Multiple sclerosis (MS) involves:
Autoimmune Reaction: The immune system mistakenly attacks myelin, the protective sheath surrounding nerve fibers in the central nervous system (CNS).
Demyelination: Destruction of myelin disrupts nerve signal transmission, leading to impaired communication between the brain, spinal cord, and the rest of the body.
Plaque Formation: Inflammatory lesions (plaques) form in the CNS, causing scars that can further impair nerve function.
Neurodegeneration: Prolonged inflammation and demyelination can lead to irreversible nerve damage and progressive neurological deficits.
Complications: MS can lead to physical and cognitive disabilities, fatigue, pain, and in severe cases, paralysis.
Clinical Evaluation
Symptoms: Assessment of symptoms such as visual disturbances, muscle weakness, sensory changes, coordination problems, and cognitive impairment.
Physical Examination: Examination findings may include abnormal reflexes, impaired coordination (ataxia), and signs of sensory or motor deficits.
Diagnostic Tests: Magnetic resonance imaging (MRI) to detect CNS lesions, cerebrospinal fluid (CSF) analysis for immune markers (oligoclonal bands), and evoked potentials to assess nerve function.
Visual disturbances such as blurred vision or loss of vision in one eye (optic neuritis).
Muscle weakness, typically in the limbs, which may affect walking or fine motor skills.
Sensory changes, including numbness, tingling, or a "pins and needles" sensation.
Coordination problems, balance difficulties, and tremors.
Cognitive impairment, such as memory problems or difficulty concentrating.
Fatigue, often severe and not relieved by rest.
Management aims to slow disease progression, manage symptoms, and improve quality of life:
Disease-Modifying Therapies (DMTs): Medications to modulate the immune response and reduce relapse rates, including interferons, monoclonal antibodies, and oral therapies.
Symptomatic Treatment: Medications for symptom management, such as muscle relaxants for spasticity, antidepressants for mood disorders, and medications for pain relief.
Rehabilitation: Physical therapy, occupational therapy, and speech therapy to improve mobility, function, and independence.
Lifestyle Modifications: Regular exercise, stress management techniques, and dietary adjustments to support overall health.
Supportive Care: Psychological support, social services, and assistive devices to help cope with the challenges of living with MS.