Multiple Sclerosis Treatment

Types of Multiple Sclerosis

The course of MS varies between individuals. The 2013 classification includes four primary types:

Clinically Isolated Syndrome (CIS): First episode lasting >=24 hours with MS-like symptoms.
Relapsing-Remitting MS (RRMS): Characterized by flare-ups followed by remission. Most common form (about 80% of cases).
Secondary Progressive MS (SPMS): Follows RRMS. Neurological function progressively worsens over time.
Primary Progressive MS (PPMS): Steady worsening of neurological function from onset, with no remissions.

Signs and Symptoms

Fatigue or muscle weakness
Difficulty walking and poor coordination
Visual disturbances (blurry/double vision, blindness in one eye)
Numbness or tingling
Muscle stiffness and spasms
Cognitive problems (planning, memory, thinking)
Bladder control issues
Mood disorders (anxiety, depression)
Sexual dysfunction

Symptoms may fluctuate or worsen as MS progresses.

Causes and Risk Factors

Though the exact cause is unknown, contributing factors include:

Genetics: Family history may raise risk.
Viral infections: Epstein-Barr virus (mononucleosis).
Geography: More common in Northern Europe.
Autoimmune disorders: Thyroid disease, Type 1 diabetes, etc.
Smoking: Increases risk, especially after early symptoms.

Diagnosis of MS

There is no single test. Diagnosis involves ruling out other conditions.

Cerebrospinal fluid test: Checks for chronic nervous system inflammation.
Blood test: Excludes other disorders.
MRI: Shows lesions on the brain and spinal cord.

Treatment Options in India

There is no complete cure, but treatment helps manage symptoms and slow progression.

Disease-Modifying Therapies (DMTs)

Injectable Medications

Beta-interferons: Reduce relapses and disease progression.
Glatiramer acetate: Blocks immune attack on myelin sheath.

Note: Can cause skin irritation at injection site.

Oral Medications

Siponimod
Dimethyl fumarate
Teriflunomide

Infusion Therapies

Natalizumab and Ocrelizumab (Ocrevus™): For RRMS and PPMS.
Mitoxantrone: For secondary-progressive MS; also used in cancer.

Note: Long-term use may lead to liver damage, infertility, or even leukemia.

Short-Term Therapies

Corticosteroids: Reduce nerve inflammation during relapses.
Plasma Exchange (Plasmapheresis): Used when steroids fail.

Symptom Management

Muscle relaxants for spasticity
Pain relievers for nerve pain
Antidepressants
Medications for bladder issues
Drugs to improve walking ability

Lifestyle and Supportive Therapies

Physical therapy: Improves mobility and muscle tone.
Regular exercise: Enhances balance, strength, and coordination.
Healthy diet: Especially Vitamin D-rich foods.
Stress management: Meditation and deep breathing help prevent relapses.
Avoid overheating: MS symptoms may worsen with heat.

Frequently Asked Questions

Q: What are the most common symptoms of MS?
A: Numbness, tingling, fatigue, vision problems, poor coordination, cognitive decline.

Q: Is MS life-threatening?
A: With proper care, most people have a normal life expectancy. However, inactive patients are more prone to complications.

Q: Is MS inherited or contagious?
A: No. MS is not contagious, and while genetic factors may increase risk, it is not directly inherited.

Q: Can MS be cured?
A: Not yet. Treatments help manage symptoms and delay progression.

Q: What’s the difference between MS and ALS?
A: MS is autoimmune and affects myelin; ALS is neurodegenerative and destroys motor neurons.