Multiple sclerosis is a condition involving your central nervous system. Sclerosis means scar or making a scar. So multiple sclerosis means making scars in multiple areas. I will define where this scar will occur and how it happens in the following article. But before we go into what Multiple sclerosis is, we need to understand what a Central Nervous System and Autoimmune disorder are, just to get the whole idea clear.
Table of contents
Central nervous system (CNS)
As the name suggests, CNS controls our whole body. The CNS is the processing center of the body and consists of the brain and the spinal cord. For protection, the brain is encased within the hard bones called the skull, while the spinal cord is protected with the bony vertebrae of our backbones. The third form of protection is cerebrospinal fluid, which provides a buffer that limits impact between the brain and skull.
The brain is the most complex organ in the body and uses 20 percent of the body’s energy. The brain consists of an estimated 100 billion neurons, where each one is connected to a thousand more. These neurons send 1000 signals per second controlling right from breathing to memories to our motor controls.
CNS has a control from physical motion to the secretion of hormones, the creation of memories, and the sensation of emotion. CNS controls our thoughts, movements, emotions, and desires. It also controls our breathing, heart rate, the release of some hormones, body temperature, and much more.
The spinal cord, running almost the full length of the back, carries information between the brain and body but also carries out other tasks. Motor commands from the brain travel from the spine to the muscles and sensory information travel from the sensory tissues- such as the skin- toward the spinal cord and finally up to the brain.
The spinal cord contains circuits that control certain reflexive responses, such as the involuntary movement your arm might make if your finger was to touch a flame.
Autoimmune Disorder
This is a disorder in your body where your immune system mistakenly attacks your body or healthy cells. Our immune system normally guards our body against foreign bacteria and viruses. When it senses this, it sends out an army of fighter cells to attack them. Normally, the immune system can tell the difference between a foreign cell and your own cell.
In the autoimmune disorder, the immune system mistakes parts of your body like healthy cells as foreign cells and releases autoantibodies that attack healthy cells. Doctors are not able to figure out exactly what causes immune system misfire, yet some are more likely to get the autoimmune disease than others.
Women are 2 times more at risk of having autoimmune disease than men. Eating high-fat, high-sugar, and highly processed foods are found to be linked to inflammation, which might set off an immune response.
Because of vaccines and antiseptics, children today aren’t exposed to as many germs as they were in the past. The lack of exposure could make their immune system prone to overreact to harmless substances.
Lupus, autoimmune disease affects more African American and Hispanic people than Caucasians. Some like multiple sclerosis and lupus are part of genetics and run-in families.
Multiple Sclerosis (MS)
Now coming back, Multiple Sclerosis is an autoimmune disease that affects the central nervous system. By now you can understand, MS affects the neurons in our CNS, so our immune system starts attacking our CNS, particularly the neurons.
Myelin sheath: Myelin sheaths are sleeves of fatty tissue that protect your nerve cells. These cells are part of your central nervous system, which carries messages back and forth between your brain and the rest of your body.
Neurons: The wiki explanation is as follows: Neurons (also called nerve cells) are the fundamental units of the brain and nervous system, the cells responsible for receiving sensory input from the external world, for sending motor commands to our muscles, and for transforming and relaying the electrical signals at every step in between. Basically, it controls everything that our body does, right from breathing, actions, coordination, speech, vision, balance, muscle control, and other basic body functions.
In the case of MS, our immune system makes scars in the Myelin sheath, thereby breaking or damaging the neurons and exposing the nerve fiber. You can relate this myelin sheath to the plastic coating of the electrical wire we have at home. When you remove that plastic coating, the inside copper wires are exposed, and this damages or breaks the electrical connections. So, the electricity wouldn’t flow efficiently or most probably will break at points. The same happens in the case of neurons, the signals wouldn’t flow properly and will break in many areas.
Types of Multiple Sclerosis
Now you got an understanding of what MS does. Let’s understand the types of Multiple Sclerosis. There are 4 types particularly.
Clinically isolated syndrome (CIS)
CIS is a pre-MS condition involving symptoms lasting at least 24 hours. These symptoms are due to demyelination (loss of myelin) in your CNS.
Relapse-Remitting MS (RRMS)
This is the most common and almost 85% of people with MS are diagnosed with RRMS. This involves clear relapses (to become worsen again after an improvement) of disease activity followed by remissions (the reduction or disappearance of the signs and symptoms of a disease). During remission periods, symptoms are mild or absent, and there’s mild to moderate disease progression. Without treatment, about half of people with RRMS go on to develop SPMS within a decade.
Primary progressive MS (PPMS)
If you have primary progressive MS (PPMS), the neurological function becomes progressively worse from the onset of your symptoms mostly without relapse or remissions. However, short periods of stability can occur when symptoms worsen and then get better.
Secondary progressive MS (SPMS)
In the initial stages, people will experience relapse and remission, but then the disease will start to progress steadily.
Symptoms of Multiple sclerosis
The first symptoms often start between the age of 20 and 40. Most people with MS have initial symptoms, also called relapses, when the condition gets noticeably worse. They’re usually followed by many times of recovery when symptoms improve. For other people, the disease continues to get worsen steadily over time. These symptoms can vary from person to person.
About 80% of the people with MS have reported fatigue. Fatigue can make it harder for you to go about doing your everyday tasks.
You will face difficulty in walking, numbness in your legs, difficulty in balancing, muscle weakness. This makes you vulnerable to injuries if you fall.
Difficulty in vision is some of the initial symptoms of MS people resulting in blurriness, double vision, blindness. It can affect one eye or both with issues coming and going or getting worsen over time.
MS causes lesions (injury to tissue) in the brain that causes speech issue often called dysarthria ranging from mild to severe. This makes our speech slurred, with long pauses, and changes in volume.
A person may need to empty his bladder or need to urinate more frequently or suddenly. Loss of bladder control is an early sign of MS. You are also at risk of catching urinary tract infections.
Demyelination (loss of Myelin) and nerve fiber damage in the brain can trigger emotional changes. This can also make it difficult to learn, concentrate, plan, prioritize, or multi-task.
Causes of Multiple sclerosis
Scientist really doesn’t know what causes MS, but researchers have found various ways how the chances of MS increases in humans.
Most forms of MS are likely to affect women than men.
Specific genes have higher chances of getting MS and these might pass down in the genes. Thus, if you have a family member with MS, the chances of you getting are high, so diagnose early.
Smoking creates the accumulation of more legions in the brain, thereby shrinking the brain. This increases the chance of developing MS.
Exposure to viruses, such as Epstein-Barr virus (EBV) or mononucleosis, may increase a person’s risk of developing MS, but research has not shown a definite link.
Some experts link low levels of Vitamin D which might affect your immune system, this creates multifunctionality to your immune system.
There is no single trigger, multiple factors come together to contribute to MS. Additionally, different people react to MS differently.
Early Diagnosis
This is a very challenging task for the Doctors presently. They carry out a physical and neurological examination, ask about symptoms, and consider the person’s medical history. No single test can confirm a diagnosis, so a doctor will use several strategies to decide if the person has MS or not.
MRI scans of the brain and spinal cord can detect active and inactive legions.
Spinal tap: Spinal fluid analysis may identify abnormalities and antibodies that suggest a previous infection or proteins consistent with a diagnosis of MS
Optical coherence tomography (OCT): In this test, a picture is taken off the nerve layers in the back of your eye to check for the optic nerve and see if there are any changes in the retina.
Blood tests: Doctors take blood samples and test them to eliminate other conditions which show similar symptoms to MS.
Visual evoked potentials (VEP) test: This test requires the stimulation of nerve pathways to analyze electrical activity in your brain.
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.
Checks of your balance, coordination, vision, and other functions to see how well your nerves are working.
Treatments
There isn’t any complete cure for MS right now. But these treatments will improve how you feel and slow the course of the disease, ease your symptoms and manage the stress that comes with this condition.
Drugs can slow down MS or help prevent further nerve damage in the early stages. These drugs can be taken through injectable medication, oral medications, and infused medications.
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.
Studies have suggested that cannabis may help relieve pain, muscle stiffness, and insomnia. However, there is not enough evidence to confirm this, and one should remember that street cannabis is different from medical cannabis.
Plasma exchange involves replacing the blood with new plasma and transfusing it back into the person. This can remove antibodies in the blood that are attacking the person’s body.
Stem cell therapy has been used to regenerate various body cells and restore function to people who have lost them due to a health condition. Maybe it can reverse the damage done by MS and restore functionality in our central nervous system.
Conclusion
It’s almost impossible to predict how MS will progress in an individual. Life expectancy in those with MS is increasing, according to various studies. About 10 to 15 percent of people with MS have only rare attacks and minimal disability 10 years after diagnosis.
Your quality of life with MS will depend on your symptoms and how well you respond to treatment. And on a safer note, it's rarely fatal. Most people with MS don’t become severely disabled and continue to lead full lives.
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