(By Dr. Bhavya Saxena, Consultant Pathologist, Global Reference Laboratory, Metropolis Healthcare Limited)


Multiple Sclerosis (MS) is an autoimmune condition which damages the protective myelin sheath that covers the nerves. It primarily affects the central nervous system including the brain, spinal cord, and optic nerves. In India, this disease was recognized in the 1960s when some physicians who received training in Neurology in the West, returned to India and identified. Approximately, 2.9 million people are affected and are living with it worldwide, mostly affecting individuals between 20 to 40 years. Women are affected more as compared to men, with the ratio being 2:1, as per some studies.


Causes Of Multiple Sclerosis:


While the aetiology of MS is still unclear, some suggest inflammation of the white and grey matter in the CNS due to focal immune cell infiltration and their cytokine by a breach in the blood-brain barrier are the cause of the formation of plaques in MS. Certain environmental factors, including exposure to some viral and bacterial agents like Epstein Barr virus, human herpes virus type 6, and mycoplasma pneumonia could be the possible cause. Whereas smoking (soluble gas such as nitric oxide and carbon monoxide can damage neurons and oligodendrocytes), vitamin deficiency (especially vitamins D and B12), diet (negative association between MS risk and high fish intake), and exposure to UV radiation are also linked with the onset of MS.


Genetic factors are also known to play a role in MS. Studies suggest that the risk of MS in members of the same family depends on the amount of genes they share. The human leukocyte antigen (HLA) region of chromosome 6 is a group of genes associated with an increased risk of MS. Patients with MS or likely to be affected, present with fatigue, numbness, bladder or bowel problems, walking difficulties, vision problems, stiffness and spasms etc.


Early Signs Of Multiple Sclerosis:


The four early signs of MS that we shouldn’t ignore are painful vision loss in one eye, facial paralysis, dizziness, and limb weakness. The general symptoms of MS and their severity vary from individual to individual, not everyone with MS experiences the same initial symptoms, and symptoms may vary. These symptoms can worsen over hours or days. Another common early symptom of MS is dysesthesia, referred to as the "MS hug." In this one would feel a tightening sensation, squeezing, banding, of the torso often mimicking those of a heart or panic attack.


The disease typically starts with the sudden onset of neurological issues, it shows a relapsing-remitting course with the absence of symptoms except for the relapses. Most cases evolve into a secondary progressive form of disease, characterized by continuous irreversible neurological impairment between the relapses.


Diagnosis Of Multiple Sclerosis:


Diagnosis of MS by MRIs of the brain, spinal cord and associated nerves can demonstrate myelin damage. Repeat MRIs can help to monitor the progression. Analysis of Cerebrospinal fluid (CSF) helps to identify various proteins released into the CSF and help in identifying MS. Common CSF findings in people with MS are the presence of oligoclonal bands. Oligoclonal bands indicate the presence of an autoimmunity. One should note that CSF alone does not help identify MS. However, a correlation between all tests including CSF and MRI with other methods can help to confirm MS. 


It’s important to identify early signs and symptoms of MS and getting treatment sooner may help in slowing the progression of the disease. Because of increased awareness, more neurologists and the availability of magnetic resonance imaging (MRI) with CSF-associated diagnostic techniques the estimate has increased over the years. Lifestyle changes following a healthy diet, regular exercise, and no smoking and limiting alcohol may help in the progression of the disease.  Also, physical rehabilitation and mental health counselling may help. The earlier the symptoms, the signs and the visits to the neurologist, the earlier it helps in reducing the burden of the disease and aids in monitoring treatment, as treatment of MS focuses largely on managing the symptoms one faces.


[Disclaimer: The opinions, beliefs, and views expressed by the various authors and forum participants on this website are personal and do not
reflect the opinions, beliefs, and views of ABP News Network Pvt Ltd.]