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Multiple sclerosis, a wide spread disease of unknown origins

D. Alwinsky, M.D. |
Multiple sclerosis (MS) is a wide spread disease with serious symptoms, attacking mostly women.

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Multiple sclerosis symptoms involve the brain, optic nerves, and spinal cord and it affect million of people around the world and it will only get worse. It is is an autoimmune disease, which means that the body's immune system attacks its own body.

The immune system attacks the myelin sheath that surrounds healthy nerve cells. Then lesions form, scars appear, and they reduced nerve function. Since our functioning depends on the communications between nerves, that is a serious problem.

Multiple sclerosis leads to muscle weakness, memory issues, fatigue, dizziness, vertigo, numbness, tingling sensations, and those are just main symptoms.

Multiple sclerosis was described back in 1868 when Jean-Martin Charcot realized that an unknown condition is similar but different than something that would be later named Parkinson's disease. The three symptoms: a characteristic tremor, involuntary eye movements, and explosive speech, were named Charcot's triad. With the development of MRI it became easier to diagnose multiple sclerosis.

We don't know exactly why multiple sclerosis appears but there are some facts everybody agree on: it is an autoimmune condition, its symptoms are similar to many other conditions, and women are 2–3 times more likely to be diagnosed than men.

But there are more bad news: We don't fully understand risk factors. Research and experience suggest that risk factors include a lack of vitamin D, smoking, obesity, infection with the Epstein-Barr virus, maybe a genetic influence, environmental factors, gut microbiota. And being a woman.

Treatment Multiple sclerosis with steroids is usual and scientist are searching for new methods of healing, from treating gut microbiota to stem cells.

The disease is chronic and progressive. Most often, without any rule, occasional improvements and worsening occur, some symptoms disappear, other appear.

In the beginning, some symptoms, for example, double pictures or retrobulbar neuritis, or pyramidal symptoms can disappear completely. Such remissions can be present for a long period of time and after several months symptoms appear again.

The longer the disease last, the rarest and weakest remissions. So, with time, symptoms don't disappear with gradual and unsustainable worsening, and new symptoms occasionally appear so patients are sooner or later, mainly because of the reduced ability, tied to bed permanently.

The disease lasts for various periods of time, and there are no criteria to conclude how long the disease will last in a particular case.

The average disease has a perennial course, in some patients lasting 5, 10, 15 and even 20 to 30 years, and in some death occurs in a few years. There are rare malign cases where tetraplegia and bulbar paralysis occur in a few months.

Equally rare are the particular forms where MS develops acutely and suddenly under the image of an acute febrile disease in which extensive neurological symptoms develop over several days.

Approximately 10 % of cases are benign forms where the disease still does not lead to a more significant disability even after 10 to 15 years. It seems that cases when the disease begins in younger years have a faster and less unfavorable course than if the disease develops in the later years of life.

Frequent emotional changes are one of the most common symptoms of MS. Euphoria appears as the cheerful mood in the patients and uncritical experience of illness and disability without a trace of uncertainty and concern like in a case of other diseases, especially chronic, are quite understandable.

Euphoria is manifested so that even in addition to the symptoms of the disease that would significantly bother everyone, for example, double pictures, incontinence, or strong paresis, the patient feels physically well as if these limitations and disorders were irrelevant.

Euphoria and good mood are common and very early symptoms of MS when other symptoms are rudimentary. However, the opposite conditions with bad mood, depression, despair and suicidal ideas can be developed, which from a psychological standpoint is quite understandable and does not require any particularly pathological or anatomical explanation.

So, what can we do now?

Not much. There is no cure. Treatment focuses on recovery from attacks, slowing the progression of the disease and managing symptoms. Some fortunate people have mild symptoms that require no treatment at all. In the early stages of the disease the immune response is strong, so a treatment with medications early can slow the disease and all symptoms that may come later.

Physical therapy can build muscle strength so strengthening may address leg weakness and other problems. Also, stiffness or spasms, especially in legs, can be reduced with medication, and it may also help to increase walking speed. Other drugs treat other symptoms like insomnia, and bladder or bowel control problems or whatever the patient experiences.


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