovery after such attacks. Fever, hot baths, sun exposure and stress can worsen attacks.


As the initial attacks are often transient, mild and limited, they generally do not prompt a visit to the physician and are sometimes identified only in retrospect, once the diagnosis has been made after further attacks. As time progresses, the severity of attacks can increase.


Early diagnosis and timely treatment decrease the severity of symptoms and the frequency of attacks. It is therefore important that MS signs and symptoms are detected well in time. The cornerstone of MS diagnosis remains the detailed neurologic history and physical examination. MRI is the most important diagnostic tool in addition to spinal fluid examination.


With early detection, several therapies could help patients lead a longer, more productive life by controlling symptoms. Disease modifying therapies such as Interferon and monoclonal antibodies are used to slow down the progression of MS, but need to be taken long term.


Severe depression is likely in MS patients. Regular counselling sessions therefore form an integral part of the treatment. Physiotherapy, speech therapy and occupational therapy are also useful. Apart from this, a healthy lifestyle, good nutrition, rest and relaxation are required too. Besides medical treatment, psychological and emotional support from family and friends is equally important.


In a nutshell, periodic health checkups, a healthy lifestyle, total avoidance of alcohol and cigarettes as well as strong willpower are needed for effective treatment of a severe neurological disease such as Multiple Sclerosis.



Wednesday, August 22, 2012