Written by Juhi Kumari |Published : May 30, 2019 5:13 PM IST
The prevalence of multiple sclerosis (MS), a progressive neurological disorder, has been increasing over the years globally. A WHO estimate suggests that in India, its incidence increased from 1.33 cases per 100,000 people in 1985 to 8.35 cases per 100,000 people in 2014. In another report published in Lancet, it has been found that the global prevalence of this condition is above 270 per 1,00,000 people. However, MS doesn't grab the attention that it requires from the global health community. That's why World Multiple Sclerosis Day is observed worldwide every year on 30th May with the aim of spreading awareness about the condition, highlighting its symptoms and dispelling the myths surrounding MS. This global campaign, initiated by the Multiple Sclerosis International Federation in 2009, centres around a theme every year. This year, the theme is Visibility, named as #MyInvisibleMS.
On this World Multiple Sclerosis Day, we tell you everything that you need to know about this disabling disease.
WHAT IS MS?
"It is an autoimmune disease of the central nervous system. In multiple sclerosis, your immune system attacks myelin, the protective covering of nerve fibres. The damage exposes the nerve fibre and disrupts (travelling of message can be slow or blocked) the communication between your brain and the body. MS is characterized by symptoms like electric-shock sensations with neck movement, tremour, lack of coordination, dizziness, prolonged double vision, slurred speech, tingling or pain in different body parts, problems with sexual, bowel and bladder functions, etc.", says Dr. Jayant Mishra, Senior Consultant Neurosurgeon, Vimhans Hospital, Delhi. If left untreated, multiple sclerosis may progress towards neurodegeneration and lead to paralysis, depression, epilepsy, etc.
Severity and symptoms of multiple sclerosis depend on the location of the affected nerve. "Most of the people with this condition experience new sets of symptoms over days, weeks, and months. Also, the disease relapses quite often after remission," says Dr. Mishra. Notably, increase in the body temperature can temporarily worsen your MS symptoms. There are various factors including age (generally affects people between the ages of 20 and 55), sex (women are more likely to suffer from multiple sclerosis), family history, race, climate, low levels of vitamin D, smoking, etc. that may increase your risk of developing this debilitating disease. "As far as its diagnosis is concerned, there is no specific test for multiple sclerosis. Doctors basically try to rule out other conditions that have similar signs and symptoms. The process of ruling out may involve diagnostic methods like blood tests, MRI, evoked potential tests, spinal tab, etc.," explains Dr. Mishra.
Currently, there is no cure for multiple sclerosis. So, neurologists rely on symptom management through certain drugs, lifestyle changes and targeted therapies. Recently, the US FDA has approved a new drug known as Mayzent for managing multiple sclerosis. This drug is likely to help you in two ways: By delaying its progression and by reducing the chance of a relapse. However, this new drug will take time to come to India.
"Some people with multiple sclerosis experience mild symptoms that do not require treatment. In significant cases doctors provide various drugs specially steroids to slow the progression of the disease and manage its symptoms," says Dr. Mishra. On this World Multiple Sclerosis Day, we tell you about the line of treatment that you can expect from your doctor if you are suffering from this condition.
These drugs are administered either orally or through intravenous injections. They are meant to reduce nerve inflammation and suppress the function of your overactive immune system. Some of the side-effects of these drugs may include hypertension, mood swings, insomnia, and fluid retention.
These are the most common medicines prescribed to patients with MS. They are injected under the skin or into muscles to minimize the frequency and severity of relapses. They may lead to certain side-effects including flu-like symptoms, liver damage, and injection-site reactions.
This is also an injectable medication. Glatiramer acetate is supposed to stop your immune cells from attacking the myelin. It may lead to skin irritation at the injection site.
This medicine is given orally to the patients twice a day to reduce relapses. This may be followed by certain side-effects including diarrhoea, nausea and lowered white blood cell count.
Fingolimod is an oral medication that is prescribed to have once a day to reduce the relapse rate. This may be followed by a bout of low blood pressure and that is why doctors monitor the patient's heart rate for six hours after the first dose. Another side effect of this drug is blurred vision.
This medication is for the patients who either do not respond to or can't tolerate other available treatment options. Generally prescribed to severe multiple sclerosis patients, natalizumab blocks the movement of potentially damaging immune cells. This medication may make you vulnerable to a viral infection of the brain called progressive multifocal leukoencephalopathy.
This immunosuppressant drug is given to patients with severe multiple sclerosis condition. Mitoxantrone can be harmful to the patient's heart and is linked to development of blood cancers.
These medicines are prescribed to relieve the patients of a very common symptom of multiple sclerosis: Muscle spasm and stiffness.
This therapy teaches the patients to do stretching and strengthening exercises. The aim is to improve their body balance, coordination, and gait and help them perform daily tasks with ease. The training also includes instructions on use mobility aids like wheelchair, walker, etc.
During this treatment, a doctor removes plasma from the patient's blood cells and mixes them with a protein solution called albumin. After this, the blood cells are put back in the body. This procedure is meant to clean the blood of the person with MS in order to manage sudden, severe attacks or flare-ups. In multiple sclerosis, the plasma of the patient's blood sometimes contains proteins that can attack her own body. Plasma exchange helps the patient to get rid of those proteins, alleviating the possibility of an immune attack and flare-up. It is performed when the manifestations of multiple sclerosis are severe and haven't eased out with steroids.
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