Multiple sclerosis

Description of the Disease

This demyelinating inflammatory disease of the central nervous system progresses constantly or relapses with neurological dysfunction symptoms, eventually leading to disability. While it is not an infectious disease, a viral infection increases the risk. Researchers have identified genetic predisposition (risk-increasing gene alleles) for developing multiple sclerosis. The highest incidence occurs in cold climate zones (frequent in Scandinavia), less common in black individuals, and even less in Asian individuals. The incidence increases when black individuals move to a cold climate zone.

Symptoms

The symptoms of this disease are diverse and can include sensory and motor impairments, cognitive and mood disturbances. The disease may hide for a while, showing no symptoms. When the spinal cord is affected, individuals may experience weakness in the legs, partial paralysis, tingling, numbness, or a general feeling that something is wrong, along with urinary and bowel disturbances. Eye damage is characteristic, leading to impaired vision and eye pain. Patients often note that vision may disappear and then return, which can be quite frightening the first time it happens. Affected parts of the brain can cause speech disturbances, imbalance, dizziness, double vision, and more.

Diagnosis

Doctors diagnose the disease using magnetic resonance imaging (MRI) of the brain, cerebrospinal fluid sampling (lumbar puncture) and examination, as well as other tests such as evoked potential testing to assess the degree of damage.

Treatment

Treatment includes immune-modulating and symptomatic approaches.

Immune-Modulating Treatment

• Doctors prescribe corticosteroids.
• Immunosuppressants such as azathioprine, cyclophosphamide, and methotrexate help manage the condition.
• Disease-modifying treatments involve beta-interferon.
• During exacerbations, plasma exchange effectively removes the patient’s damaged blood plasma for those unresponsive to corticosteroids.

Symptomatic Treatment

Various medications address different symptoms:

• Amantadine alleviates fatigue.
• Muscle relaxants reduce muscle stiffness.
• Anticholinergics and antidiuretics help manage urinary disturbances. Sensory impairments improve in cold environments or after bathing in cold water.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology