Multiple Sclerosis – Symptoms, Diagnosis and Treatment

Multiple sclerosis is a chronic condition that affects the central nervous system, which includes the brain and spinal cord. It occurs when the immune system mistakenly attacks the protective covering of nerve fibres called myelin. This can cause problems with how nerves send messages throughout the body, leading to problems like reduced mobility and pain. Multiple sclerosis is the most common chronic neurological disease in young adults. According to Multiple Sclerosis Australia, more than 33,000 Australians live with the condition [1]. Most individuals diagnosed are women and aged between 20-40 years old. At 24-7 Medcare, we provide accessible healthcare services, including virtual consultations, to assist individuals with multiple sclerosis manage their condition. Our experienced GPs can offer guidance, diagnosis and treatment options within the convenience of your own home.
 

What is Multiple Sclerosis?

Multiple sclerosis is a long-lasting condition that affects the central nervous system, which includes the brain and spinal cord. It happens when the body's immune system mistakenly attacks a protective covering around nerve fibres called myelin [2]. This causes problems with how nerves send messages, leading to different symptoms. The exact cause of multiple sclerosis is unknown. Still, it involves a mix of genes and things in the environment. Multiple sclerosis usually starts in early adulthood, affecting women more often than men [1]. The disease can vary from person to person, with times of getting worse and then better, or sometimes a steady decline.

Multiple Sclerosis Symptoms and Signs

Multiple sclerosis is a chronic autoimmune disease affecting the central nervous system, causing many symptoms and signs. Signs and symptoms of multiple sclerosis can vary significantly from person to person, and they often fluctuate in severity and frequency. Common symptoms include [2]:

• Fatigue
• Problems with coordination and balance.
• Muscle weakness, which may lead to problems with mobility,
• Numbness or tingling sensations, often affecting the limbs or the face.
• Vision problems, such as blurred vision or double vision
• Cognitive changes can also occur, resulting in difficulties with memory, attention, and problem-solving
• Emotional symptoms like depression, anxiety, and mood swings.

 

Multiple Sclerosis Diagnosis and Testing

When your GP suspects someone might have multiple sclerosis, they are typically referred to a neurologist who specialises in nervous system disorders. The diagnostic process involves a comprehensive evaluation that includes a detailed medical history, a thorough physical examination, and various diagnostic tests [3]. However, no single clinical assessment can diagnose this condition, so a combination of medical tests may be necessary.

MRI Imaging

MRI imaging is a helpful tool in diagnosing multiple sclerosis [4]. It takes detailed brain and spinal cord pictures, showing abnormalities like lesions or inflammation. During the scan, the patient lies on a table and goes inside a machine that uses a strong magnet and radio waves to create the pictures. A radiologist then carefully looks at the images to check for signs of multiple sclerosis. The radiologist's findings, other tests and the patient's medical history help doctors with diagnosis. MRI scans are essential in confirming multiple sclerosis and guiding treatment plans for the disease.

Lumbar Puncture

A lumbar puncture is a procedure that can help diagnose multiple sclerosis [5]. It involves inserting a needle into the lower back to collect a small cerebrospinal fluid sample. The cerebrospinal fluid is then examined for specific markers indicating multiple sclerosis. The procedure is usually done with the patient lying on their side, and a local anesthetic is used to numb the area. The collected sample is sent to a laboratory for analysis. The lumbar puncture results, along with other tests and the patient's symptoms, help doctors with a diagnosis.
 

Multiple Sclerosis Causes

The exact causes of multiple sclerosis are still not fully understood. However, researchers believe a few potential causes may play a role [6]. 1. Genetics: Certain genes inherited from our parents may increase the chances of developing multiple sclerosis. However, genes alone are not enough to cause multiple sclerosis. 2. Environmental factors: Environmental factors, such as infections or exposure to certain substances, could trigger the immune system to mistakenly attack the protective covering of nerves in the central nervous system called myelin. Some potential triggers include viral infections (such as Epstein-Barr virus), low vitamin D levels, smoking, and exposure to certain toxins [7]. 3. Autoimmune Response: Multiple sclerosis is considered an autoimmune disease, meaning the immune system mistakenly attacks the body's tissues [8]. In the case of multiple sclerosis, the immune system targets the protective covering of nerve fibres, known as myelin. This immune response leads to inflammation and myelin damage, which disrupts nerve signal transmission. It's important to note that while these factors are thought to contribute to the development of multiple sclerosis, they don't guarantee that someone will get the disease. The causes of multiple sclerosis are still being studied, and researchers are working hard to uncover more information.
 

Multiple Sclerosis Treatment

When it comes to treating multiple sclerosis, several options are available to help manage the symptoms and slow down the progression of the disease. The treatment plan for multiple sclerosis is often tailored to each person's specific needs. Here are some common treatment approaches:

Multiple Sclerosis Medications

Various medications can be prescribed to manage multiple sclerosis symptoms, reduce inflammation, and modify the immune system's response [9]. These medications can help decrease the frequency and severity of multiple sclerosis relapses, control symptoms like muscle stiffness and pain, and slow down the progression of the disease.

Rehabilitation Therapies

Rehabilitation therapies, such as physiotherapy, occupational therapy, and speech therapy, can help individuals maintain strength, balance, and mobility. These therapies aim to improve overall function and independence, manage symptoms, and enhance quality of life.

Lifestyle Modifications

Making healthy lifestyle choices can positively impact multiple sclerosis management. This includes regular exercise, a balanced diet, managing stress levels, and getting enough restful sleep. Additionally, avoiding known triggers, such as extreme temperatures or excessive physical exertion, can help manage symptoms.

Supportive Care

Multiple sclerosis can have a significant impact on a person's emotional well-being. Counselling or support groups can provide valuable emotional support and help individuals cope with the challenges of living with multiple sclerosis. It's also important to regularly communicate with healthcare providers and seek their guidance. It's essential to note that while there is currently no cure for multiple sclerosis, the treatment options available can help individuals manage their symptoms, maintain their quality of life, and slow down the progression of the disease. Treatment plans are typically personalised, considering the individual's specific symptoms, disease course, and overall health.
 

Complications

Multiple sclerosis can lead to various complications affecting a person's daily life. Here are some common complications to be aware of [10]:

Physical Dysfunction

Multiple sclerosis can cause difficulties with mobility, balance, and coordination. This can make walking, performing daily tasks, or engaging in physical activities harder. Muscle weakness, spasticity (muscle stiffness), and fatigue are common physical challenges associated with multiple sclerosis.

Sensory Change

Multiple sclerosis can affect the senses, leading to problems with vision, hearing, and sensation. Vision problems like blurred vision, double vision, or vision loss can occur. Numbness, tingling, or pain in different parts of the body may also be experienced.

Cognitive Issues

Some individuals with multiple sclerosis may experience cognitive changes, affecting memory, attention, problem-solving, and information processing. Difficulty multitasking, organising thoughts, and finding the right words are common mental challenges.

Emotional and Mental Health

Multiple sclerosis can have an impact on a person's emotional well-being. Depression, anxiety, and mood swings can occur due to the stress of managing a chronic condition and dealing with its challenges.

Fatigue

Fatigue is a common symptom of multiple sclerosis and can significantly affect everyday life. It is often described as an overwhelming sense of tiredness that is not relieved by rest.

Bladder and Bowel Problems

Multiple sclerosis can affect bladder and bowel function, leading to frequent urination, urgency, incontinence, constipation, or difficulty emptying the bladder or bowel.

Sexual Dysfunction

Multiple sclerosis can cause sexual problems, including reduced libido, erectile dysfunction in men, and decreased sensation or difficulty reaching orgasm in both men and women. It's important to remember that not everyone with multiple sclerosis will experience all of these complications, and the severity can vary from person to person. However, knowing these potential challenges can help individuals and their healthcare team address and manage them effectively.
 

Recovery

Multiple sclerosis is a chronic condition that lasts for a long time and doesn't currently have a cure. The course of multiple sclerosis is unpredictable and depends on various factors such as the type of multiple sclerosis, the severity of symptoms, and individual differences. For some people with multiple sclerosis, the disease may follow a relapsing-remitting pattern, where they experience periods of relapses or flare-ups with worsening symptoms, followed by periods of remission where the symptoms improve or stabilise [10]. Others may have a progressive form of multiple sclerosis, where the symptoms gradually worsen over time without distinct periods of remission. Factors like age, severity of symptoms, and response to treatments can also influence multiple sclerosis. It's important to note that while multiple sclerosis can be challenging, many individuals with multiple sclerosis lead fulfilling lives and can manage their symptoms with proper medical care and support.
 
 

Receiving quality care from highly experienced doctors is essential for a prompt diagnosis and receiving the correct medical treatment. With 24-7 MedCare, you can experience telemedicine from the convenience of your own home. Our friendly online doctors will be available 24/7 for a consultation, anytime and anywhere in Australia.

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