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Multiple sclerosis, or M.S., is a chronic autoimmune disorder affecting our central nervous system, CNS, and the brain, spinal cord, and optic nerves. Multiple sclerosis symptoms can be simple muscle weakness or, in severe cases, vision loss. Symptoms tend to worsen during flares and improve during times of remission. It is impossible to predict how multiple sclerosis will progress in any individual.
In multiple sclerosis, our immune system attacks the protective myelin sheath that covers the nerve fibers. It causes communication problems between our brain and the rest of our body. M.S. can cause permanent damage to the nerve fibers.
Types of Multiple sclerosis and stages
There are four types of Multiple sclerosis:
- Clinically isolated syndrome (CIS): It is a single, first episode, with symptoms lasting for a minimum of 24 hours. If another episode occurs later, the healthcare professional could diagnose it as relapse-remitting M.S.
- Relapse-remitting MS (RRMS): RRMS is the most common form of M.S., and about 85% of the cases of M.S. are of RRMS. There are episodes of new symptoms or increased symptoms. The symptoms are often followed by periods of remission, subsiding the symptoms totally or partially.
- Primary progressive M.S. (PPMS): In the case of PPMS, the symptoms worsen without remission. Almost 15% of people with M.S. have PPMS.
- Secondary progressive M.S. (SPMS): In the beginning person experiences episodes of relapse and remission. After that, the disease starts to progress steadily.
Multiple Sclerosis Symptoms
Multiple sclerosis symptoms vary widely among patients and greatly depend on the severity and location of nerve fiber damage in the CNS.
Early signs and symptoms of MS
The central nervous system controls all body activities, and M.S. affects the CNS. Therefore, the symptoms can affect any part of our body. The most common Multiple Sclerosis Symptoms are as per below.
- Pain: Severe pain is one of the most common symptoms of MS. Neuropathic pain is directly due to M.S., but muscle stiffness can cause localized pain.
- Muscle weakness: Due to nerve damage, one can develop muscle weakness.
- Numbness and tingling: One of the earliest symptoms of M.S. is a pins and needles-type sensation. It can affect the face, arms, legs, and body.
- Bladder problems: An early sign of M.S. is loss of bladder control. Persons with M.S. can face difficulty emptying their bladder or a need to urinate frequently or suddenly.
- Fatigue: One of the most common symptoms of M.S. is fatigue which affects the person’s ability to perform regular duties at home or at the workplace.
- Dizziness and vertigo: Vertigo and dizziness are common symptoms of M.S., along with balance and coordination issues.
- Muscle spasms: Painful muscle spasm is an early sign of MS. It happens due to damage to nerve fibers in the spinal cord.
- Tremor: Involuntary shaking is another symptom of M.S.
- Vision problems: Blurred or double vision can be symptoms of MS. MS symptoms include partial or total loss of sight.
- Emotional changes and depression: Demyelination and damage to the nerve fiber can trigger emotional changes causing depression.
- Learning and memory problems: People with M.S. faces difficulty in planning, learning, prioritizing, multitasking, and concentrating.
- Lhermitte’s sign: One can experience an electric shock-like sensation during neck movement. It is called Lhermitte’s sign.
Less common Multiple Sclerosis Symptoms include:
- Headaches
- Hearing loss
- Itching
- Respiratory problems
- Seizures
- Speech disorders
- Problems with swallowing
Patients with M.S. pose a greater risk of UTI (urinary tract infections), less activity, and impaired mobility. The patient’s ability to think and sensitivity to heat, along with perception change, is also common in M.S.
M.S. affects persons differently. For some people, it begins with a subtle sensation, and the symptoms do not progress for months or years. But for some, symptoms worsen rapidly, within weeks or months.
Causes of MS
The cause of multiple sclerosis is unknown. It’s considered an immune-mediated disease in which our body’s immune system attacks its cells. The immune system malfunction eradicates the myelin sheath that safeguards our brain and spinal cord nerve fibres. Damaged protective myelin exposes the nerve fibre. As a result, the messages traveling along the nerve fibre could be slowed or blocked.
The reasons are not clear why MS develops in some and not in others. Genetics and environmental factors seem to cause MS.
Risk factors
Several factors increase the risk of developing MS.
- Age: MS usually onset around 20 and 40. But it can happen to younger and older people.
- Sex: Studies found that women are more prone to MS than men.
- Family history: A family history of the disease puts you at high risk of developing the disease.
- Race: The chance of acquiring MS is higher in people of Northern European heritage. The lowest risk groups are those with Asian, African, or Native American ancestry. According to a recent study, there may be more Black and Hispanic young individuals with multiple sclerosis than previously believed.
- Climate: In nations with temperate climates, such as Canada, the northern part of the United States, New Zealand, south-eastern Australia, and Europe, MS is far more prevalent.
- D vitamin: Low vitamin D levels and little sun exposure are linked to an increased risk of MS. There is mounting evidence that vitamin D contributes significantly to MS. Low blood levels of vitamin D have been linked to an increased risk of developing multiple sclerosis (MS). The natural source of vitamin D, sunlight, is thought by some experts to contribute to the explanation of the north-south distribution of MS. Living nearer to the equator exposes people to more sunshine all year long. As a result, they typically possess greater levels of vitamin D produced naturally, which is known to enhance immune function and may serve as protection against diseases like MS that are immunological-mediated.
- The genetics: MS is not a hereditary condition, meaning it is not passed down from parent to child. But there is a genetic risk for MS that could be inherited. About 1 in 750 to 1000 people in the general population are at risk of having MS. If one of an identical pair of twins has MS, The second twin has a one in four chance of developing MS. Although far less than in the case of identical twins, the risk of acquiring MS is enhanced when additional first-degree relatives (parents, siblings, and children) also have the disease. There are over 200 genes known, and each one adds a modest percentage to the overall risk of getting MS. The development of MS is influenced by several factors, including genetic risk, which is still being researched.
- Obesity: Numerous studies have demonstrated that obesity during childhood and adolescence—especially in girls—increases the risk of having MS in the future. According to other studies, early-life obesity may potentially raise the likelihood of getting multiple sclerosis (MS). Additionally, obesity may increase MS activity and inflammation in people who already have the disease.
- Smoking: Additionally, there is more and more proof that smoking has a significant impact on MS. According to studies, smoking increases the likelihood of having MS, makes the condition more severe, and hastens the disease’s course. Fortunately, there is evidence linking quitting smoking to a decreased rate of disability development, whether it occurs before or after the onset of MS.
Complications
- Multiple sclerosis patients may also experience the following:
- Muscle spasms or stiffness
- Severe lassitude or paralysis, usually affecting the legs
- Issues with the bowels, bladder, or sexual function
- Cognitive problems, such as forgetfulness or trouble finding words
- Depression, anxiety, and mood swings are examples of mood disorders
- Seizures are highly infrequent.
There is no cure for multiple sclerosis, however, early diagnosis and some treatments help to manage Multiple Sclerosis Symptoms.
References
1.McNamara, L. (2015, October 5). Multiple sclerosis (MS). Hopkinsmedicine.org. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/multiple_sclerosis/conditions/
2. Multiple sclerosis. (n.d.-a). Nih.gov. Retrieved January 13, 2023, from https://www.ninds.nih.gov/health-information/disorders/multiple-sclerosis
3. Multiple sclerosis. (n.d.-b). Nhs.uk. Retrieved January 13, 2023, from https://www.nhs.uk/conditions/multiple-sclerosis/
4. Multiple sclerosis. (2020, February 25). Harvard Health. https://www.health.harvard.edu/diseases-and-conditions/multiple-sclerosis-a-to-z
5. Wikipedia contributors. (2023, January 12). Multiple sclerosis. Wikipedia, The Free Encyclopedia. https://en.wikipedia.org/w/index.php?title=Multiple_sclerosis&oldid=1133141008