Multiple Sclerosis: Causes, Symptoms, Complications

Multiple sclerosis (MS) is a disabling neurological disease that affects the central nervous system. While in the UK and USA, MS affects up to 150 people in 100,000, in India its prevalence is up to 10 in 100,000. However, this number may be underrepresented as MS can be difficult to diagnose. It can present itself through umpteen number of symptoms, it is chronic, in that it can last for years or for your entire life, and cannot be cured. If you’re wondering what is MS, it would help to know that it is an autoimmune disease in which your immune system does damage to the protective sheath covering nerve fibers.

MS is rarely fatal but may reduce life expectancy by months or years. However, treatment can be helpful and can even slow down the progression of MS. Hence, it is important to know more about MS, especially its early signs.

Here’s a rundown of multiple sclerosis, its causes, symptoms, and treatment.

What is Multiple Sclerosis?

Multiple sclerosis arises when the immune system acts abnormally and attacks the central nervous system, which comprises the brain, optic nerves, and spinal cord. In the case of MS, the immune system causes damage to:

• The sheath that protects the nerve fibers (myelin)
• The nerve fibers
• The cells that make myelin

The damaged areas develop scarring and sclerosis, which is etymologically linked to the word ‘hard’, here, refers to scarring. So, while MS stands for multiple sclerosis, multiple sclerosis itself refers to ‘multiple areas of scarring’, as per the definition given by the National MS Society. Depending on the extent of damage done, MS symptoms in persons vary by type and intensity.

Multiple Sclerosis Causes

Various factors may contribute to the development of multiple sclerosis, including genetics, viral infections, and environmental factors. While the exact cause of MS is still unknown, researchers believe it is likely due to a combination of these factors.

Genetics plays a role in MS, as the disease is more common in people with specific genes. For example, people with the HLA-DRB1*1501 gene are more likely to develop MS.

Viral infections have also been linked to the development of MS. The Epstein-Barr virus, responsible for mononucleosis, has increased the risk of MS. Also, people with MS are more likely to have been exposed to certain viruses, such as herpes, in their early years.

Environmental factors may also contribute to the development of MS. For example, people who live in colder climates are more likely to develop the disease. In addition, exposure to certain toxins, such as cigarette smoke, has been linked to an increased risk of developing MS.

The exact cause of MS is unknown. So, there are no known ways of preventing it or getting it. However, scientists believe the cause to be a combination of:

• Genetics
• Environmental factors

While the cause of the MS disease is not known, medical experts have enumerated several risk factors such as:

• Being between age 20 and 40 for the onset of MS
• Being female (as it affects more women than men)
• Having a Vitamin D deficiency
• Living further away from the equator
• Smoking
• Obesity
• Previous Epstein-Barr virus infection

Research on risk factors such as these helps scientists come closer to pinpointing the cause of MS, while also debunking unproven theories.

Early Symptoms of Multiple Sclerosis

Multiple sclerosis is a chronic, degenerative disease of the nervous system. It is characterized by the deterioration of the myelin sheath, the protective covering that surrounds and insulates nerve cells. This insulation is vital for the proper functioning of the nervous system.

The symptoms of multiple sclerosis vary widely from person to person and can range from mild to debilitating. The most common early symptom is Optic Neuritis, inflammation of the optic nerve. It can cause vision loss or distortion in one or both eyes.

Other early symptoms include:

• Loss of balance
• Numbness or tingling in the extremities
• Weakness
• Fatigue
• Bladder or bowel problems

These symptoms can come and go, or they can be progressive and worsen over time. If you experience any of these symptoms, you must see a doctor as soon as possible for a proper diagnosis.

Symptoms of Multiple Sclerosis

If you have been diagnosed with multiple sclerosis, you may be wondering what symptoms you may experience. Here we will discuss some of the more common signs of MS and what to expect.

You must talk to your doctor if you are experiencing any of the following symptoms. While there is no cure for MS, treatments available can help manage the symptoms.

Multiple sclerosis causes a wide range of symptoms, even as it affects the central nervous system, which controls a majority of the body’s functions.

Common multiple sclerosis symptoms are:

• Numbness or weakness in one or more limbs
• Electric shock sensation when moving neck (Lhermitte’s sign)
• Fatigue
• Blurred vision or double vision
• Eye pain
• Loss of vision in one eye (Optic neuritis)
• Chronic pain
• Muscle spasms
• Dizziness
• Tremors
• Unsteady gait
• Bladder and bowel problems
• Tingling sensation
• Stiffness
• Vertigo
• Learning difficulty
• Memory and concentration problems
• Anxiety
• Sexual problems
• Slurred speech
• Trouble chewing

As you can see, the symptoms caused by MS range across the board and may easily be mistaken for those of another disease. So, if you have any of these symptoms and aren’t suffering from another disease, you can talk to your doctor to assess the risk of you having MS. Moreover, many of these symptoms are also early signs of multiple sclerosis, meaning that if you spot them quickly, your treatment efforts should bear more fruit.

Types of Multiple Sclerosis

There are four types of multiple sclerosis (MS), distinguished by their symptoms and disease course.

1. Relapsing-remitting MS (RRMS) is the most common type of MS, characterized by periods of relapse (or worsening of symptoms) followed by remission (or partial or complete recovery). Most people with RRMS eventually transition to secondary-progressive MS (see below).
2. Secondary-progressive MS (SPMS) is characterized by a more steadily progressive worsening of symptoms, with or without periods of remission and relapse.
3. Primary-progressive MS (PPMS) is a less common type of MS, characterized by a slowly progressive worsening of symptoms from the outset, with no periods of remission.
4. Progressive-relapsing MS (PRMS) is a rarer form of the disease, characterized by a slowly progressive worsening of symptoms from the outset, with superimposed periods of acute relapse.

MS can cause a wide range of symptoms, which may differ from one person to another and change over time. The most common symptoms include fatigue, walking difficulties, bladder and bowel problems, numbness or tingling, and vision problems.

Multiple Sclerosis Diagnosis

Multiple sclerosis is not easy to diagnose. Moreover, there is no test, at present, that can positively assert that you have MS. Most often, diagnosis for multiple sclerosis takes the path of ruling out other conditions. Some techniques doctors may use to arrive at a diagnosis are:

• Neurological exam: To assess whether the nervous system is impaired in a way that points to MS
• Blood tests: To rule out diseases that have MS-like symptoms
• MRI scan: To spot scarring of the myelin around the nerves
• Spinal tap (Lumbar puncture): To extract cerebrospinal fluid for analysis of nervous system issues
• Evoked Potential Test: To assess how your nervous system responds to stimuli

Sometimes the diagnosis of MS needs time because of the nonspecific nature of the symptoms. Then, your doctor may be able to identify the particular course of MS, namely:

• Clinically isolated syndrome (CIS)
• Relapsing-remitting MS (RRMS)
• Primary progressive MS (PPMS)
• Secondary progressive MS (SPMS)

Complications of Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, degenerative disease of the nervous system that affects millions worldwide. Although there is no cure for MS, treatments available can help manage the symptoms and slow the progression of the disease.

However, MS can also lead to several complications, some of which can be serious or even life-threatening. Here are some of the most common complications of MS:

Fatigue

Fatigue is one of the most common symptoms of MS, and it can be debilitating. MS can cause extreme fatigue, making it difficult to carry out everyday activities.

Muscle weakness

Muscle weakness is another common symptom of MS. This can lead to problems with mobility and balance and can make it challenging to carry out everyday activities.

Balance problems

Balance problems are a common symptom of MS and can be caused by muscle weakness and problems with coordination. It can make it difficult to walk and perform other activities.

Bladder and bowel problems

Bladder and bowel problems are common in people with MS. These problems can be caused by muscle weakness, loss of sensation, and problems with coordination.

Sexual problems

Sexual problems are common in people with MS. These problems can be caused by muscle weakness, loss of sensation, and problems with coordination.

Pain

Pain is a common MS symptom and can be caused by inflammation, muscle weakness, and nerve damage.

Depression

Depression is a common complication of MS and can be caused by the physical and emotional effects of the disease.

Risk Factors for Multiple Sclerosis

There are a variety of risk factors for multiple sclerosis, including:

Age

Multiple sclerosis is most often diagnosed in people between the ages of 20 and 40.

Sex

Women are more likely than men to develop multiple sclerosis.

Family history

If you have a close relative with multiple sclerosis, you're more likely to develop the condition.

Viral infections

Some viruses have been linked to an increased risk of multiple sclerosis.

Autoimmune disorders

If you have certain autoimmune disorders, such as thyroid disease, type 1 diabetes, or inflammatory bowel disease, your risk of multiple sclerosis increases.

Smoking

Smoking cigarettes increases the risk of multiple sclerosis.

If you have any of these risk factors, you must talk to your doctor to monitor you for multiple sclerosis. Early diagnosis and treatment are critical to managing the condition.

Treatment of Multiple Sclerosis

There is no one-size-fits-all answer to how to treat multiple sclerosis (MS). The best approach depends on the individual, their MS type, and their symptoms' severity.

That said, a few general principles can guide treatment decisions. First, it's essential to work with a team of specialists who are experienced in treating MS. This team should include a neurologist, an MS specialist, and other health care providers as needed (e.g., physical therapist, rehabilitation doctor, mental health provider, etc.).

Second, early and aggressive treatment is typically the best approach. It means starting medication as soon as possible after diagnosis and taking it even if there are no symptoms. The goal is to prevent MS flare-ups (relapses) and slow the disease's progression.

You can use many medications to treat MS; the best one for each person depends on various factors. The most common drugs include interferon beta, glatiramer acetate, and natalizumab.

In addition to medication, other things can be done to help manage MS symptoms and improve quality of life. These include exercise, physical therapy, occupational therapy, and lifestyle changes (e.g., diet, stress management, etc.).

If you or someone you know has been diagnosed with MS, talk to your doctor about the best treatment approach. Getting started on treatment as soon as possible is essential to improve the chances of a good outcome.

There is no cure for multiple sclerosis, but treatment can help:

• Address symptoms
• Aid recovery
• Treat relapses
• Slow down the progress of MS

Based on your symptoms, the doctor may suggest anything from exercise and more sleep to corticosteroids, antidepressants, plasma exchange, and disease-modifying therapy. Patients with the relapsing type of MS be given treatment with a disease-modifying drug. Such a drug alters the way the immune system operates to target MS. These drugs may be injectable, oral, or infused medications.

However, to help you cope with the symptoms and their effects, do not be surprised if doctors suggest physical therapy, occupational therapy, or some other form of rehabilitation. Since the symptoms of MS can worsen over time, it is best to get medical aid early. MS does not prove to be debilitating for the majority of patients. So, paralysis is not a worry here. But, many will need aid to walk and move about over the course of time.

The prognosis on MS is that it can have potentially severe consequences, but its course is hard to predict. Nevertheless, early treatment is understood to be important to avoid long-term disability. However, since diagnosing MS is a tricky task, you may need to keep a check on the symptoms you experience and schedule regular consultations with your doctor.

An easy way to have quick access to relevant doctors is to use the healthcare platform provided by Bajaj Finserv Health. You can get in touch with the best doctors, book appointments at their clinics online, consult via video, and store and share personal health records too. This way you can assess the risk of MS in an ongoing manner. If you are diagnosed with MS, the platform also helps you keep track of any medication you may need to take and help you schedule future reviews with doctors. Begin your journey to a healthy lifestyle now!