Sclerosis

Sclerosis

What is multiple sclerosis?

Multiple sclerosis is a chronic and progressive autoimmune disorder that affects the brain, optic nerve, and spinal cord. The body’s immune system mistakenly attacks the fatty myelin sheaths that form a protective coating around neurons.

This process of demyelination causes inflammation, leaves the nerves exposed and causes them to develop scars, which disrupt the electrical impulses that the brain sends to communicate with the body so that they can’t travel along the nerves as easily.

MS can come on in attacks or be silently active on your myelin in the background. More scars or lesions form with each bout of MS. The word sclerosis means scars, so MS is essentially multiple scars on the nerves. These get worse over time, which is why it’s seen as a progressive disease.

Medications and therapies have been shown to slow down the progression, alter its course and reduce disability, but there is currently no cure.

The scars and subsequent communication problems they cause between neurons and the brain can cause motor problems, vision impairments, pain, memory and cognitive issues and various other challenges.

How is MS diagnosed?

Because the symptoms of MS can be apparent in a number of different diseases and disorders, there are a few things that need to be observed over time for a diagnosis of MS to be confirmed. Often, the McDonald criteria are followed in diagnosing MS.

This requires two things:

• Evidence that the damage to the central nervous system is getting worse in multiple locations in the body, meaning that an MRI (magnetic resonance imaging) scan shows multiple lesions occurring in different parts of the body.

What treatments are there for MS?

There are various treatments to slow the progression, change the course of the disease and reduce disability and symptoms. These are usually administered orally, as intravenous infusions or with injections.

Common treatments include:

• Disease-modifying therapies (DMTs) that target the body’s immune system to modify it so that it reduces its attack on the central nervous system.
• Corticosteroids that reduce inflammation and therefore symptoms during a relapse.
• Other medications that are used to manage symptoms.

Many clinicians agree that the most important thing is to diagnose accurately and start treatment as soon as possible. This is because every relapse hits the central nervous system hard and even when there are no symptoms, the disease may be actively doing damage in the background. A delay in treatment could lead to greater disability later on in life.

You can also get rehabilitative treatments, such as physiotherapy or occupational therapy, to help with muscular dysfunction and stiffness. Your doctor and neurologist will be able to advise you on the best combination of treatments for you.