Multiple Sclerosis (MS)

1399/07/10 - 12:10 / 112

Multiple sclerosis or MS, is a long-lasting disease that can affect your brain, spinal cord, and the optic nerves in your eyes. It can cause problems with vision, balance, muscle control, and other basic body functions.

The effects are often different for everyone who has the disease. Some people have mild symptoms and don’t need treatment. Others will have trouble getting around and doing daily tasks.

MS happens when your immune system attacks a fatty material called myelin, which wraps around your nerve fibers to protect them. Without this outer shell, your nerves become damaged. Scar tissue may form.

The damage means your brain can’t send signals through your body correctly. Your nerves also don’t work as they should to help you move and feel. As a result, you may have symptoms like:

  • Trouble walking
  • Feeling tired
  • Muscle weakness or spasms
  • Blurred or double vision
  • Numbness and tingling
  • Sexual problems
  • Poor bladder or bowel control
  • pain
  • Depression
  • Problems focusing or remembering

 

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The first symptoms often start between ages 20 and 40. Most people with MS have attacks, also called relapses, when the condition gets noticeably worse. They’re usually followed by times of recovery when symptoms improve. For other people, the disease continues to get worse over time.

In recent years, scientists have found many new treatments that can often help prevent relapses and slow the disease’s effects.

What Causes MS?

Doctors don’t know for sure what causes MS, but there are many things that seem to make the disease more likely. People with certain genes may have higher chances of getting it. Smoking also may raise the risk.

Some people may get MS after they’ve had a viral infection - like the Epstein-Barr virus or the human herpesvirus 6 -- that makes their immune system stop working normally. The infection may trigger the disease or cause relapses. Scientists are studying the link between viruses and MS, but they don’t have a clear answer yet.

Some studies suggest that vitamin D, which you can get from sunlight, may strengthen your immune system and protect you from MS. Some people with higher chances of getting the disease who move to sunnier regions seem to lower their risk.

Getting a Diagnosis

It can be hard to Diagnose MS, since its symptoms can be the same as many other nerve disorders. If your doctor thinks you have it, he’ll want you to see a specialist who treats the Brain and nervous system, called a neurologist. She’ll ask you about your medical history and check you for key signs of never damage in your brain, spinal cord, and optic nerves.

There’s no single test that can prove you have MS. Your doctor will use a few different ones to check you. These may include:

  • Blood tests to rule out diseases that cause similar symptoms, like Lym disease and AIDS.
  • Checks of your balance, coordination, VISION, and other functions to see how well your nerves are working.
  • A test that makes detailed pictures of the structures in your body, called an MRI. 
  • Analysis of the liquid that cushions your brain and spinal cord, called cerebrospinal fluid (CSF). People with MS usually have specific proteins in their CSF.
  • Tests (called evoked potentials) that measure the electrical activity in your brain.
  • OCT (Optical coherence tomography) used to detect changes in the retina which could warn of brain atrophy

 

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Treatment

There is no cure for MS right now, but a number of treatments can improve how you feel and keep your body working well.

Your doctor can also prescribe drugs that may slow the course of the disease, prevent or treat attacks, ease your symptoms, or help you manage the stress that can come with the condition.

Your doctor may give you steroids to make your MS attacks shorter and less severe. You can also try other drugs, like muscle relaxants, tranquilizers or botox to ease muscle spasms and treat some of the other symptoms.

A physical therapist can teach you exercises that will keep up your strength and balance and help you manage fatigue and pain. An occupational therapist can teach you new ways to do certain tasks to make it easier to work and take care of yourself. If you have trouble getting around, a cane, walker, or braces can help you walk more easily.

Along with treatment, you can do other things to ease your MS symptoms. Get regular exercise and avoid too much heat to boost your energy. Ask your doctor about trying yoga to ease fatigue or stress . Take care of your emotional health, too. It’s OK to ask family, friends, or a counselor for help with any stress or anxiety you may feel. Support groups are also great places to connect with other people living with MS.

What’s the Outlook for MS?

Research is giving doctors more treatment options for the condition, a better idea of what causes it, and the ability to diagnose it earlier. Stem-cell and genetic research may soon help doctors repair damaged nerves or stop the disease before it causes damage.

Scientists are also looking for new ways to treat MS in clinical trials. These trials test new drugs to see if they're safe and if they work. They're often a way for people to try new medicine that isn’t available to everyone. Ask your doctor if one of these trials might be a good fit for you.

Possible Causes of Multiple Sclerosis

Doctors still don't understand what causes multiple sclerosis. But ongoing research shows that from your genes, to where you live, to the air you breathe, there are many factors in play.

Your Immune System Goes Awry

MS is an autoimmune condition. Doctors don’t know why, but something tells your immune system to attack your body. With MS, the focus is on myelin, a fatty substance that covers the nerve fibers in your brain and spinal cord. Its job is to protect them like the plastic that wraps around the wires in your phone charger. When myelin is messed up, your nerves can’t send messages back and forth the way they should. Without their protective coating, your nerves can get damaged, too.

You might be more likely to get MS if you have another autoimmune condition like inflammatory bowel disease thyroid disease, or type 1 diabetes.

Multiple Sclerosis (MS): Early Signs and Common Symptoms

People with (MS) tend to have their first symptoms between the ages of 20 and 40. Usually the symptoms get better, but then they come back. Some come and go, while others linger.

No two people have exactly the same symptoms. You may have a single symptom, and then go months or years without any others. A problem can also happen just one time, go away, and never return. For some people, the symptoms get worse within weeks or months.

Keep track of what’s happening to you. It’ll help your doctor monitor your disease and help her understand how well your treatment works.

 

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Early Signs of MS

For many people, the first brush with what’s later diagnosed as MS is what doctors call clinically isolated syndrome (CIS). This episode of neurological symptoms usually lasts 24 hours. It happens when your immune system mistakenly tells your body to attack myelin, the protective sheath over nerve cells in your brain and spaine. You may hear your doctor call this demyelination. It causes scars, or lesions, that make it harder for signals to travel between your brain and your body.

There are two types of CIS:

  • Monofocal episode: You have one symptom.
  • Multifocal episode: You have more than one symptom.

The most common symptoms in CIS are:

optic neuritis: This condition damages the nerve that connects your eye to your brain. It usually affects just one eye, but in rare cases, it involves both. You might notice:

  • Blurry vision 
  • Colors appear dull
  • pain in your eye, especially when you move it

Numbness & Tingling: It usually affects your legs. You might feel:

  • An electric shock-like feeling when you move your head or neck. It may travel down your spine or into your arms or legs.
  • Numbness, often in your face
  • Tingling

Not everyone who has CIS will get MS. The odds are higher if you have lesions in your brain from loss of myelin. If you have another CIS or other MS symptoms later, your doctor will do a test called an MRI that takes a picture of your brain to look for them.

Primary MS Symptoms

These come from ongoing damage to your myelin. They aren’t pleasant, but your MS treatment team can help you keep most of them under control with medication, rehabilitation, and other tactics. The most common symptoms are:

Bladder and bowel problems: You may have to pee more often, need to go at night, or have trouble emptying your bladder fully. Bowel issues like constipation are also common.

Clumsiness or lack of coordination: MS can make it hard to get around. You might have:

  • Trouble walking
  • A hard time keeping your balance
  • Changes in your gait

Dizziness: You may feel lightheaded. You probably won't have vertigo, that feeling that the room is spinning.

Emotional changes and depression : It’s tough to adjust to the idea that you have a chronic disease, let alone one that’s hard to predict and that will take a physical toll. Fear of the unknown can make you anxious. Plus the disease damages nerve fibers in your brain, and that can affect your emotions. So can medications, like corticosteroids, used to treat MS.

eye problems: In addition to the optic neuritis that comes with CIS, MS can cause:

Fatigue: You may feel very tired. It often comes on in the afternoon and causes weak muscles, slowed thinking, or sleepiness. It isn’t usually related to the amount of work you do. Some people with MS say they can feel tired even after a good night's sleep.

Heat-related problems: You might notice them as you warm up during exercise. You could feel tired and weak or have trouble controlling certain body parts, like your foot or leg. As you rest and cool down, these symptoms are likely to go away.

Muscle spasms : They usually affect your leg muscles. They’re an early symptom for almost half the people with MS. They also affect people with progressive MS. You might feel mild stiffness or strong, painful spasms.

Sexual troubles: These include vaginal dryness in women and erection problems in men. Both men and women may be less responsive to touch, have a lower sex drive, or have trouble reaching orgasm.

Speech problems: MS could cause long pauses between your words and slurred or nasal speech. You might have swallowing problems as the disease advances.

Thinking problems: It might be hard to focus from time to time. This will probably mean slowed thinking, poor attention, or fuzzy memory. Some people have severe problems that make it hard to do daily tasks, but that’s rare. MS doesn’t usually change your intellect or ability to read and understand conversation.

Tremors: About half of people with MS have them. They can be minor shakes or so intense it’s hard to do everyday activities.

Trouble walking: MS can cause muscle weakness or spasms, which make it tough to walk. Balance problems, numb feet, and fatigue can also happen.

Unusual sensations: In addition to the pins and needles sensation that’s part of CIS, you might also have severe itching, burning, stabbing, or tearing pains. You could feel a tightness around your ribs or upper belly known as the MS hug. Doctors call these uncomfortable symptoms dysesthesia.

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Secondary Symptoms

These are problems created by your primary MS symptoms, not by damaged myelin.

  • Not being able to empty your bladder can lead to a bladder infection.
  • If you have trouble walking and are often fatigued, you’re likely to become less active. That can take a toll on your muscle tone, make your breathing shallow, and even affect your bone density.

Doctors can treat secondary symptoms, but the goal is to avoid them by treating the primary symptoms.

Tertiary Symptoms

These are the social, psychological, and job-related problems of life with MS.

  • If MS makes it hard for you to walk or drive, you may not be able to do your job well.
  • Because it’s tough to get around and hard to talk to people about what life with a chronic disease is like, you may not be as social as you once were.
  • You could get depressed. It’s a byproduct of the changes MS makes in your brain and in your life.

Because MS varies so much, it's best not to compare yourself with other people who have it. Your experience is likely to be different. Most people learn to manage their symptoms and can keep leading full, active lives.

Multiple Sclerosis (MS) Diagnosis & Tests

It can be a challenge for doctors to diagnose (MS). There’s no single test that can prove you have it. And many conditions have symptoms that seem like MS.

A neurologist -- a doctor who specializes in treating the disease -- should be able to help. They’ll ask how you’re feeling and help you figure out if your symptoms mean you have MS or another problem.

What Do Doctors Look For?

A certain set of signs points to MS. Your doctor will need to:

  • Find damage to at least two spots on your brain
  • Prove the damage happened at different points in time
  • Rule out any other diagnosis

What Are the Tools for Diagnosis?

The doctor will start by asking you about your medical history and your symptoms. They’ll also do a few tests to see if your brain and spinal cord are working as they should. These include:

MRI: This imaging test lets the doctor take a closer look at your brain. They can see changes caused by multiple sclerosis like signs of inflammation in the deep parts of your brain or spinal cord.

But older people or those with high blood pressure and diabetes also can have the same kinds of spots on a brain MRI. So the doctor will consider other info, including your symptoms, along with the scan results or the enhancement of lesions before they make a diagnosis.

 

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Also, an MRI result that says things are normal doesn’t rule out MS. You could be one of a small number of people who have lesions in places the scan can’t show.

Lumbar puncture: This test, which you may also hear called a spinal tap, checks the fluid that runs through your spinal column. Doctors use it to look for high levels of proteins and other substances that are signs of the disease. It can help diagnose MS, but it, too, isn’t absolute proof.

Evoked potentials: These electrical nerve tests can help doctors confirm if MS has affected the parts of your brain that help you see, hear, and feel. The doctor will place wires on your scalp to test your brain's response as you watch a pattern on a video screen, hear a series of clicks, or get electrical pulses on your arm or leg.

Blood tests: They can’t diagnose MS, but the doctor will use them to look for substances in your blood that point to it. Most importantly, they can help your doctor rule out conditions that look like MS.

After a Diagnosis

It may take a long time to figure out that you have MS. If you’ve been waiting years or months, the news might be a relief. Or it could be a huge shock. Either way, you’ll have concerns about what the disease means for your life and your family. That's completely understandable.

Talk with others -- your friends, your doctor, a support group, or a counselor -- about your feelings. Your health care team can help you decide the best ways to treat your disease and live with it day to day. MS affects everyone differently, so what works for one person with the condition may not be what’s best for you.

Tips for Living With MS

When you get an illness like bronchitis or the flu, you know you'll be feeling better and back to normal within a week or so. A long-lasting condition like multiple sclerosis is different. It can affect your life in many ways.

It doesn't have to keep you from being happy, though. A positive attitude can be one of the best ways to handle the changes MS can bring. The condition shouldn't define who you are. You just have an extra challenge in your day-to-day life.

Here are some ways to stay upbeat:

Take Care of Your Mind

Get help if you need it. If you’re struggling with the disease’s impact on your life, reach out to someone. Sometimes just talking about what’s bothering you can lighten your mental load. It will also help you understand and better manage the many effects of MS.

Possible Causes of Multiple Sclerosis

Doctors still don't understand what causes multiple sclerosis. But ongoing research shows that from your genes, to where you live, to the air you breathe, there are many factors in play.

Your Immune System Goes Awry

MS is an autoimmune condition. Doctors don’t know why, but something tells your immune system to attack your body. With MS, the focus is on myelin, a fatty substance that covers the nerve fibers in your brain and spinal cord. Its job is to protect them like the plastic that wraps around the wires in your phone charger. When myelin is messed up, your nerves can’t send messages back and forth the way they should. Without their protective coating, your nerves can get damaged, too.

You might be more likely to get MS if you have another autoimmune condition like inflammatory bowel diseasethyroid disease, or type 1 diabetes.

 

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Prepared:


Neshat Khosravi - Microbiologist

Refrence:

https://www.webmd.com

 

 

 

 



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