Multiple sclerosis is a common autoimmune neurological disorder. It affects the central nervous system. It usually affects women more than men. Commonly begins between ages 20 and 40, but can be seen at any age. Genetic influence is suggested by a 10 fold increase in risk in first degree relatives. It is a progressive disease, the nerve damage gets worse with time. Pathologically it results from the damage to the myelin sheath (a protective material), which surrounds nerve cells. The process is due to the entry of activated (against host cell) T lymphocytes through blood-brain barrier. When these immune cells attack the nervous system inflammation occurs. Inflammation destroys the myelin, leaving multiple areas of scar tissue (sclerosis). It causes nerve impulses to slow down or become blocked, leading to the symptoms of multiple sclerosis. Certain factors have been linked with causation like altitude, environment and genetic as stated. As a result it is more common in temperate zones and less in tropical zone.
This condition is due to autoimmunity, in which the immune system attacks the host cells.
There are several forms of the disease. Weakness, numbness, tingling or unsteadiness in a limb is noted initially. It is followed by a decrease in suffering when coordination, judgment, memory and ability to control small movements develop gradually. Other symptoms are wide form of cognitive impairment to sensory dysfunction like depression, difficulty in speaking or understanding, dizziness, double vision, eye discomfort, facial pain, fatigue, loss of balance, muscle atrophy, uncontrollable spasm of muscle groups, numbness or abnormal sensation in any area, pain in the arms or legs, paralysis in one or more arms or legs, frequent urination, vertigo, vision loss and gait abnormalities, etc. Sometimes other general symptoms like constipation and loss of hearing are observed. Symptoms may vary with each attack.
Examination and investigation
Symptoms are similar to other neurological problems like decreased or abnormal sensation, decreased ability to move a part of the body, speech or vision changes or loss of neurological functions due to decrease in nerve function. Babinski's reflex (occurs when the lateral side of the sole of the foot is rubbed with a blunt implement so as not to cause pain or injury; positive response: great toe flexes toward the top of the foot and the other toes fan out) is usually positive. Eye examination would reveal abnormal pupil responses, changes in the visual fields or eye movements, rapid eye movements triggered by movement of the eye, decreased visual acuity or problems with the internal structures of the eye. MRI scan of head and spine, lumbar puncture test and cerebrospinal fluid tests help confirmation.
The focus is to control symptoms and maintain a normal quality of life. Physical, speech and occupational therapies can help improve the person's outlook, reduce depression, maximize function, and improve coping skills.
Prognosis varies from individual to individual. Many well-managed cases continue to walk and function with minimal disability for 20 or more years. Complications are progressive disability, urinary tract infections. Side effects of drugs and steroids if used need to be addressed as complications.
CAM therapy for multiple sclerosis
The therapy is to be planned according to the individuals affections. Acupuncture may help enhance immune function, normalize digestion, and address disease conditions. There are studies and results have been reported by using this therapy which show that when used in conjunction with other modalities, acupuncture can provide effective relief for many MS symptoms. A survey conducted at the University of British Columbia, 566 patients with definite MS reported using alternative therapies, with acupuncture being the most common method used. The rest of the questionnaire focused on the reported effects of acupuncture, with respondents citing reduced pain, decreased spasticity, improved bladder and bowel dysfunction, and alleviating tingling and numbness, among others.
Ayurveda and herbal remedies
In-coordination of limbs, loss of control, loss of balance, trembling with the peculiar symptom of the remedy intolerance of heat.
Illusions of sight, objects appear too large; hypochondria, words run together while reading, symptoms along with great dryness of mouth.
Depression with great desire to commit suicide; decreased capacity of memory; slow activities; over sensitiveness to noise; confusion; photophobia; vision impairment – upper part of the objects invisible;
Depression with weeping; unclear understanding and vague memory; talkative; delusions; visionary illusion of blue colour; trembling and right sided paralysis.
Increased reflexes; want of nerve power; depression and feeling of sleepiness always; loss of sensation starts from the fingertips; improper gait as if paroxysm attacks.
Sensitive to noise, light, odours, touch, electrical changes and thunder storms; nerve weakness; fearfulness with an hallucination as if something were creeping out of every corner; impaired memory; sensory and motor paralysis ascending from the tips of finger and toes.
Loss of sensation to pain with muscular weakness; rigidity of muscles; tremors; all these symptoms followed by complete paralysis; contraction of pupils and twitching and spasm of ocular muscles; tingling sensation in the spine; jerky movement of limbs on going to sleep.
Weakness, numbness and tingling starts especially from extensor group of muscles of upper limb; spasm of muscle; depression with fear of being killed; impaired memory and slow in understanding and learning.
Muscle spasm and stiffness of face and neck; dull mental activities; acts predominantly on spinal cord; acute episode attacks comes suddenly and goes off; extreme mental irritability.
Mental irritability and depression; functional disturbance of nervous system, not too much of destruction; trembling of hands; burning in soles; complaints worse at night.
Chorea and spinal irritability; mood disorder with impulse to destruct; trembling, twitching, jerking and numbness of legs.