Multiple sclerosis (MS) is a chronic autoimmune disease that affects the myelin sheath and conduction pathway of the CNS. MS is attributed to viral, genetic, immunologic, and environmental etiologic factors. Viruses are established as causes of demyelination and inflammation. Thus, it is likely possible that a virus or other infectious agent triggers MS. (Dobson & Giovannoni, 2019). The key clinical features of MS are muscle weakness and spasticity, fatigue, inability to direct or limit movement, intention tremors, paresthesia, decreased sensitivity to pain, and impaired motor coordination. Other signs and symptoms include slurred speech, double vision, dysphagia, nystagmus, changes in peripheral vision, tinnitus, decreased visual and hearing acuity, and vertigo (Dobson & Giovannoni, 2019). In addition, individuals with MS have bowel and bladder dysfunction, alterations in sexual function, and cognitive changes.
No single specific diagnostic test is definitive for MS, and it is diagnosed based on clinical findings. Tests often ordered include an MRI of the brain and spinal cord and a cerebrospinal fluid examination. Treatment of MS entails immunomodulatory therapy (IMT) to treat the underlying immune disorder and medications to relieve or modify symptoms (Hauser & Cree, 2020). Acute MS relapses are managed with Methylpredni
solone, Dexamethasone, or Plasma exchange. Interferon-beta is an immunomodulator used to modify the course of the disease and has antiviral effects.
MS is associated with complications like bladder and bowel dysfunction, cognitive impairment, vision changes, sensory impairment, and venous thromboembolism. If left untreated, more than 30% of MS usually develop significant physical disability within 20–25 years after disease onset (Hauser & Cree, 2020). However, some of the disease-modifying agents used in MS delay the progression of disability.
References
Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis – a review. European journal of neurology, 26(1), 27–40. https://doi.org/10.1111/ene.13819
Hauser, S. L., & Cree, B. A. C. (2020). Treatment of Multiple Sclerosis: A Review. The American journal of medicine, 133(12), 1380–1390.e2. https://doi.org/10.1016/j.amjmed.2020.05.049
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