Multiple sclerosis (MS) is a progressive, debilitating, immune mediated, and eventually fatal neurodegenerative disorder where the myelin sheath – the insulating cover of all neurons — in the central nervous system (CNS) becomes damaged due to inflammation. It so happens that the body’s immune system attacks these myelin sheaths (mostly the white matter of the brain and spinal cord) when the T cells cross the blood-brain barrier to attack the epitopes presented by the myelin sheath cells. As a result, MS is more appropriately termed an “immune mediated” disease, and not an “auto-immune” disease, as the exact target of these T cells and the cause of their behavior remains unknown.
This attack disturbs and progressively destroys the conduction of nerve impulses, leading to scarring and permanent damage to the myelin sheath and consequently the nerve fibres, and resulting in severe neurodegenerative complications, such as impaired vision, loss of senses, loss of balance, loss of control over voluntary muscles, and all other bodily functions connected to the CNS. A classic hallmark of MS is the exacerbation or ‘flare-up’ of symptoms which occur repeatedly within spans of months to years in the relapsing-remitting form of the disease.
Until now, there has been no such approved ‘cure’ for MS, only short term medications which can treat patients with symptomatic attacks and flare-ups. They merely keep the patient under control for that particular bout of exacerbation, and do not have any guaranteed long-term effect.
Proper diagnosis and a thorough check up in accordance with the patient’s history of symptomatic attacks can help a physician zero in on the possibility of an MS diagnosis, with MRI and CSF testing showing typical lesions (scars / plaques) in the brain considered to be the most definitive way to confirm multiple sclerosis. MS has the potential of causing severe damage in its initial phases of attacks, and hence the earlier the treatment starts, the more effective it is for the patient.
Since the condition is a very serious one, with the patient progressively experiencing the disease’s symptoms, there is an issue of emotional stress as well. Clinicians have noted that it is very important that friends and family of those who suffer with MS provide as much support as possible. This is vital in maintaining a healthy lifestyle for the patient, to prevent further flare-ups and reduction in lifespan.
Epidemiology of Multiple Sclerosis1:
MS affects around 2 to 2.5 million people globally, with women being affected twice or three times as many as men. It affects people between the ages 20 and 50. The average age of diagnosis of MS is 29 years for women and 31 years for men. According to data provided by the National Multiple Sclerosis Society, in the United states, an estimated 400,000 people are affected by MS. However, this is just an estimate, as the CDC does not require physicians in the U.S. to report new cases of MS, and the symptoms are also not pronounced during the initial stages. The prevalence estimate varies between 58 to 95 per 100,000 population.
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