Multiple sclerosis (MS) is an auto-immune disorder of the central nervous system. It is a demyelinating disease in which the protective covers of the nerves are damaged by the body’s own immune system. It is one of the most common disabling disorder of the central nervous system which affects young adults. The mean onset age of MS is approximately 30 years and the disease rarely occurs before 10 or after 60 years of age. The manifestation of symptoms in around 70% of cases occurs among those aged between 20 and 40. According to one recent estimate by the National Multiple Sclerosis Society (NMSS), around 947,000 people in the country suffer from MS and this number of affected people is more than twice the long-estimated figure of 400,000. This finding shows that the prevalence rate is almost twice in northern states as compared with southern ones—around 110–140 cases per 100000 vs. 57–78 cases per 100000. The onset of MS has major financial and economic implications which are reflected in the expenses incurred, both direct and indirect, associated with MS; the expenses range anywhere between $8,528 $52,244 per patient per year.
Symptoms of multiple sclerosis
MS is characterized by loss of myelin sheath which covers the neurons and gliosis. Although the white matter is considered as the main affected area, recent studies have shown small lesions in the grey matter. Due to loss of myelin structure, plaques, a pathological hallmark of the disease, is formed in the central nervous system. They are categorized into active or acute, chronic active, and chronic inactive. According to the NMSS, MS has the following symptoms:
- Fatigue, weakness, and difficulties in walking
- Numbness and tingling
- Spasticity—involuntary muscle spasms
- Vision problems, dizziness, and vertigo
- Bladder, sexual, and bowel problems
- Emotional changes, pain, cognitive issues, and depression
The following are some of the lesser common symptoms associated with MS:
- Speech problems, itching, and tremor
- Breathing problem, hearing loss, headache, and swallowing problems
Clinically isolated syndrome (CIS)
CIS is the first clinical manifestation of neurologic symptoms due to inflammation and demyelination in the central nervous system. An acute CIS episode of the optic nerve, spinal cord, or the brainstem is observed in around 85% of young adults who develop MS. A CIS episode lasts for at least 24 hours.
Types of multiple sclerosis
MS is divided into 4 categories based on its effects on the body with time.
- Relapsing-remitting MS (RRMS): This is the most frequent type of MS. About 85% of MS patients fall under this category. People with RRMS experience attacks when symptoms flare up. After an attack, a recovery period without symptoms follows. This period can last weeks, months, or longer.
- Secondary-progressive MS (SPMS): Most people diagnosed with RRMS will eventually transit to SPMS over time. In SPMS, the neurological symptoms get worse and could cause disability.
- Primary-progressive MS (PPMS): PPMS affects about 10% of the total MS patients and is characterized by worsening neurological functions. In this condition, no relapse and remission is observed.
- Progressive-relapsing MS (PRMS): PRMS is a rare form of MS with a prevalence rate of around 5%. A characteristic feature of PRMS is that it is a steadily deteriorating type of MS with acute relapses but no remissions.
Risk factors of multiple sclerosis
- Women are at higher risk for developing MS
- In 15% of cases, an MS patient has a family history of MS
- Identical twins have 1 in 3 chances to develop the disease
If any of the symptoms are observed, it is imperative to consult a doctor at the earliest.
