Multiple Sclerosis
- Nikhil Kuzhimuriyil Sunil
- Jan 17, 2025
- 2 min read
Multiple Sclerosis is a chronic autoimmune neurological disorder. The immune system attacks the myelin of the nerve cell—the outermost part of the nerve fiber—leading to decreased nerve conduction. The condition may follow a relapsing-remitting or progressive course, varying in duration.
Types
1. Relapsing-remitting MS – Alternating periods of attacks and remissions.
2. Primary-progressive MS – Steady progression of the disease from onset without remission.
3. Secondary-progressive MS – A combination of relapsing-remitting and progressive types.
4. Progressive-relapsing MS – Steady progression of the disease, interspersed with acute attacks.
Causes
1. Autoimmune disorder – The body’s immune system attacks the myelin sheath of nerve cells as it would foreign bodies.
2. Genetics – A family history of similar conditions.
3. Stress – Factors like a busy lifestyle, lack of sleep, and work-related pressure may contribute.
Clinical Features
1. Intention tremor – Tremors occurring during voluntary movement.
2. Nystagmus – Rapid, involuntary eye movements that last for a few seconds.
3. Scanning speech – Speech characterized by broken words and long pauses.
- Charcot’s triad – Intention tremor, scanning speech, and nystagmus were the classic symptoms for diagnosing MS.
4. Loss of balance.
5. Generalized muscle weakness.
6. Fatigue.
7. Paresthesia – Altered sensations, particularly in the extremities.
8. Bladder dysfunction – Urinary urgency and incontinence observed in some patients.
Diagnosis
1. Evoked potential – A test to identify nerve damage by measuring brain signals in response to stimuli.
2. Magnetic resonance imaging (MRI) – The most reliable diagnostic tool for confirming MS.
Treatment
Medication
1. Medications for managing symptoms – Corticosteroids like methylprednisolone are prescribed to suppress immune activity.
2. Disease-modifying therapy (DMT) – Includes IV Rituximab every six months and IV Alemtuzumab, which help reduce disease progression.
Diet
1. Vitamin D and other vitamin supplements – Support proper immune system functioning.
2. Probiotics – Promote gut health and help reduce inflammation.
3. Protein-rich foods – Aid in muscle repair and overall health.
Physiotherapy Management
Physiotherapy aims to improve and maintain voluntary control, slow disease progression, and ensure the patient remains active and functionally independent.
Rehabilitation focuses on:
1. Balance training– Prevents falls by using obstacle courses, exercises for sudden perturbations, and single-leg activities.
2. Strength training– Maintains muscle mass by activating all available nerve cells, reducing fatigue, and improving overall activity.
3. Gait training– Focuses on slower, controlled walking steps through techniques like treadmill walking, stair-climbing exercises, and walking on uneven surfaces.
4. Hydrotherapy– Helps maintain muscle strength through water resistance.
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