MULTIPLE SCLEROSIS is an autoimmune disease of the central nervous system (CNS) characterized by chronic inflammation, demyelination, gliosis, and neuronal loss. The course may be relapsing-remitting or progressive in nature. Lesions in the CNS occur at different times and in different CNS locations. Because of this, multiple sclerosis lesions are sometimes said to be "disseminated in time and space." The clinical course of the disease is quite variable ranging from stable chronic disease to a rapidly evolving and debilitating illness. The most common form of the disease is relapsing-remitting multiple sclerosis; however, several other forms exist


The specific cause of multiple sclerosis is unknown. The most widely accepted theory is that multiple sclerosis is an autoimmune disease that preferentially destroys the CNS while the peripheral nervous system is spared. Demyelination causes symptoms of multiple sclerosis. Damage to myelin leads to symptomatic flares in multiple sclerosis. These damaged areas often do not fully recover leading to areas of scarring, damage, and ongoing symptoms. Over time, these cumulative areas of damage can lead to disability. Of note, patients can also develop subclinical areas of damage that are detectable early in the disease course only by radiographic studies

Sign & symptoms

Affected system. Multiple Sclerosis will present with symptoms that vary depending on the location of the affected nerve. Symptoms usually appear suddenly and quickly within minutes or hours, but in rarer cases the symptoms may be dangerous and take weeks to months to develop.

1. Early symptoms

  • Numbness and weakness in one or several limbs progressing from paresthesis
  • Visual disturbances such as double vision, atrophy of one optic nerve
  • Impaired ocular movement
  • Fatigue is typically the early symptoms that will present with MS
  • Pain : Headache, chronic neuropathic pain, paroxysmal limb pain
  • Cognitive symptoms : Short-term memory deficits, diminished executive function, diminished attention/concentration
  • Affective Symptoms : Depression, anxiety.
  • Motor symptoms : spasticity, spasms, ataxia, impaired balance and gait
  • Speech and swallowing : dysarthria, dysphonia, dysphagia
  • Bladder/Bowel symptoms : spastic or flaccid bladder, constipation, diarrhoea and incontinence
  • Sexual Symptoms : impotence, decreased libido, decreased the ability to achieve orgasm

Factors all appear to have a role in MULTIPLE SCLEROSIS development

  • Immunologic factor - The body’s immune cells attack the CNS and ultimately destroy nerve conduction. The T cells (the white blood type in the immune system) somehow become sensitized to proteins in the CNS. When T cells are activated, the CNS enters through blood vessels and produce damaging inflammation
  • Environmental factor - MS is more prevalent in areas farther from the equator in colder climates. Vitamin D plays an important role where people living in climates that are more exposed to the sun, their bodies naturally produce more vitamin D. The vitamin D improve immune function and protect the body from autoimmune diseases
  • Genetic factor - The risk of MS increases in a person who has a first-degree family member with the disease, however, MS is not considered to be hereditary.

  • Infectious factor - There is a possibility that viruses and other infectious agents may trigger the onset of MS. The argument of virus cause is supported by the presence of oligoclonal bands in the brain and cerebrospinal fluid, which persists throughout the lifetime. The presence of oligoclonal bands is found exclusively in infectious CNS disorders
  • Gut microbiome factor - The gastrointestinal microbiota may play an important role in the pathogenesis of MS. According to the “hygiene hypothesis”, reduced exposure to infections in childhood can increase the risk of allergic and autoimmune diseases. Intestinal bacteria can also affect the integrity of the blood-brain barrier. However it is difficult to say with certainty whether changes in the intestinal microbiota are the cause or consequence of MS because MS patients have immunological and microbial changes several months to years before the onset of clinical disease.


These factors may increase your risk of developing multiple sclerosis

  • Age - Multiple Sclerosis can occur at any age, but onset usually occurs around 20 and 40 years of age. However, younger and older people can be affected.
  • Sex - Women are more than two to three times as likely as men are to have relapsing-remitting Multiple Sclerosis
  • Family history - If one of your parents or siblings has had MS, you are at higher risk of developing the disease.
  • Vitamin D - Having low levels of vitamin D and low exposure to sunlight is associated with a greater risk of Multiple Sclerosis.
  • Smoking - Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

  • Certain infections - A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis
  • Race - White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.
  • Climate - Multiple Sclerosis is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.
  • Certain autoimmune diseases - You have a slightly higher risk of developing MS if you have other autoimmune disorders such as thyroid disease, pernicious anemia, psoriasis, type 1 diabetes or inflammatory bowel disease.

multiple sclerosis treatments

  • Strength and aerobic training - The resistance training program is recommended for maintaining bone and muscle mass. This training is carried out regularly and with sufficient intensity, have evidence of improvement in patients with MS. Exercise improves impairments of aerobic capacity, lower extremity muscle strength, fatigue, and depression; reduced activity limitations such as walking performance and balance; and confirms that it positively impacts quality of life.

  • Aquatic exercise programs - have a positive effect on persons with progressive multiple sclerosis. It promotes general health, improves energy levels and mental health, and aids social interaction in the presence of physical disability.
  • Specific balance exercises - can improve balance. Poor postural control increases the risk of falls. MS patients have increased sway in quiet stance, delayed postural perturbations and reduced ability to move towards limits of stability.


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