Multiple Sclerosis - Causes, Symptoms and Treatment

Multiple Sclerosis Multiple sclerosis (MS) is a disease that affects the central nervous system (CNS) and can disable the brain and the spinal cord. According to Lassmann (2018), MS is a demyelinating disease of the CNS that results in focal lesions in gray and white matter and diffusion of the neurodegeneration in the entire brain. The disease causes inflammation that facilitates tissue injury throughout the MS stages. Lassmann (2018) states, “Focal inflammatory in the meninges and the perivascular spaces appear to produce soluble factors.” The factors, directly or indirectly, cause the myelin's demyelination covering the nerve fibers or neurodegeneration by activation microglia—oxidative injury and mitochondrial damage complete demyelination, or neurodegeneration, resulting in a state of virtual hypoxia. The paper discusses the causes, symptoms, diagnosis, and treatments of MS.

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MULTIPLE SCLEROSIS2 Causes In most patients, doctors and scientists believe that MS results from immune system attacks. Some factors, such as toxins or viruses, may be responsible for the immune system attack on myelin, causing its inflammation. The inflammation results in lesions or tissue scar that interfere with the brain's communication signals with other body parts. Some researchers have reported that specific genes may increase the susceptibility of an individual to MS. However, the disease on not hereditary.

Symptoms MS symptoms may develop at once or may start from a mild stage and progress gradually. At the early development stages of MS, the patient possesses signs such as numbness and tingling effects in the arms, legs, sides of the face, blurry vision in one eye, and weak legs or uneven balance. Once the disease has fully developed, the patient will experience fatigue, walking, vision, and bladder control. The patient will still experience numbness and tingling effects in different body parts, muscle stiffness, and difficulty in body coordination and balance.

The disease also affects the brain to the extent that the patient develops thinking, learning, and planning problems. Silveira et al. (2019) note that MS patients have high instances of psychiatric manifestations that are likely to worsen the disease and life quality. The authors also state that the patients have depression, making them develop poor adherence to MS treatment, reduced functional status, and more significant risks for suicide.

Diagnosis The diagnosis of MS in patients involves neurological examination and may also include a series of tests. Brownlee et al. (2017) report that the diagnosis is based on neurological symptoms and signs beside the CNS lesions dissemination evidence in space and time. A doctor

MULTIPLE SCLEROSIS3 performing the diagnosis may ask the patient to avail their clinical history. The process will require proof of demyelination in varying areas of the CNS and at different times. The doctor should eliminate various health conditions that manifest similar symptoms as MS. The various MS diagnostic tests include optical coherence tomography (OCT) that involves taking pictures of the nerve layers behind the eye and examining whether the optic nerves are growing thinner. The test also involves magnetic resonance imaging (MRI), spinal tap, blood tests, and visual evoked potentials (VEP). The latter entails the analysis of brain electrical activity by stimulating the nerve pathways. Blood tests help doctors to rule out diseases with similar MS symptoms. The MRI uses a dye with a different color to realize active and inactive lesions in the CNS. Treatment Recently, there has not been any establishment of MS cure. However, there are various treatments that scientists and doctors have proposed for controlling MS condition, and they are administered according to the specific symptoms that an individual manifests. The treatment may involve treatments for individual symptoms, treating relapses to enhance recovery, or reducing relapses utilizing therapies that modify the disease. Tintore, Vidal-Jordana, and Sastre-Garriga (2019) note that there has been the approval of various MS treatments, including IFNβ and glatiramer acetate, useful in the treatment of relapsing-remitting MS, and natalizumab. The latter was the first monoclonal antibody treatment to be approved. Other approved treatments are fingolimod, teriflunomide, dimethyl fumarate, and cladribine—all these are oral medications.

Alemtuzumab and ocrelizumab are the latest monoclonal antibodies that help in the treatment of MS. Patients should begin MS treatment at early stages and maintain regular MRI monitoring to ensure the treatment response and its safety.

MULTIPLE SCLEROSIS4 Multiple sclerosis (MS) affects the CNS and can disable the brain and the spinal cord in critical conditions. The immune system strikes myelin, the protective layer surrounding the nerves, causing inflammation and lesions that disrupt communication or coordination between the brain and other body parts. MS patients experience fatigue, numbness and tingling effects, partial vision loss, muscle stiffness, and difficulty walking. Neurological examination, blood tests, and magnetic resonance imaging (MRI) are essential for diagnosing MS. The diagnosis requires a doctor to eliminate various diseases with similar symptoms as MS. Even though there is no cure for MS, scientists and doctors have approved several treatment mechanisms to control MS. The treatment should begin at early MS stages, and MRI monitoring is necessary to track the treatment response and safety.

MULTIPLE SCLEROSIS5 References Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017). Diagnosis of multiple sclerosis: progress and challenges. The Lancet, 389(10076), 1336-1346. Retrieved 25 November 2020, from https://www.sciencedirect.com/science/article/abs/pii/S014067361630959X Lassmann, H. (2018). Multiple sclerosis pathology. Cold Spring Harbor perspectives in medicine, 8(3), a028936. Retrieved 25 November 2020, from http://perspectivesinmedicine.cshlp.org/content/8/3/a028936.short Silveira, C., Guedes, R., Maia, D., Curral, R., & Coelho, R. (2019). Neuropsychiatric Symptoms of Multiple Sclerosis: State of the Art. Psychiatry Investigation, 16(12), 877. Retrieved 25 November 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933139/ Tintore, M., Vidal-Jordana, A., & Sastre-Garriga, J. (2019). Treatment of multiple sclerosis— success from bench to bedside. Nature Reviews Neurology, 15(1), 53-58. Retrieved 25 November 2020, from https://www.nature.com/articles/s41582-018-0082-z/