Multiple Sclerosis (MS)

Multiple Sclerosis is a chronic illness that usually strikes individuals between the ages of 20 and 40 and is about three times more common in women than men.

What is multiple sclerosis?

Multiple Sclerosis (MS) is a chronic autoimmune disorder targeting the central nervous system (CNS), specifically the brain and spinal cord.

The immune system damages the myelin sheath, impairing nerve impulse transmission and resulting in diverse neurological symptoms.

Types of Multiple Sclerosis

MS is classified into several types based on disease progression:

• Relapsing-Remitting MS (RRMS): The most common form, accounting for about 85% of cases. It features episodes of symptom flare-ups followed by remission. Various disease-modifying therapies (DMTs) target this form.
• Secondary Progressive MS (SPMS): Many with RRMS eventually transition to SPMS, characterised by steady progression with fewer or no remissions. Emerging therapies like BTK inhibitors and stem cell transplants are being explored.
• Primary Progressive MS (PPMS): Affects about 10–15% of MS patients. Symptoms worsen steadily without distinct relapses, often resulting in greater disability, particularly among men.
• Progressive-Relapsing MS (PRMS): The rarest form, involving a progressive worsening of symptoms with occasional relapses but no remission periods.

Guillain-Barré Syndrome (GBS) vs. Multiple Sclerosis (MS)

Signs and Symptoms

MS symptoms vary depending on the location and extent of CNS damage. They may worsen during relapses and improve during remission. Common symptoms include:

• Fatigue: Overwhelming tiredness not relieved by rest.
• Numbness and Tingling: Pins and needles in limbs or torso.
• Muscle Weakness: Especially in the legs, affecting mobility.
• Vision Problems: Blurred vision, optic neuritis, or eye pain.
• Coordination and Balance Issues: Leading to instability and falls.
• Spasticity: Involuntary muscle stiffness and spasms.
• Cognitive Changes: Memory loss, slower processing, concentration difficulties.
• Bladder and Bowel Dysfunction: Urgency, incontinence, constipation.
• Pain: Including nerve-related sharp or burning sensations.
• Dizziness and Vertigo: Sensations of spinning or imbalance.
• Emotional Changes: Depression, anxiety, mood swings, and pseudobulbar affect.

Multiple Sclerosis Causes

Although the exact cause of MS remains unknown, it likely results from a complex interplay of genetic predisposition and environmental factors.

• Genetic links to other autoimmune diseases like type 1 diabetes and rheumatoid arthritis.
• Environmental triggers such as Epstein-Barr virus infection, vitamin D deficiency, smoking, and geographical latitude.

How to prevent multiple sclerosis?

Because the exact causes are unclear, definitive prevention of developing MS is not possible. However, reducing certain risk factors may help:

• Vitamin D Maintenance: Supplements may lower MS risk, especially in regions with low sunlight.
• Avoiding Smoking: Smoking increases both the risk and severity of MS.
• Infection Control: Preventing infections like Epstein-Barr virus may lower risk, although not conclusively.

Multiple Sclerosis Diagnosis

Diagnosing MS requires evidence of:

• Damage to the CNS, particularly lesions in the brain or spinal cord.
• Multiple episodes of neurological dysfunction separated by time and location.

The diagnosis typically involves:

• MRI Scans: Detects CNS lesions and demonstrates disease progression.
• Cerebrospinal Fluid (CSF) Analysis: Identifies immune activity specific to MS.
• Evoked Potentials: Measure delayed nerve conduction.
• Neurological Examination: Identifies signs consistent with MS.

The McDonald Criteria facilitate earlier and more accurate MS diagnosis by emphasising:

• Dissemination in Space and Time: Lesions in different parts of the CNS at different times.
• Supporting Evidence: MRI, CSF analysis, and evoked potential tests enhance diagnostic certainty.

Multiple Sclerosis Treatment Options

Disease-Modifying Therapies (DMTs)

These therapies reduce relapse frequency, slow disability progression, and minimise CNS lesions. Options include:

• Injectable Medications: Interferons and glatiramer acetate.
• Oral Medications: Fingolimod, dimethyl fumarate, and teriflunomide.
• Infusion Therapies: Natalizumab and ocrelizumab, particularly targeting B-cells in progressive MS.

Symptom Management

Focused on improving daily function and quality of life through:

• Corticosteroids: Manage relapses.
• Muscle Relaxants: Reduce spasticity (e.g., baclofen).
• Pain Medications: Gabapentin or pregabalin for neuropathic pain.
• Fatigue Treatments: Modafinil to improve alertness.
• Bladder/Bowel Treatments: Medications and catheter use as needed.
• Mental Health Support: Antidepressants and cognitive therapy.

Supportive Care

Improving long-term health and independence via:

• Physical and Occupational Therapy: Enhance mobility and daily function.
• Psychological Support: Therapy and support groups for emotional health.
• Assistive Devices: Mobility aids to maintain independence.

Lifestyle Changes and Complementary Therapies

• Exercise: Strengthens muscles and improves mood.
• Healthy Diet: Supports overall health, though specific diets are still being studied.
• Stress Management: Techniques like meditation and yoga to reduce symptom flare-ups.

Can You Die From Multiple Sclerosis? 

MS itself is rarely fatal. However, complications from severe disability—such as respiratory infections or swallowing difficulties—can reduce life expectancy.

Most individuals live for decades with MS, especially with proper medical management, rehabilitation, and symptom control.

Early Diagnosis and Ongoing Care

Early intervention and multidisciplinary care are vital for managing MS. Advances in research, clinical trials, and personalised treatment strategies continue to improve outcomes.

At Prince Court Medical Centre, the best hospital in Kuala Lumpur, Malaysia, our expert neurologists provide world-class care tailored to your needs.

With cutting-edge technology and a patient-centred approach, we ensure early diagnosis and proactive management to help you maintain a productive, fulfilling life.

Trust Prince Court for exceptional neurological care.

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