MULTIPLE SCLEROSIS

Geeta Mohan
 Multiple sclerosis
• Multiple sclerosis (MS) is a demyelinating disease in
which the insulating covers of nerve cells in the brain
and spinal cord are damaged. This damage disrupts
the ability of parts of the nervous system to
communicate, resulting in a range
of signs and symptoms, including physical, mental,
and sometimes psychiatric problems.
• It is a progressive disease that attacks the myelin
sheath of axons in the CNS .
• Degeneration of myelin sheath is so severe
sometimes that the associated axons become
dysfunctional and degenerate , ultimately hard scar
tissue develop in the CNS
Multiple sclerosis

• Although the exact cause is unknown, it's

considered to be an autoimmune disease – a
disorder in which the body’s immune system
attacks part of the body ,where the myelin sheath
is the focus of faulty immune reaction.
• Risk factors for the disease include being between
15-60 years of age; women have about two to
three times the risk for multiple sclerosis than
men.
Multiple sclerosis
Multiple sclerosis
Symptoms and signs depend on where the nerves are demyelinated and may
include:
Visual including double vision or loss of vision
• Numbness
• Visual disturbances
• Tingling or weakness (weakness may range from mild to severe)
• Paralysis
• Vertigo or dizziness
• Erectile dysfunction ( impotence)
• Pregnancy problems
• Incontinence (or conversely, urinary retention)
• Muscle spasticity
• Incoordination of muscles
• Tremor and ataxia (loss of motor coordination)
• Painful involuntary muscle contractions
• Slurred speech
• Fatigue
• Cognitive deficits and emotional changes
Multiple sclerosis

There are four types of MS:

1) Relapsing-remitting multiple sclerosis (RRMS),
2) Secondary-progressive multiple sclerosis (SPMS),
the most common type
3) Primary-progressive multiple sclerosis (SPMS)
4) Progressive-relapsing multiple sclerosis (PRMS)

1. Relapsing-remitting MS (RRMS) is characterized by

clearly defined relapses of increased disease activity
and worsening symptoms. These are followed by
remissions in which the disease doesn’t progress.
Symptoms may improve or disappear during remission.
Approximately 85 percent of patients are diagnosed
with RRMS at onset.
Multiple sclerosis
2. Untreated, about 50 percent of people with RRMS transition
to secondary-progressive MS (SPMS) within a decade of the
initial diagnosis.
3. Primary-progressive MS (PPMS) is diagnosed in about 10
percent of MS patients at onset. People with PPMS experience a
steady progression of the disease with no clear relapses or
remissions. The rate of PPMS is equally divided between men
and women. Symptoms usually begin between the ages of 35
and 39.
4. Progressive-relapsing MS (PRMS) is the rarest form of MS,
representing about 5 percent of MS patients. People with PRMS
have clear relapses combined with a steady progression of the
disease.
Multiple sclerosis

Among the general population, MS affects more than 2.3

million people. The ratio of women with MS to men with the
disease is 2 to 1. Approximately 10 to 20 percent of people
with MS have a benign course of the disease
Multiple sclerosis
• In India, MS was recognized only in the late 1950s
• The true incidence and prevalence of MS in India are
difficult to ascertain owing to the lack of large-scale,
well-designed epidemiological studies. The earlier
crude estimates of clinically definite MS suggested a
low prevalence of 1–3 per 100,000 individuals, with the
exception of Parsee population, which had a high
prevalence of approximately 20–25 per 100,000
individuals
• With the increase in the number of neurologists in India
as well as easy and affordable availability of magnetic
resonance imaging (MRI), more cases of MS are now
being diagnosed throughout India, with a rough
estimated prevalence of 5–10 per 100,000 individuals.
Most tropical countries have a lower percentage of MS
patients than countries from temperate climates.
Researches believe this has something to do with
vitamin D. T
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Multiple sclerosis
• The cause of multiple sclerosis is unknown. It's considered an autoimmune
disease in which the body's immune system attacks its own tissues. In the
case of MS, this immune system malfunction destroys myelin (the fatty
substance that coats and protects nerve fibers in the brain and spinal cord).
Cause
• 1) Immunological -immune system malfunctions and attacks the CNS
• 2) Genetic –If one parent has MS, the risk of their children getting the
disease is estimated to be between 2 and 5 percent.
• Scientists believe that people with MS are born with a genetic susceptibility
to react to certain (unknown) environmental agents. An autoimmune
response is triggered when they encounter these agents.
3 )Environmental -Epidemiologists have seen an increased pattern of MS
cases in countries located farthest from the equator. This correlation causes
some to believe that vitamin D may play a role.
• 4) Infections -measles virus , human herpes virus-6 (HHV-6)
Multiple sclerosis

• Other Risk Factors :Women are two to three

times more likely to develop MS than men are.
• Age: According to the Mayo Clinic, MS usually
strikes between the ages of 20 and 40.
• Ethnicity: People of northern European descent
are at highest risk of developing MS
• Trigger factors : Stress, smoking, heat, certain
medications, lack of sleep and infections like UTI,
flu
Multiple sclerosis
• Treatment for MS
Although there is no cure for MS, there are
treatment options to help manage MS symptoms
The most common treatment category is
corticosteroids, which reduce nerve inflammation.
In cases that don’t respond to steroids, some doctors
prescribe plasma exchange. In this treatment, the
liquid portion of your blood (plasma) is removed and
separated from your blood cells, which are then mixed
with a protein solution (albumin) and put back into
your body.
Multiple Sclerosis

Credits :
Wikipedia
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