Multiple Sclerosis

Multiple sclerosis is a condition that can affect your brain, spinal cord, and optic nerves in the eyes. It can cause potential symptoms, including problems with vision, arm or leg movement, sensation, or balance. Multiple sclerosis is a lifelong condition that may cause serious disability.

The effects of this condition vary for everyone. Some people may have mild symptoms and may not need any treatment. Some may have difficulty doing their daily tasks.

MS is an autoimmune disease in which the body's immune system attacks its own tissues. The immune system malfunction destroys the fatty substance (myelin) that covers and protects nerve fibers in the brain and spinal cord.

When the protective myelin is damaged and the nerve fiber is exposed, the signals that travel along that fiber slows down or gets blocked.

The symptoms of this condition are:

• Trouble walking
• Weakness
• Numbness
• Tremor
• Partial or complete loss of vision
• Fatigue
• Slurred speech
• Problems with sexual, bowel, and bladder function

The causes of MS are unknown, but there are a few things that make the disease more likely, such as a combination of genetics and environmental factors that are responsible.

According to studies, some may get MS after they had a viral infection like the Epstein Barr virus or the human herpesvirus 6, which makes the immune system slow or stop working normally.

In case you're a smoker, you'll probably have a worse case as it progresses faster.

Genes do play a role.

These factors may increase the risk-

• Age
• Family history
• certain infections
• race- people who are far away from the equator, like northern European descent have a higher risk of developing MS.
• Vitamin D deficiency

There are no particular tests available of MS, the tests are done to rule out other conditions that may have similar signs and symptoms, known as a differential diagnosis.

The doctor will start by asking you about your medical history and the symptoms. Then the doctor may recommend:

• Blood tests
• Lumbar puncture
• MRI
• Evoked potential tests

Diagnosing MS could be more difficult in people with unusual symptoms or progressive disease. For these people, further testing with spinal fluid analysis, evoked potentials, and additional imaging may be required.

There is no cure for multiple sclerosis. But medicines and lifestyle changes may help you manage the disease.

Treatment for MS attack:

• Corticosteroids
• Plasma exchange (plasmapheresis)

Treatments to modify progression:

For primary-progressive MS, Ocrevus is the only FDA-approved disease-modifying therapy. People who have taken this therapy are less likely to progress than those who have not taken the therapy.

For relapsing-remitting MS, there are many disease-modifying therapies (DMT).

Therapies used to treat MS carry significant health risks, therefore selecting the right therapy for you depends on careful consideration of many factors, that includes duration and severity of disease, the effectiveness of previous MS treatments, other health issues, cost, and child-bearing status.

Treatment options for relapsing-remitting MS include injectable and oral medications.

Injectable treatments include:

• Interferon-beta medications
• Glatiramer acetate

Oral treatments include:

• Fingolimod (Gilenya)
• Dimethyl fumarate (Tecfidera)
• Diroximel fumarate (Vumerity)
• Teriflunomide (Aubagio)
• Siponimod (Mayzent)
• Cladribine (Mavenclad)

Infusion treatments include:

• Ocrelizumab (Ocrevus)
• Natalizumab (Tysabri)
• Alemtuzumab (Campath, Lemtrada)

Physical therapy for MS:

• Physical therapy - stretching and strengthening exercises
• Muscle relaxants
• Medications to reduce fatigue
• Medication to increase walking speed
• Other medications are given for depression, pain, sexual dysfunction, insomnia, and bladder or bowel issues.