What is multiple sclerosis?
Often shortened to MS, multiple sclerosis is a disease which affects the brain and spinal cord. In MS, the outer protective lining of a nerve cell, called myelin, is progressively lost as the body mistakenly attacks it. This is why MS is called an autoimmune or immune-mediated disease.
Not much is understood about multiple sclerosis, but the destruction of myelin sheath results in severe to profound symptoms. Myelin is very like plastic coating around electrical wires, except that it is made up of fat and enhances the transmission of nerve signals. With the loss of myelin, nerve signals between the brain and the body are distorted or interrupted, resulting in neurological symptoms.
Although not a hereditary disease, MS is thought to be connected with genetic factors that result in a predisposition to developing the disease.
Things to know about MS
Not much is known about MS, neither is there a global registry for new cases. Figures so provided are simply estimates. However, here is most of what we know about multiple sclerosis:
- It is a more common disease in North America, Europe, Australia and New Zealand than in Asia or other tropical regions. It is seen that as we move farther from the equator (hotter regions) towards the poles (colder regions), the prevalence and incidence increases.
- MS is estimated to be about 2-3 times more common in women than in men.
- The most susceptible age group is between 20 and 50 years with the first symptoms generally appearing between 30 and 35 years of age. Also, it is more common among Caucasians and people of European descent (Northern and Central European, to be specific), while it is rarely diagnosed among Asians, Hispanics, and Africans.
- It is widely believed that the incidence of MS is increasing. The cause is yet to be determined, but it may be due to some environmental factors like viruses and bacteria or due to a change in lifestyle. However, these are only speculations.
- Canada, San Marino, and Denmark have the highest prevalence of MS.
- It is estimated that around 2.3 million people around the world are living with MS, of which 1 million reside in the continental US alone.
- 2-5 percent of all MS cases are diagnosed in children, says 2013 research.
- MS symptoms are unpredictable and vary from person to person and time to time
- Recent studies say that people with MS live, on an average, 7 years less than the general population.
- MS can be treated. However, early treatment is the best way to prevent any further neural or neuro-motor damage.
- Diagnosis of MS is very tough. It is given a definitive diagnosis through MRI, but physicians still have to wait for the symptoms to progress before reaching any conclusion as no test is available for diagnosing MS. Also, there is no certain way of telling how the disease will progress or which type it will turn into.
- It is very expensive to treat multiple sclerosis. Based on severity, health care costs can come out anywhere between $30,000 and $100,000. In 2016, it was found that for a person suffering from MS, the total lifetime cost was around $4.1 million.
Types of MS
Multiple Sclerosis is of 4 types:
Clinically Isolated Syndrome (CIS)
It is the first episode of MS neurological symptoms. The episode lasts for 24 hours or more and is caused by inflammation of the nervous system, as nerve cells get stripped of myelin.
In CIS MRIs, demyelinated nerve cells are shown to have lesions or scars around it, thus giving the disease its name.
It cannot be said with certainty if CIS will lead to the development of MS. National MS society guesstimates that there is a 60-80% chance of getting a definitive diagnosis in a few years if the MRI shows brain lesions.
Approx. 85% of the cases begin with this disease course. It is demarcated by clearly-defined relapses, attacks or exacerbations, which may last for days to weeks.
The symptoms may abate with no noticeable progression between remissions, paired with full or partial recovery.
Primary Progressive (PPMS)
Around 15% of cases are diagnosed with PPMS, according to the National MS Society, with symptoms beginning between 35 and 39 years of age. People with PPMS experience a gradual but steady progression of MS with fewer or no relapses or remissions.
Secondary Progressive (SPMS)
SPMS starts off behind relapsing-remitting MS diagnosis, but later the disability takes off into a consistently progressive course with or without any evidence of relapse. There may or may not be any changes in MRI scans either. According to a 2017 study, if untreated, 50% of RRMS cases evolve into SPMS within the first ten years of diagnosis.
Symptoms of MS
No two people diagnosed with MS have the same set of symptoms, which further sets hurdles during identification and diagnosis. It cannot be easily ascertained if a person has MS or not, and if they do, what symptoms they should be prepared for.
In fact, there is such a lack of demarcating characteristics in the initial phases that misdiagnoses are common.
Here are the common Multiple Sclerosis symptoms:
- changes in speech
- numbness, tingling or burning in limbs
- muscular spasms
- facial pain
- loss of short-term memory
- hearing impairment
- blurred or double vision, or total vision loss
- erectile dysfunction, lack of sexual desire
- difficulty swallowing
- reduced olfactory and gustatory sense
- tremors, seizures
- depression, personality changes
- Bell’s palsy
- loss of balance, vertigo
- incontinence, constipation
- weakness, fatigue
While millions grapple with the uncertainty of MS, the awareness that only can prove to be a relief for both the afflicted and their families. While several medicines and treatments are available, with many more in the pipeline, the cause behind MS is still shrouded in ambiguity. However, it is expected that MS will soon be easily manageable, even if not well-understood.