Multiple Sclerosis

Multiple sclerosis (MS) is a common, chronic, degenerative neurological disease, marked by nerve disturbance and of unknown cause.  It is characterised by multiple areas of inflammation and demyelination within the Central Nervous system; in the brain and spinal chord. Demyelination means that the myelin sheath that surrounds the nerve cells are destroyed. This is likened to stripping plastic insulation from a strip of copper wire and exposing the core. A key function of the myelin is to facilitate transmission of nerve impulse. Hence, demyelination causes nerves impulses to be slowed or halted. Common age of onset of MS is 20-45 years old. Frequency of MS is reported to be increasing.

Although there is no specific known cause, possible contributing factors include genetic predisposition (first degree relatives), or being an identical twin. Interestingly, geography also appears influence risk, with the prevalence of MS being directly related to the distance from the equator – the further away from the equator, the higher the incidence. Possible reasons for this are said to be due to solar exposure and other environmental factors.

Abnormal immune responses and increase serum and CFS antibodies to common viruses, especially measles, have been found in MS patients. However there is no definite link between MS and any one infective agent.

Major symptoms/features of the disease are as follows:

• Optic neuritis - eyeball pain, aggravated by movement of the eye. Loss of vision over a period of days. Double vision.
• Weakness in one or both hands or legs – of sudden and rapid onset or slowly progressive.
• Sensory changes – loss of feeling or numbness in one or both feet is common; spreading to the waist, with loss of sensation in the urethra, rectum and vagina. Poor dream recall due to poor brain levels of serotonin.
• Lifestyle difficulties – changes in bowel, bladder and sexual function.
• Physical trauma – resulting from accidents caused by poor co-ordination, and abnormal gait and vision.
• Also – spasm of limbs, difficulty in speaking, neuralgia, clumsiness, loss of balance and vertigo. Fatigue.
• Uncommon presentations of MS include epilepsy, and dementia.

The course of the disease can either be relapsing or remitting in most patients, while in some it is progressive from onset. Depression and memory defects are common. In its most severe form MS may cause increasing disabilities until the patient is bedridden.

Beyond exercise, occupational therapy, physiotherapy and counselling, nutrition plays a major part in treatment and symptom management. Ongoing Professional diagnosis and advice is of paramount importance.