Multiple Sclerosis (MS)
Multiple sclerosis(MS) is a chronic autoimmune disorder that affects the centrel nervous system(CNS), especially the brain, spinal cord and optic nerves. When a person has an autoimmune disease, the immune system attacks healthy tissue, just as it might attack a virus or bacteria.
In the case of Multiple sclerosis(MS), the immune system attacks the myelin sheath that surrounds and protects the nerve fibres, causing inflammation. Myelin also helps the nerves conduct electrical signals quickly and efficiently.
Multiple sclerosis(MS) means “scar tissue in multiple areas.” When the myelin sheath disappears or sustains damage in multiple areas, it leaves a scar or sclerosis. These areas are also called plaques or lesions. They mainly affect –
• the brain stem
• the cerebellum, which coordinates movement and controls balance
• the spinal cord
• the optic nerves
• white matter in some regions of the brain
As more lesions develop, nerve fibers can break or become damaged. As a result, the electrical impulses from the brain do not flow smoothly to the target nerve. This means that the body cannot carry out certain functions.
As MS affects the CNS, which controls all the actions in the body, symptoms can affect any part of the body.
The most common symptoms of MS are –
• Muscle weakness –
People may develop week muscles due to lack of use or stimulationdue to nerve damage.
• Numbness and tingling –
A pins and needles type sensation is one of the earliest symptoms of MS that can affect the face, body or arms and legs.
• Lhermitte’s sign –
A person may experience a sensation like an electric shock when they more their neck, known as Lhermitte’s sign.
• Fatigue –
Fatigue is one of the most common symptoms of MS. This can undermine a person’s ability to function at work or at home.
• Dizziness and vertigo –
These are common problems, along with balance and co ordination issues.
• Bladder problems –
A person may have difficulty emptying their bladder or need to urinate frequently or suddenly. Loss of bladder control is an earlysign of MS.
• Spasticity and muscle spasms –
This is an early sign of MS.Damaged nerve fibres in the spiral cord and brain can cause painful muscle spasms, particularly in the legs.
• Gait and mobility changes –
MS can change the way people walk, because of muscle weakness and problems with balance, dizziness and fatigue.
• Pain –
Pain in a common symptoms in MS. Neuropathic pain in directly due to MS. Other types of pain occur because of weakness or stiffness of muscles.
Some people with MS may experience involuntary quivering movements.
• Sexual dysfunction –
Both males and females may lose interest in sex.
• Vision problems –
Some people may experience double or blurred vision, a partial or total loss of vision, or red-green colour distortion.This usually affects one eye adges.
• Learning and memory problems –
These can make it difficult to concentrate, plan, learn and prioritise.
Some less common symptoms-
• speech disorders
• hearing loss
• swallowing problems
• respiratory problems
In the later stages, people may experience changes in perception and thinking and sensitivity to heat.
MS affects individual differently. For some, it starts with a subtle sensation, and their symptoms do not progress for months or years.Sometimes, symptoms worsen rapidly, within weeks or months.
The cause of MS is unknown.It is considered as an autoimmune disease in which the body’s immune system attacks its own tissues. In the case of MS, this immune system malfunction destroys the fatty substance that coats and protects nerve fibres in the brain and spinal cord (myelin).
Myelin can be compared to the insulation coating on electrical wires. When the protective myelin is damaged and the nerve fiber is exposed, the messages that travel along that nerve fiber may be slowed or blocked.
A combination of genetics and environmental factors appears to be responsible.
• Clinically isolated Syndrome ( CIS) –
It is a pre-MS condition involving one episode of symptoms lasting atleast 24-hours. These symptoms are due to demyelination in your CNS.
• Relapsing remitting MS(RRMS) –
It involves clear relapses of disease activity followed by remissions. During remission periods, symptoms are mild or absent, and there’s no disease progression. RRMS account for about 85% of all cases.
• Primary progressive MS (PPMS) –
In PPMS neurological function becomes progressively worse from the onset of your symptoms. However, short periods of stability can occur.
• Secondary progressive MS (SPMS) –
SPMS occurs when RRMS transitions into the progressive form. You may still have noticeable relapses in addition to disability or gradual worsening of function.
Your MS may change and evolve, for example, going from RRMS to SPMS. You can only have one type of MS at a time, but knowing when you transition to a progressive form of MS may be difficult to predict.
Risk factors –
• Age – Most people receive a diagnosis between the ages of 20 and 40 years.
• Sex – Most forms of MS are twice as likely to affect women then men.
• Genetic factors – Susceptibility may pass down in the genes, but scientists believe an environmental trigger is also necessary for MS to develop, even in people with specific genetic features.
• Smoking – Smokers tend to have more lesions and brain shrinkage and non-smokers.
• Infections – Exposure to viruses, such as Epstein-Bau Virus (EBV), human herpes virus type 6 (HHV6) and mycoplasma pneumonia.
• Vitamin D deficiency – MS is more common among people who have less expose to bright sunlight.
• Vitamin B12 deficiency – The body uses vitamin Bwhen it produces myelin. A lack of this vitamin may increase the risk of neurological diseases, such as MS.
No single test can confirm a diagnosis, so a doctor will use several strategies when deciding whether a person meets the criteria for a diagnosis.
These include –
• MRI scans of the brain and spinal cord, which may reveal lesions.
• Spinal fluid analysis, which may identify antbodies that suggest a previous infection.
• an evoked potential test, which measures electrical activity in response to stimuli.
There is no cure for multiple sclerosis(MS). Treatment typically focuses m speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary.
Treatment for MS attacks –
• Corticosteroids –
Medicines such as oral prednisone and intravenous methylprednisolone are prescribed to reduce nerve inflammation.
• Plasma exchange –
Plasma exchange may be used if your symptoms are new, severe and haven’t responded to steroids.
Treatment for slow progression –
Several disease- modifying therapies (DMTs) are available for the relapsing forms of multiple sclerosis(MS). There work by changing the way the immune system functions.
The following DMTs currently have approval –
• Injectable medications –
▪︎interferon beta 1-a (Avonex and Rebif)
▪︎ interferon beta- 1b (Betaseron and Extavia)
▪︎ glatiramer acetate (Copaxone and Glatopa)
▪︎ peginterferon beta-1a (Plegridy)
• Oral medications –
▪︎dimethyl fumarate (Tecfidera)
▪︎ marenclad (Cladribine)
▪︎ mayzent (Siponimod)
• Infused medications –
▪︎ ocrelizumab (Ocrevus)
▪︎ natalizumab (Tysabri)
Ayurvedic Perspective –
Multiple sclerosis (MS) is a disease where conduction of nerve impulses is affected which means that it is a disorder due to aggravation of Vata dosha.This aggravation can be due to a number of reasons, the main reason being agnimandhya And formation of ama. Ama obstructs the pathways of circulation and brings derangement in the balance of body humors. Here, obstruction to the flow and aggravation of Vata occurs. Thus it can be considered as an Aavaranaja Vata Vyadhi. It can be correlated with Snayusada.
• Shirobasti –
• Shirodhara –
• Vasti –
• Pizhichil –
Beneficial Yogasanas –
• Uttanasana –
• Matsyendrasana –
• Ashwagandha –
• Guduchi –
• Chamomile tea –
• Dandelion root tea –
• Mahavatavidhvansan Ras
• Vrihatvatachintamani Ras
• Rasraj Ras
• Tryodashang Gugglu
• Chandraprabha Vati
• Shilajeet Rasayan
• Ekangveer Ras
• Godanti Bhasm
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