Multiple sclerosis is estimated to affect approximately 2.5million people across the globe and is a common form of autoimmune disease.
This blog post provides a general overview of multiple sclerosis, together with information about the common symptoms, causes and treatment of this potentially debilitating condition.
What is multiple sclerosis?
Multiple sclerosis is a chronic disease that affects the body’s central nervous system. It is characterised by inflammation of the protecting coating around the nerve fibres that join the nerve cells in an individual’s brain and spinal cord.
The inflammation causes a destruction of the protective coating (the myelin sheath) and leaves behind scar tissue. The affected nerve cells are unable to communicate with each other (and thereby cannot transmit or receive impulses) and this leads to a range of physical and mental conditions.
Multiple sclerosis can take a variety of different forms. In some cases, the symptoms can occur in isolated attacks (relapsing form) and, in others, through attacks building up over time (progressive form).
In between attacks, an individual might notice that the symptoms disappear. However, in some cases, an individual’s mental problems can remain as the condition gets progressively worse.
What are the common symptoms of multiple sclerosis?
Symptoms may come and go and there can be relapses and remissions lasting from days and even months. However, whilst the signs of multiple sclerosis are many and varied, some of the most common symptoms that sufferers can face include the following:
- trouble with co-ordination, balance, walking and speaking;
- tremors of any of the extremities;
- numbness and tingling feeling in arms, hands, legs and feet; and
- facial pain.
It is common for those suffering from multiple sclerosis to also experience a wide range of emotional and mental symptoms such as depression, anxiety and the ability to think coherently.
What are the causes of multiple sclerosis?
Whilst the exact causes of multiple sclerosis remain unknown, it is generally thought that a combination of factors play a role in causing the condition which lead to the white blood cells attacking the nerve fibres protective coating.
Whilst the general view is that multiple sclerosis cannot be inherited, it is also widely believed that genetics can play a role, since it is slightly more prevalent in certain family groups. Many believe that smoking and stress can increase the risk of developing multiple sclerosis and scientists usually take the view that microbes, such as those that cause a viral infection, can be responsible for triggering the condition.
How should multiple sclerosis be treated and managed?
Whilst there is currently no cure for multiple sclerosis, there are a range of treatments that can help to improve an individual’s mental and physical functions following an attack. In some cases, certain treatments can even help prevent further attacks. The main aim of any therapy is to allow the sufferer to maintain the full use of their body, to the extent possible following an attack, and to prevent such individual becoming permanently disabled.
What are the different types of treatment for multiple sclerosis?
Disease-modifying therapies can help reduce the number of relapses an individual suffers and the seriousness of them, together with helping to slow down any damage caused by any relapses which build up over time. A number of the different disease modifying therapies currently available include the following:
Alemtuzumab (also known by its brand name Lemtrada) is often used as the first form of disease modifying treatment. An individual will be eligible for this form of treatment if they have suffered from a relapsing form of multiple sclerosis and they’ve had a relapse within the last year.
The treatment is delivered via a drip in hospital in two courses and usually a year apart. The first course of treatment, usually involves an individual attending hospital for a five-day period. The drip will be administered for about four hours each day. The second course of treatment, given a year later, will involve the sufferer attending hospital for around three days for the same treatment. In some cases, sufferers may need one or two additional courses of the same treatment.
Avonex (interferon beta-1b)
Avonex is the brand name for a beta interferon drug. It is usually injected into the muscles once a week. An individual will be eligible for this form of treatment if they’ve had relapsing multiple sclerosis and experienced a recent relapse; and if they’ve suffered a secondary progressive form of the condition and continue to experience relapses.
Betaferon (interferon beta-1b)
Betaferon is another form of beta interferon drug and is injected under an individual’s skin every other day. As with Avonex, an individual will be suitable for this form of treatment if they’ve had relapsing multiple sclerosis and experienced a recent relapse; and if they’ve suffered a secondary progressive form of the condition and continue to experience relapses.
Dimethyl fumarate (Tecfidera)
Dimethyl fumarate (also known by its brand name of Tecfidera) is a tablet that is taken twice a day. This treatment is usually prescribed where an individual has suffered a relapsing form of multiple sclerosis, if they’ve had a recent relapse or if there are signs that their condition remains active.
Extavia (beta interferon-1b)
Extavia is usually injected under the skin every other day. It is usually prescribed where an individual has had a recent relapse, if they have secondary progressive multiple sclerosis and if their recent MRI scans show signs that their condition remains active.
Fingolimod (generally known by its brand name Gilenya) is taken for relapsing multiple sclerosis. Where an individual lives in the UK will usually determine whether or not they are offered this form of treatment. It is delivered in the form of a tablet that should be taken once a day.
Glatiramer acetate (Copaxone)
Glatiramer is injected under the skin once a day or three times a week. It’s usually prescribed for an individual with relapsing multiple sclerosis.
Natalizumab is usually administered through a drip in hospital. Individuals are eligible for this form of treatment if they have relapsing multiple sclerosis and they’ve had a relapse in the past year. It may also be prescribed for relapsing multiple sclerosis and the sufferer has had at least two relapses in the last year and MRI scans show signs that an individual’s multiple sclerosis remains active.
Plegridy (peginterferon beta 1a)
Plegridy may be prescribed for relapsing multiple sclerosis and where an individual has suffered a recent relapse or they have secondary progressive multiple sclerosis and experienced significant relapses. It is injected under the skin every two weeks.
Rebif (beta interferon-1a)
Injected under the skin three times a week, Rebif is offered in circumstances where an individual has a relapsing form of the condition and they’ve experienced a recent relapse. It can also be offered if an individual has a secondary progressive form of the condition and they still suffer significant relapses.
Teriflunomide is a tablet that is taken once a day. Eligibility is determined where a sufferer has relapsing multiple sclerosis and they’ve had a recent relapse or if MRI scans show signs that their condition is active.
Following a healthy diet allows an individual to receive the right levels of vitamins and minerals which can help to manage the symptoms of multiple sclerosis. Being overweight or underweight can also have an impact on the severity of a person’s symptoms and, therefore, maintaining a healthy diet can be very beneficial when it comes to managing the condition.
Physiotherapy and regular exercise
Physiotherapy and regular exercise will help target problems with mobility, balance, posture and tiredness that many individuals suffer with multiple sclerosis. Both physiotherapy and regular exercise can be extremely beneficial (irrespective of an individual’s level of disability) and if an individual is recovering from a relapse or where their symptoms are getting worse.