Multiple Sclerosis
- Praveer Balaka
- Jan 17, 2022
- 3 min read
Updated: Apr 10, 2022
Praveer Balaka
MedArc Research
You wake up, and feel tingling, electrifying sensations coursing through your body. You feel like you have super speed, but come to the horrifying realization that your leg went numb, and you cannot move it. Fatigued, you get out of bed and have trouble coordinating your steps. Your eyes begin to hurt when you move them, and your vision becomes blurred. Doesn't sound very pleasant, right? Unfortunately, this remains the sad reality of millions of people around the world with Multiple Sclerosis, or MS. Although MS can be primary-progressive, meaning symptoms progress over time, in most cases, MS is relapsing-remitting. This means that symptoms improve over time, but redevelop over the course of a few weeks. Following this disease pattern, it is likely that people (50%) develop secondary-progressive MS, in which they stop having periods of relapse, and their symptoms gradually pile up without an improvement period. Regardless of the disease course, MS is a neurological disease that is difficult to battle, with a variety symptoms, and no specific diagnostic test.
To understand the causes of these symptoms, we should learn the regular function of a brain that does not have MS. In the central nervous system, composed of the brain and spinal cord, neurons communicate between each other to carry out autonomic and somatic functions. The means of communication is an action potential, in which opening of ion channels causes the membrane potential of a neuron to increase in charge, causing it to fire. This impulse travels down the axon of a neuron, ultimately releasing neurotransmitters at the synaptic cleft, enabling neural communication. In the central nervous system, cells called oligodendrocytes produce a myelin sheath around the axon. This makes it easier and more efficient for the impulse to travel down the axon, as they jump to Nodes of Ranvier (unmyelinated portions) between the myelin sheath on the axon. Conversely, the lack of myelin makes neuronal communication have many problems, resulting in a variety of problems and symptoms in the body.
Although the cause of multiple sclerosis is unknown and still being investigated, it is believed to be an autoimmune disease, in which the immune system releases T cells, which activate B cells, to attack its own myelin sheaths. Neural communication enables all functions of our body, which is why the destruction of myelin, which would inhibit this communication, produces such a wide variety of symptoms. Some of these symptoms include problems in vision, coordination, movement, speech, and an assortment of other bodily functions. MS is not a genetically inherited disease, but research shows that there is a genetic risk factor that is susceptible to inheritance. Some environmental factors that may be linked with MS include low levels of vitamin D, regular smoking, and obesity.
As mentioned earlier, there is no test that can diagnose multiple sclerosis. Rather, doctors carry out differential diagnosis, in which they rule out other possibilities for your symptoms to accurately conclude that MS is the probable cause. Assessing genetic risk and taking blood tests are some ways that doctors can do this, and MRI scans can also indicate areas of MS in your brain. Although there is no cure for MS, there are a number of treatments to help slow the progression of MS, which may not even be necessary depending on the severity of the symptoms. In terms of MS attacks, corticosteroids help reduce nerve inflammation, and plasma exchange can reduce the severity of symptoms. Treatments to slow progression work more effectively earlier on the onset of the disease.The only FDA approved treatment for primary-progressive MS is ocrelizumab, and is only slightly effective. Relapsing-remitting MS has a multitude of treatments that are injectable, oral, and infusion, which makes it a little easier to slow the disease. Physical therapy can also help with coordination and movement, in order to make daily life easier.
Multiple Sclerosis is a relatively rare disease, but its impacts on people are undeniable and unnerving. Educating people about this sporadic disease will spread more awareness, spearheading efforts to combat MS. As for the future of MS, scientists and doctors are actively investigating the causes, in order to better understand the disease and work on more effective treatments.
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