Multiple sclerosis: what you need to know

Multiple sclerosis (MS)
is disease surrounded by myth. Patients are portrayed as locked into a hospital bed, silent and relying on others for help. Although this is true for some patients, MS is actually the most common neurological disorder of young adults and is managed well in the community. Many of you will have a family member with this disease who lives an active and healthy life. In aid of 'World MS Day' it is worth getting the facts.

MS can affect anyone, but is most seen in women from ages 20-40. It is a disease of the nervous system whereby over time the body loses the ability to perform its usual tasks. This can be anything from loss of sight or balance, to changes in mood or movement. Common symptoms are complete loss of vision in one eye or walking problems. Diagnosis is by history and MRI imaging. There are four subtypes of MS, each with variable rates of progression and disability. The most serious causes a steady deterioration over years. It cannot be cured, but is managed well with medication.

In this disease the body's nervous system, our 'information superhighway', begins to break down. The cause of this is something called ' autoimmune disease'. This is where the body's own immune system, which usually helps to protect us from infections, turns on itself. The reasons for this are complicated and not fully known. The primary problem in MS is autoimmune destruction of the myelin sheath. This is the insulation for our nerve wiring

Once this substance breaks down, the nerve may no longer work properly or at all. There is no information delivered to the part of the body affected. The end result of this process can be almost anything, but classically visual loss and paralysis are dominant symptoms. Depending on the subtype of MS, the rate and severity of these symptoms differ. If you are concerned that you may have these symptoms, or just want some reassurance, your GP will be able to advise.

Autoimmune disease tends to ebb and flow, with periodic worsening of symptoms as the disease worsens and then relaxes. This is what we call a 'flare' and 'remission.' Often patients will go months to years in remission, without serious worsening. Upon a 'flare', the patient may be treated in hospital or in a residential home. Many of these patients then return to normal life, sometimes with some new level of disability. These changes may be permanent.

We cannot cure the condition as yet, but doctors can use medication to slow it down dramatically. The use of medications designed to hamper the immune system, which is the offending party, are very effective at slowing the destruction of myelin. Research at this time revolves around developing a better understanding of the signals and mechanisms involved in the immune system's effects on nerves. The best way to get involved in helping to find a cure is by donating directly to research causes.

For MS support visit The MS Society

Ben is a young NHS doctor in the Southwest. His interests including neurology, health communication, and medical ethics. He is also an avid advocate of compassionate care and quality improvement, running a project in the southwest around medical humanities.

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