BENGALURU: Multiple sclerosis (MS) is an auto-immune inflammatory disease of the central nervous system resulting in repeated demyelination and damage to the brain, spinal cord and optic nerves. The immune cells inflict targeted and repetitive damage to the myelin coating of the central nervous syst em r e sul t ing in the characteristic clinical and MRI changes of MS. A host of environmental factors and genetic predisposition combine to result in this disease. The role of each of these in the pathophysiology of MS is yet to be fully ascertained. It is more prevalent in countries with a temperate climate where it is a major cause of disability, but is being increasingly diagnosed in tropical countries, including India.
This may reflect the increased incidence of the disease or may be due to the widespread availability of advanced investigation techniques like MRI. MS commonly occurs in patients between ages 20 to 45 years and is more common in women.
A variety of symptoms in MS depends on the areas of the central nervous system. Symptoms are acute in onset and may occur in the form of impaired vision in one or both eyes, numbness or weakness in a part of the body, impairment of bladder function, unsteady gait and incoordination. Fatigue and shooting pain in the face or extremities are some of the uncommon symptoms of MS. One should seek immediate medical attention if any of these symptoms appear.
The diagnosis of MS is established by the presence of typical clinical features described above and supported by investigations like MRI, cerebrospinal fluid analysis and blood investigations. Once the diagnosis of MS is established, the patient is immediately administered a short course of steroids to reduce brain inflammation and enhance healing. Treatment is usually lifelong and requires regular monitoring with MRI brain and blood tests under the supervision of a neurologist. The effect of medications is enhanced by a healthy lifestyle with emphasis on good nutrition and regular exercise. (HOD and Consultant - Neurology, Epileptology, Manipal Hospital)