Multiple sclerosis is a chronic, unpredictable disease of the central nervous system (CNS), which is made up of the brain, spinal cord, and optic nerves. It is thought to be an immune-mediated disorder, in which the immune system incorrectly attacks healthy tissue in the CNS.
In multiple sclerosis, damage in the central nervous system (CNS) interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body.
Prevalence
Worldwide, more than 2.3 million people have a diagnosis of MS. Most people are diagnosed between the ages of 20 and 50, although children and older adults may develop it. anyone may develop MS but there are some patterns. MS is three times more common in women than men. this gender difference has been increasing over the past 50 years.
Causes of MS
The cause of MS is not known. Scientists believe MS is triggered by a combination of factors. Those factors are,
▪️ Immunological factors
▪️ Environmental factors
▪️ Infectious factors
▪️ Genetic factors
Risk factors
There is no single risk factor that provokes MS, but several factors are believed to contribute to the overall risk.
Low vitamin D level
Smoking
Obesity
Geographic gradient
Symptoms
MS symptoms are variable and unpredictable. No two people have the same symptoms, and each person’s symptoms can change or fluctuate over time.
More common symptoms
MS Hug ( Dysesthesia)- squeezing sensation around the torso
Fatigue - Occurs in about 80% of people, can significantly interfere with the ability to function at home and work, and may be the most prominent symptom in a person who otherwise has minimal activity limitations.
Numbness and tingling - Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
Vision problems - The first symptom of MS for many people. Optic neuritis, neuromyelitis optica, blurred vision, poor contrast or color vision, and pain on eye movement can be frightening — and should be evaluated promptly.
Weakness - Weakness in MS, which results from deconditioning of unused muscles or damage to nerves that stimulate muscles, can be managed with rehabilitation strategies and the use of mobility aids and other assistive devices.
Walking( Gait) difficulties - Related to several factors including weakness, spasticity, loss of balance, sensory deficit, and fatigue, and can be helped by physical therapy, assistive therapy, and medications.
Pain - Pain syndromes are common in MS. In one study, 55% of people with MS had "clinically significant pain" at some time, and almost half had chronic pain.
Depression and problems with memory and concentration.
Less common symptoms
Tremor
Seizures
Breathing problems
Speech problems & Hearing problems
Loss of taste
Types of MS
The most common types of MS are
Relapsing-Remitting MS (RRMS)
The most common disease course – is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks – also called relapses or exacerbations – are followed by periods of partial or complete recovery (remissions).
Secondary-Progressive MS (SPMS)
SPMS follows an initial relapsing-remitting course. Some people who are diagnosed with RRMS will eventually transition to a secondary progressive course in which there is a progressive worsening of neurologic function (accumulation of disability) over time.
Primary-Progressive MS (PPMS)
PPMS is characterized by worsening neurologic function (accumulation of disability) from the onset of symptoms, without early relapses or remissions.
Treatments
Medications
If you have been diagnosed with MS, the National MS Society recommends you consider treatment with one of the FDA-approved "disease-modifying" drugs as soon as possible following the definite diagnosis of MS with active or relapsing disease. These medications help to reduce the frequency and severity of MS attacks, the number of new lesions in the CNS and may slow the progression of disability.
Physical therapy
Physical therapists (PT) evaluate and address your body’s ability to move and function, with particular emphasis on walking and mobility, strength, balance, posture, fatigue, and pain. Physical therapy might include an exercise program, gait (walking) training, and training in the use of mobility aids (poles, canes, crutches, scooters, and/or wheelchairs) and other assistive devices. The goal is to promote independence, safety, and achieve and maintain optimal functioning. In addition, rehabilitation can help prevent complications such as de-conditioning, muscle weakness from lack of mobility, and muscle contractures related to spasticity. Physical therapy can also include pelvic floor exercises to address urinary/bladder issues. pelvic floor exercises can be performed on the recommendation of a physiotherapist.
accordingly, physiotherapy plays a vital role in the rehabilitation process while helping in promoting activity and exercise for people with MS to help you resume, or maintain, an active and independent life. It can be valuable for many MS symptoms and is particularly useful for managing stiffness, balance, spasticity, and spasms. Physiotherapy involves a holistic approach, which considers the body as a whole.
References
https://www.nationalmssociety.org/What-is-MS
https://mymsaa.org/ms-information/overview/introduction/
Safna Hussain
