About the disease

Multiple sclerosis is an illness of immune system when the protective sheath covering nerves, causes problems between the brain stems and other parts of the body. It is also known in medical circles as demyelinating disease because the sheath which surrounds the cells gets damaged and consequently nerve endings also become dysfunctional. Ultimately nerves damage themselves, and this process is irreversible. There is no remedy for multiple sclerosis, only medicine and other treatment options which can alleviate the symptoms and slow down the progression of the demyelinating disease. Symptoms of this disease can be different depending on the extent, location and severity of the nervous system disruption. In severe cases, patients who were primarily diagnosed with demyelinating disease can even lose the ability to walk and talk. Detecting multiple sclerosis is difficult in the early stages. Usually they appear at the age between 25 to 45. Very rarely the disease occurs in people older than 50 years. Female population suffers from demyelinating disease twice more often than men. White people, especially those who were primarily born in the Northern part of Europe, are at the highest risk of developing demyelinating disease. The lowest risk of demyelinating disease is among those who were born in Asia, Africa or America. This disease occurs mostly in the Europe with 60 people per 200,000 population having it. Demyelinating disease is much more widespread in Scandinavia and New Zealand. Overall multiple sclerosis prognosis is favorable, because usually people who have it can lead the normal lifestyle regardless of its type.  

Multiple sclerosis causes

The exact and researched causes of demyelinating disease are unknown. It is believed that demyelinating disease is an autoimmune illness, which practically means that the immune system paradoxically destroys its own tissues. In multiple sclerosis, the sheath, a special layer that covers, protects and supports the nerve endings of the brain cord, destroys itself. When myelin sheath is damaged or even destroyed, transmission of impulses that flow along the nerves can be slowed down or blocked. The reason for that may be a complex combination of such common factors as genetic predisposition and childhood infections, which can provoke demyelinating disease. Some viruses are associated with multiple sclerosis. Barr- Epstein virus can trigger the development of demyelinating disease.

Overall multiple sclerosis causes are:

• Viral infections in childhood
• Toxins
• Autoimmune disease
• Full combination of the above

Usually multiple mutations of genes provoke the immunological disease. It was not yet confirmed if multiple genes mutations are the direct cause of demyelinating disease, but doctors strive to research this issue.   

Symptoms

• Numbness, weakness, pain of one, two or even more extremities
• Partial or almost complete loss of vision in one eye. It is often accompanied by pain in the eye
• Blurred contours
• Sensations of electric shock under certain head movements
• Nervous tremors
• Problems with movement coordination
• Uncertain gait
• Increased fatigue
• Dizziness
• Fever
• Prickle
• Problems with urination
• Dizziness

Diagnosis

There are no special tests or diagnostics for the detection of multiple sclerosis. Diagnosis is solely based on exclusion of other diseases of the nerve system that might cause similar symptoms.

• If there is any suspicion that a patient of multiple sclerosis, blood test is done to check for presence of other infection or inflammation of nerve endings.
• A doctor can also perform lumbar puncture, during which a little amount of spinal fluid is removed from the lower spine for thorough laboratory analysis. Testing of this sample can detect abnormalities of demyelinating disease, such as abnormal and excessive levels of antibodies. This method also allows to see if there are other diseases that have neurological dysfunctions similar to multiple sclerosis symptoms.
• Magnetic imaging (MRI) produces detailed images of internal organs by magnetic field. MRI can reveal nerve endings lesions that indicate damage in the brain and spinal cord. 

Treatment

Treatment is generally aimed at combating attacks and providing symptoms relief. Some of the symptoms are so minor that patients do not require treatment. During the remission when a person does not have any symptoms, treatment also not necessary. It is an attack, that can be quite dangerous.

• Usually doctors prescribe drugs intravenously to reduce the inflammation, which is exacerbated during the attack. Side effects can manifest themselves in the form of high blood pressure, mood swings and weight gain. Long-term use can cause vision illness, high blood sugar and increased risk of viral infections. That`s why people who are prescribed with such drugs need always check at doctors`s to see if there are any deteriorations with vision and blood sugar level.
• Plasmapheresis. The method is similar to dialysis, because technically it separates the blood cells from the plasma, which is the liquid part of blood. Such plasma exchange is sometimes used to help cure severe symptoms of multiple sclerosis, when patients do not respond to steroids which are assigned intravenously.
• Lymph node irradiation. The total exposure of the lymph nodes to irradiation is mostly used as a treatment for malignant tumors. Sometimes it can be used as a treatment for autoimmune diseases, including Hodgkin's disease and rheumatoid arthritis. Sometimes irradiation of lymph nodes is the only choice that doctors have because patient`s condition may be resistant to other therapies. In addition, this method of treatment option can create a long-term immunosuppression with an absolute decrease in the number of lymphocytes. In that way  person with multiple sclerosis will not feel as much pain in joints as they used to during the attack.
• Doctors can prescribe immunosuppressants as well. They can be harmful to the heart and recent studies showed that immunosuppression can contribute to the development of blood cancers such as leukemia. So they are used only in severe cases, when it is necessary. Also doctors recommend patients with multiple sclerosis to undergo the physiotherapy. A physical therapist can teach a patient how to stretch the muscles, so that they will not cause pain. Also such exercises can contribute to the strengthening of muscles.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko