‘Multiple Sclerosis’ Diagnosis and Treatment

World Multiple Sclerosis Day is celebrated every year on May 30. The day helps raise awareness about MS, connect and unite patients with the disease.

Regarding the MS disease, the global theme from 2020 to 2023 has been declared to be “relationship” with respect to patient care and treatment. In the light of the central idea of ​​these three years, the theme of “Relationships” has been declared, keeping in mind innovation and quality in disease awareness, diagnosis, treatment.

This central idea challenges the barriers to social connections that occur in patients with the disease, which can lead to social isolation in multiple sclerosis patients. This theme of connections provides people with MS with a network, the factors that foster self-care and the motivation to live a committed life.

The central idea of ​​”connections” is to enable MS patients to achieve the following goals:

A: Encouragement to challenge social barriers and misconceptions about the disease and overcome social isolation

B: Community composition of MS patients

A: Effective care and promotion of healthy living with this disease

D: To simplify and standardize the supply of medicines and health facilities for MS patients

Multiple Sclerosis is a chronic disease that affects the central nervous system (brain). It is a disabling disease of the central nervous system. It is an inflammatory disease that usually affects people between the ages of 20 and 40.

The central nervous system includes the brain, spinal cord, nervous system, and spinal cord. Almost all aspects of a patient are affected due to this disease, due to which young people become disabled in their prime.

One person is diagnosed with this disease every five minutes worldwide. According to the available data, around 3 million people around the world have been affected by this disease. Multiple Sclerosis is more common in women.

Most of the patients suffering from this disease belong to the cold regions which include Europe, North America and especially Scandinavian countries. In the list of South Asian countries, Pakistan is also included in the list of countries where there is a large number of people suffering from this disease.

According to a conservative estimate of the number of people suffering from ‘Multiple Sclerosis’ in Pakistan, the number of diagnosed patients of this disease in the country is around 50 to 60 thousand. Alarmingly, nearly a quarter of patients develop severe physical disability within five years.

Multiple Sclerosis affects the brain and causes damage to the rest of the body. When the disease occurs, the nervous system is severely affected due to the disorder/inflammation/swelling of the sheath around the brain cell called “Sheath” Myelin, due to which various symptoms may occur in the affected person.

Symptoms of ‘Multiple Sclerosis’

The early symptoms of multiple sclerosis are not necessarily the same in every patient, sometimes the symptoms are temporary and vague. Due to which the diagnosis of this disease can be a difficult process for a general physician. Therefore, it is important to consult a neurologist.

Symptoms of ‘Multiple Sclerosis’ include weakness, tingling sensation/hearing, loss of body balance, temporary loss of vision, complete or partial double vision, tremors, muscle stiffness, slurred speech. Includes hangovers and memory disturbances.

Sometimes the patient also complains of muscle twitching/twisting, or face/body numbness problems. Urinary obstruction/bladder weakness is important among the few proven symptoms of ‘multiple sclerosis’. Likewise, digestive disorders, especially constipation, are also important symptoms. These symptoms are more common in male patients.

Diagnosis of ‘Multiple Sclerosis’

A complete medical examination by a neurologist is essential for the diagnosis of multiple sclerosis.

Along with the necessary diagnostic tests based on clinical examination, especially MRI. Through this, brain/spinal images help a lot in diagnosing the disease.

Also, if vision is affected, an eye test called VEP is also done. A neurologist must thoroughly examine the eye, body muscles, and sensory system before starting treatment. Along with this, the following issues must also be taken into consideration for diagnosis and treatment:

1. Fatigue: Most patients may experience severe fatigue during the course of the disease.

2. Bladder discomfort: Frequent urination/needling/incomplete emptying of the bladder or taking too long to empty.

3. Impaired ability to think/understand, also known as cognitive issues.

Types of ‘Multiple Sclerosis’

There are three types of ‘Multiple Sclerosis’.

1. PPMS Primary Progressive Multiple Sclerosis (PPMS)

2. RRMS (RRMS) Relapsing-remitting Multiple Sclerosis

3. SPMS (SPMS) Secondary Progressive Multiple Sclerosis

In the first type, the chances of disability are very high. The second type is the most common type of disease. About 85 percent of patients suffer from it initially. The third type has the same initial symptoms as “RRMS” but the patient progresses slowly towards disability.

The most serious stage of multiple sclerosis is the one in which the patient suffers from various major psychological problems. During the continuous progression of the disease, most of the nerve cells are destroyed and physical disability becomes a complex situation.

It is classified to assess this physical disability. The most commonly used system for this is called EDSS i.e. Expanded Disability Status Scale. This system classifies physical disabilities and this classification is done on the basis of medical examination.

Treatment of ‘Multiple Sclerosis’

You can also call this disease a stubborn disease in the context of treatment. The most important part of treating this disease is to treat the patient according to the disease. Symptoms are generally different for each patient with multiple sclerosis. If not treated properly, the disease can progress and even cause total disability.

The disease cannot be completely eradicated, but as a result of recent research, some drugs have been discovered that can slow down the disease process as well as reduce it to a good extent.

For patients with multiple sclerosis, it is very important that, after a correct diagnosis, disease modifying therapy should be used in addition to conventional treatment to prevent progression of the disease process. . This can be very helpful in improving the patient’s quality of life.

Important Tips for Multiple Sclerosis Patient

Since Multiple Sclerosis is a lifelong disease, an atmosphere of friendship and trust must be maintained between the patient and the doctor. The patient should be aware of worsening symptoms, especially symptoms that persist for more than 24 hours and are increasing in severity.

Inform your doctor about it. The patient should avoid sun and harsh weather. The treatment of ‘Multiple Sclerosis’ is not only expensive but also long-term and it is not possible for a common man to bear the cost, in this context the government should provide free medicines to the patients of ‘Multiple Sclerosis’. Be sure.

It is very important for multiple sclerosis patients to take proper care of their physical, emotional, social and spiritual aspects so that they can have a positive outlook towards living a healthy life. Rehabilitation plays an integral role in the treatment of multiple sclerosis.

Neurorehabilitative goals for the patient include encouraging independence and improving quality of life. While drugs play an important role in the treatment of this disease, neurorehabilitative measures such as physiotherapy, speech and swallowing therapy, occupational therapy and psychological counseling play an extremely important role.

(Professor Dr. Abdul Malik is serving as a professor and neurologist at Liaquat College of Medicine and Dentistry, Karachi and is a senior member of Pakistan Islamic Medical Association (PIMA).)