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Multiple sclerosis (MS) is a disease which affects the central nervous system and it can be potentially disabling.

The immune system seems to produce antibodies which start to attack the the sheath covering nerve fibres. This can eventually lead to a disruption of the communication which occurs between the brain and the rest of the body. The nerve fibres themselves may also be affected in this disease.

Causes

The reason behind the immune system producing antibodies is unknown, but the cause may lie behind certain environmental and genetic factors.

MS would therefore be considered an autoimmune disease.

Risk factors

The following are factors which could increase ones risk of developing this condition.

  • Age - usually affects people between 15 and 60 years old, but it can develop in anyone.
  • Gender - females are 2 times more likely than males to develop this issue.
  • A family history of first-degree relatives (siblings, parents) having this disease.
  • Race - white people, especially of northern European descent, seem to be at the highest risk.
  • Other autoimmune diseases - having issues such as diabetes, thyroid disease or rheumatoid arthritis also increases the chance of developing MS.
  • Climate - MS is most commonly seen in areas with temperate climates such as Europe, Australia, New Zealand and the United States.
  • Certain infections - viruses such as Epstein-Barr (EBV) have been linked to the development of MS.
  • Tobacco use - smokers who experience an initial episode of symptoms of MS, are more likely than non-smokers to experience a second episode.

Symptoms and disease progression

Signs and symptoms of MS can differ among individuals and this is also due to what type of MS a patient may have. The symptoms may include the following:

  • Pain or tingling sensation in parts of the body.
  • Weakness or numbness in one or more limbs. This usually will occur on one side of the body at a time.
  • Partial or complete vision loss in one eye at a time and it can be associated with pain on moving the eye.
  • Double vision which occurs for a prolonged period of time.
  • Lack or coordination or an unsteady gait.
  • Tremors in the hands.
  • Dizziness.
  • Fatigue.
  • Slurred speech.
  • Loss of bladder and/or bowel control.

Diagnosis

There's no specific diagnostic test available to confirm MS. Rather, through clinical examination and findings on certain tests, one can rule out other possible issues thereby strengthening the suspicion for this disease.

Clinical examination

A doctor will assess the patient and look for any neurological signs due to the patient's symptoms. These patients would then be referred to a neurologist to assess them further.

Blood tests

This is done to rule out diseases and conditions which have similar signs and symptoms such as MS.

Lumbar puncture/spinal tap

This test is done to look for the presence of antibodies, which cause MS, in the spinal fluid of the patient. Again, this is also done to rule out other possible infections.

Magnetic resonance imaging (MRI)

This is probably the investigation which gives the most information regarding MS. It can visualize possible lesions on the brain or spinal cord which can be caused by this disease, and are usually noted as being white spots which are visible when contrast is injected in the patient. 

Complications

MS may results in the following complications:

  • Paralysis, usually of the legs.
  • Muscle spasms or stiffness.
  • Mental changes such as mood swings and forgetfulness.
  • Issues with bladder and bowel control, as well as sexual functioning.
  • Epilepsy.
  • Depression.

 

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