Multiple Sclerosis - Symptoms, Tests & Available Treatments

In MS, the immune system, which is the body's defence mechanism, launches an attack on the protective covering known as myelin. Myelin wraps around nerve fibres, facilitating smooth communication between the brain and the rest of the body.

This immune assault on myelin can disrupt the flow of messages within the nervous system. Over time, the disease may result in lasting damage or a gradual decline in the health of nerve fibres.

Disclaimer: The information provided in this article is for informational purposes only and is not meant to substitute or replace professional medical advice. Consult your doctor or a qualified healthcare professional to know more about the condition.

Symptoms and Their Variations

Multiple sclerosis symptoms can considerably differ from person to person and may evolve over time, depending on the location of affected nerve fibers.

Some of the common symptoms of multiple sclerosis include the following -

• Numbness or weakness in one or more limbs, often affecting one side of the body at a time
• Impaired coordination
• Slurred speech
• Difficulty maintaining balance or walking
• Partial or complete loss of vision, usually affecting one eye and sometimes accompanied by pain related to eye movement
• Prolonged double vision
• Persistent fatigue
• Tingling sensations
• Blurry vision
• Vertigo
• Electric-shock feelings associated with certain neck movements, particularly bending the neck forward (Lhermitte sign)
• Challenges related to sexual, bladder, and bowel functions
• Cognitive issues
• Mood disturbances

When to Seek Medical Assistance?

It's advisable to consult a doctor if any of the above symptoms arise without a discernible cause.

Disease Progression

For most individuals with MS, the disease follows a pattern of relapsing and remitting.

During relapses, new symptoms emerge or existing ones worsen over a span of days or weeks. This is followed by periods of remission during which symptoms partially or completely subside.

Increases in body temperature can exacerbate symptoms temporarily, though these instances aren't considered true disease relapses but rather pseudo relapses.

Over a span of 10 to 20 years from disease onset, about 20% to 40% of individuals with relapsing-remitting MS may transition to secondary-progressive MS. This stage involves a steady progression of symptoms, with or without remission periods.

Some individuals may also experience primary-progressive MS, which is characterised by a gradual onset and continuous progression of symptoms without distinct relapses.

Exploring Causes and Risk Factors

The root cause of multiple sclerosis remains unidentified, though it’s recognised as an immune-mediated disease where the immune system erroneously targets the body's own tissues.

In MS, this misguided immune response specifically attacks the fatty substance myelin, which envelops and safeguards nerve fibres within the brain and spinal cord.

The presence of myelin is similar to the insulation on electrical wires. When this protective myelin is compromised and nerve fibres are exposed, the transmission of messages along these fibres can slow down or be blocked altogether.

The precise reasons behind the development of MS in certain individuals and not others remain unclear. However, a combination of genetic and environmental factors is presumed to contribute to this phenomenon.

Factors that might increase the likelihood of developing multiple sclerosis include -

• Age, with the onset of MS typically occurring between the ages of 20 and 40 years
• Race, with a higher risk for people of Northern European descent and lower risk for those of Asian, African, or Native American heritage
• Family history, with individuals having a parent or sibling with MS being at a higher risk
• Particular infections, with various viruses like Epstein-Barr linked to MS
• Obesity, which might raise the risk, particularly among females during childhood and adolescence
• Smoking, as smokers with an initial MS symptom have an elevated chance of confirming relapsing-remitting MS
• Climate, as MS is more prevalent in regions with a temperate climate
• Vitamin D levels, with low levels and minimal sunlight exposure associated with greater MS risk
• Gender, as women are 2 to 3 times more likely than men to experience relapsing-remitting MS
• Genetics, with a specific gene on chromosome 6p21 associated with MS
• Certain autoimmune disorders, including thyroid disease, pernicious anaemia, psoriasis, type 1 diabetes, or inflammatory bowel disease

Possible Complications

Individuals with multiple sclerosis may encounter additional challenges in the form of -

• Severe weakness or paralysis, usually in the legs
• Seizures (only in rare cases)
• Cognitive difficulties such as trouble finding words or forgetfulness
• Muscle stiffness or spasms
• Mood disturbances, like depression, anxiety, or mood swings
• Issues with bladder, bowel, or sexual functions

Diagnostics and Tests

Multiple sclerosis (MS) doesn't have specific tests for diagnosis. Instead, doctors often determine if someone has MS by excluding other conditions that share similar signs and symptoms. This process is known as a differential diagnosis.

The diagnostic journey often starts with a comprehensive medical history review and a thorough physical examination. Following this initial assessment, your doctor may suggest the following steps -

• Blood Tests: These tests help rule out other diseases that might have symptoms similar to MS. Specific biomarker tests for MS are still being developed, and they could potentially aid in diagnosis by identifying unique markers associated with the disease.
• MRI (Magnetic Resonance Imaging): MRI scans can reveal lesions, or areas of damage, in the brain, cervical, and thoracic spinal cord. Sometimes, a contrast material is injected intravenously to highlight active lesions.
• Clinical Pattern Recognition: For several individuals with relapsing-remitting MS, a diagnosis can be relatively straightforward based on the observed pattern of symptoms along with brain imaging scans, such as an MRI.
• Spinal Tap (Lumbar Puncture): In this procedure, a small sample of cerebrospinal fluid is taken from the spinal canal for analysis in a laboratory. Abnormalities in certain antibodies linked to MS can be detected. This test is also valuable for excluding other conditions that mimic MS symptoms. An emerging antibody test could potentially make this process faster and more cost-effective.
• Evoked Potential Tests: These tests measure the electrical signals generated by your nervous system in response to stimuli. Visual or electrical stimuli are used, and these tests assess the speed at which information travels along nerve pathways.

It’s worth noting that in cases where symptoms are atypical or the disease progresses in an unusual manner, further testing might be necessary. This could include additional imaging, spinal fluid analysis, and evoked potential tests.

Treatments Available

While no particular cure for MS is available currently, medical professionals use several treatments to manage the symptoms and the progression of the disease. Here are the usual goals of the treatments utilised for MS -

• Attacking Symptoms: During MS attacks, corticosteroids may be used to reduce inflammation, although they come with potential side effects like mood swings, fluid retention, and more.
• Plasma Exchange: For severe symptoms unresponsive to steroids, plasma exchange may be performed. This procedure involves the separation of blood’s liquid part (plasma) from blood cells before reintroduction in the body along with particular solutions.
• Slowing Progression: Disease-modifying therapies (DMTs) aim to reduce the frequency of relapses, limit the formation of new lesions, and delay disability accumulation. Various DMT options exist, ranging from injectables to oral medications and infusions.
• Managing Symptoms: Physical therapy can help manage symptoms like muscle stiffness and gait issues. This can also be used along with medications, which can address spasticity, fatigue, and other symptoms associated with MS.

It's important to note that the selection of the right DMT involves careful consideration of factors such as disease duration, severity, previous treatments, overall health, cost, and even pregnancy plans.

How Can the Right Health Insurance Help with Conditions like Multiple Sclerosis?

MS requires patients to be brought in for multiple tests and monitoring, which can lead to considerably high treatment costs. On top of that, the therapies and medications involved in the treatment for prolonged periods can themselves bring fairly high expenses.

However, if you have a health insurance plan with a critical illness cover, you can easily get the necessary financial assistance in such cases. With this cover, you can get a lump sum amount provided if you are diagnosed with a critical illness like multiple sclerosis.

With this amount, you can take care of the expenses related to emergency services, outpatient and inpatient care, prescription medications, and more. You can also use this amount to cover your loss of income or debt obligations. This can bring peace of mind for yourself as well as your family members and loved ones.

To sum up, living with MS can certainly be challenging. However, maintaining normal activities, staying connected, pursuing hobbies, and seeking support from friends, family, and support groups can significantly improve the quality of life for those diagnosed with MS.

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