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Multiple sclerosis, which is characterized by neurological signs caused by nerve tissue damage, results in severe disabilities in patients. Stem cell transplant therapy has shown to help reverse disabilities and help improve morbidity and mortality.
Multiple sclerosis (MS) is a demyelinating disease, which means that it's a condition that causes stripping of the sheath, called myelin, that covers nerve tissue. The tissue involved includes the nerve cells in the brain and the spinal cord.

This disease then causes a breakdown in communication between the brain and the body. One can use the analogy of the nervous pathways in the body resembling highways littered with potholes. 

How does multiple sclerosis come about?

There are 3 ways in which myelin covering the nerve cells are damaged. These include the formation of plaques on the affected tissue in the central nervous system, inflammation of this tissue and breakdown of the myelin sheaths of neurons.

MS is also thought to be an auto-immune condition where there's interaction of the patient's genetics and certain environmental factors. These have been hypothesized to include issues such as tobacco smoke exposure, exposure to certain solvents, increased stressors or previous infections with mumps/rubella/measles and other viruses. 

What are the signs and symptoms?

The signs and symptoms of MS depends on where in the central nervous system the disease is causing damage. Therefore, the clinical presentation in these patients can vary tremendously.

These signs and symptoms can then include the following:

  • Paraesthesia, which is a decrease in or loss of sensation in the limbs and can include the sensation of "pins and needles".
  • An increase in reflexes in the limbs.
  • Muscle spasms.
  • Ataxia, which is difficulties with balance and coordination. The cerebellum will be affected here.
  • Problems with swallowing and speech.
  • Eye related issues such as nystagmus, double vision (diplopia) or optic neuritis.
  • Fatigue.
  • Acute or chronic pain.
  • Bladder and/or bowel related problems such as chronic diarrhoea, constipation or incontinence.
  • Emotional issues and mood disorders such as depression.

There are signs though which seem to be characteristic of MS and they are the following:

  • Uhthoff's phenomenon is when there is a worsening of symptoms when the patient is exposed to higher than normally experienced temperatures.
  • Lhermitte's sign is characterized by an electrical-like sensation that runs down the back when the patient bends their neck.
MS can present either gradually, which worsens over time without there being any recovery periods, or it can present as episodes of sudden worsening which can last for days up to months and then followed by periods of improvement.

Diagnosing MS

The most commonly used way to diagnose MS is through the McDonald criteria. This criteria focuses on clinical findings, laboratory results and radiological evidence of lesions being found in different areas and at different times.

Diagnosing MS can be difficult in the initial stages of the disease. The neurological signs and symptoms which it produces though would warrant a referral to neurologist. They would then further examine the patient and ask for imaging investigations such as CT and MRI scans to be performed. The findings here include the presence of plaques on brain tissue. Cerebrospinal fluid analysis may show signs of chronic inflammation involving the central nervous system. This finding gives merit to the possible diagnosis of MS when the clinical picture and radiological findings point to the same disease.

Continue reading after recommendations

  • Burt, R. K., Traynor, A. E., Pope, R., Schroeder, J., Cohen, B., Karlin, K. H., ... & Stefoski, D. (1998). Treatment of autoimmune disease by intense immunosuppressive conditioning and autologous hematopoietic stem cell transplantation. Blood, 92(10), 3505-3514.
  • Burt, R. K., Cohen, B. A., Russell, E., Spero, K., Joshi, A., Oyama, Y., ... & Karlin, K. (2003). Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation–based conditioning regimen to prevent disease progression in patients with high disability scores. Blood, 102(7), 2373-2378.
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