Multiple Sclerosis And Other Demyelinating Disease

Multiple Sclerosis And Other Demyelinating Disease

What is demyelinating disease?

A demyelinating disease is any condition that results in damage to the protective covering (myelin sheath) that surrounds nerve fibers in your brain, optic nerves and spinal cord. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

Multiple Sclerosis is common demyelinating disease. Other disorders include optic neuritis, NMO spectrum disorder and acute disseminated encephalomyelitis.

What is multiple sclerosis (MS)?

Multiple sclerosis (MS) is a chronic illness involving your central nervous system (CNS). The immune system attacks myelin, which is the protective layer around nerve fibers.

This causes inflammation and scar tissue, or lesions. This can make it hard for your brain to send signals to the rest of your body.

What are the types of MS?

​ 1. Clinically isolated syndrome (CIS)
2. Relapsing-remitting MS (RRMS)
3. Primary progressive MS (PPMS)
4. Secondary progressive MS (SPMS)
5. Progressive-Relapsing MS (PRMS)

What are Signs and Symptoms of MS?

1. Numbness or weakness in one or more limbs that typically occurs on one side of your body at a time, or the legs and trunk
2. Partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement
3. Prolonged double vision
4. Tingling or pain in parts of your body
5. Electric-shock sensations that occur with certain neck movements, especially bending the neck forward (Lhermitte sign)
6. Tremor, lack of coordination or unsteady gait
7. Slurred speech
8. Fatigue
9. Dizziness
10. Problems with bowel and bladder function

How is MS diagnosed?

1. MRI scan – MRI brain with whole spine with contrast study
2. Evoked potentials test – Visual evoked potential (VEP), Brainstem auditory evoked response (BAER)
3. Spinal tap (lumbar puncture)- CSF Analysis including Oligoclonal band. 
4. Blood tests - To eliminate other conditions with similar symptoms.

What are the treatment options available for MS?

Acute relapse of MS

1. Corticosteroids
2. ACTH/Plasmapheresis

Disease modifying drugs for MS

Injectable medications

1. Interferon beta-1a
2. Interferon beta-1b
3. Glatiramer acetate
4. Peginterferon beta-1a

Oral medications

1. Teriflunomide
2. Fingolimod
3. Dimethyl fumarate

Infused medications

1. Alemtuzumab
2. Mitoxantrone
3. Ocrelizumab
4. Natalizumab

Other treatment

1. Physical therapy
2. Drugs for symptomatic treatment