World Multiple Sclerosis Day

World Multiple Sclerosis Day is observed on the 30th of May to advocate the suffering of individuals battling multiple sclerosis. World Multiple Sclerosis Day was first started in 2009 as an initiative of the Multiple Sclerosis International Federation to promote awareness of multiple sclerosis to the public.
 

The theme of World Multiple Sclerosis Day 2023 is "I Connect, We Connect." This theme -aims to raise solidarity by supporting the patients and creating connections with each other, as multiple sclerosis takes a toll on the affected individual's self-esteem and mental health.

What Is Multiple Sclerosis?

Multiple sclerosis is a chronic autoimmune disease in which the body's immune cells target and attack the myelin sheath (modified plasma membrane), a protective layer of nerve fibers around the brain and spinal cord that leaves a permanent scar. It is called multiple sclerosis since it leaves a scar over multiple areas, such as the brain stem, spinal cord, and optic nerves. This scarring of nerve cells leads to inflammation which causes alteration in generating brain signals to different body parts and functions.

Causes Of Multiple Sclerosis 

• Vitamin D and Vitamin B 12 Deficiency: Vitamin D is crucial for the functioning of the immune system; a decline in the counts of vitamin D causes dysfunctions in the immune system leading to autoimmune diseases. Vitamin B 12 plays an essential role in myelin sheath production; when the levels are low, the myelin sheath synthesis gets reduced and eventually degenerates.
• Virus: It has been reported that the Epstein-Barr virus can increase the risk of multiple sclerosis.
• Function of the immune system: The immune system plays a crucial role in protecting the body from harmful substances and pathogens. However, in the case of multiple sclerosis, an autoimmune disorder, the immune system malfunctions and mistakenly attacks healthy cells. Scientists are actively researching the factors that contribute to this erroneous targeting and damage caused by immune cells.
• Lifestyle factors: Smoking and obesity are two significant factors that trigger inflammation and lead to a hyperactive immune system that can progress into an autoimmune disease.

Types Of Multiple Sclerosis

• Relapsing-remitting multiple sclerosis: If a recurrent episode succeeds the initial attack, the patient is likely to have relapsing-remitting multiple sclerosis. Almost 85% of patients are primarily diagnosed with multiple sclerosis. Patients are presented with the first set of symptoms only in their 20s, followed by that they may experience recurrent attacks of multiple sclerosis, which is called a relapsing phase. Since the recovery from the attacks requires weeks to months, it is called the remitting phase.
• Primary progressive multiple sclerosis: This type of multiple sclerosis occurs in people aged above 40 years. Primary progressive multiple sclerosis is tough to treat, and the patients show poor response to the treatment as the symptoms are worse due to frequent episodes of relapse and no remitting phase.
• Secondary progressive multiple sclerosis: Since multiple sclerosis is a degenerative and progressive disease, people diagnosed with relapsing and remitting multiple sclerosis can develop secondary multiple sclerosis gradually after 10-20 years. This type is developed as a result of the extended remitting phase.

Symptoms Of Multiple Sclerosis:  

• Lack of coordination
• Difficulty walking
• Numbness or tingling sensation
• Urinary incontinence
• Visual difficulty
• Difficulty concentrating
• Tremors
• Muscle contraction
• Weakness in muscles
• Bowel and bladder problems
• Sexual dysfunction

Diagnostic Test

Since the symptoms are similar to other neurological conditions, it is often difficult to diagnose multiple sclerosis. Yet there are few diagnostic tests to confirm the condition, including, 

• Neurological examination: Your neurologist may perform a physical examination test to find the nerves' reflexes, muscle strength, and it's functioning.
• Blood Test: It is performed to check for specific biomarkers associated with multiple sclerosis conditions.  
• Spinal fluid tap: It is also called a lumbar puncture, a procedure to extract the spinal fluid will be done to analyze the constituents of the fluid and detect the presence of proteins responsible for causing inflammation.
• Imaging tests: A MRI Scan will be conducted to investigate the presence of lesions over multiple areas in the brain.
• Evoked potential test determines the individual's neural activity in response to the electrical activity.

Treatment Of Multiple Sclerosis

Although no permanent cure for multiple sclerosis exists, treatment options are available to slow down the disease progression and decrease the relapsing episodes. 

• Disease-Modifying therapies: These agents are administered as injections. The disease-modifying agents are prescribed to prevent the relapse of multiple sclerosis. Glatiramer and Natalizumab decrease the episodes of multiple sclerosis. Natalizumab will be used as a first-line treatment for treating severe multiple sclerosis. These medicines inhibit the circulatory immune cells that damage the nerve fibers.
• Muscle relaxants: Most multiple sclerosis patients find difficulty balancing due to the uncontrollable muscle contraction that makes the limbs stiffer. Certain muscle relaxants like Baclofen are prescribed to ease lower limb stiffness.
• Chemotherapy: Mitoxantrone is a drug that suppresses the overwhelmed immune system and reduces the inflammation that triggers multiple sclerosis.
• Interferons: Interferons Beta- 1a and 1b will be given to prevent the exacerbations of the symptoms and reduce the disease frequency. The goal of administering interferons is to prevent multiple sclerosis relapse, which is given via intravenous mode that acts by blocking the immune cells that damage the myelin sheath.
• Physiotherapy: Physical therapy can be used as a complementary therapy to alleviate muscle contraction.

Bottom line

"Believe you can, and you're halfway there."

Many people lack awareness of multiple sclerosis and fail to empathize with the affected individuals. Multiple sclerosis is a disabling disease that must be brought into the limelight, so on this World Multiple Sclerosis Day 2023, let's spread awareness in our social circle. Thus, let us build connections and keep the patients from feeling isolated.