Multiple Sclerosis

MS is characterised by ‘disseminated demyelination’ which is when the insulating matter that surrounds our nerves (myelin) is destroyed and the electrical messages which travel through the nerves are interrupted. It usually presents in adolescence or young adulthood with relapses and remissions continuing throughout the patient’s lifetime. It is unlikely to occur before puberty or after the age of sixty. Once MS occurs, the body itself attacks the nerve insulating matter, exacerbating the condition. In Australia alone there are over 15,000 people currently suffering from MS and it is the most common cause of neurological disability. Worldwide there are approximately 2-5 million MS victims, according to World Health Organisation statistics. The initial lesion on the nerve is a plaque, with a small surrounding area of demyelination. As the body attacks its own nerves, this lesion becomes a sunken, inflamed scar. There are four different types of MS: Benign multiple sclerosis – least severe form Relapsing remitting multiple sclerosis – periods of wellness interrupted by periods of illness Secondary chronic progressive – long term disease, gets worse over time Primary progressive – steady decline over time Early symptoms of MS: pain on eye movement and rapid deterioration in vision numbness and tingling in limbs leg weakness double vision clumsiness/uncoordination facial pain/paralysis/weakness speech difficulty bladder and bowel dysfunction paralysis of lower limbs fatigue tremors depression symptoms are generally worsened with heat and exercise Diagnosis is made through Magnetic Resonance Imaging (MRI scan), physical examination and blood tests. Treatment usually involves corticosteroids durin exacerbations and various drugs to treat muscle spasticity and uncoordination. Supportive measures such as podiatry and physiotherapy may be necessary. Prognosis is different for every patient – sufferers may remain very active or progress to a chairbound/bedbound state depending on severity of disease. Approximately 5% die within 5 years of onset but many remain well and retain their mobilty for 20 years or more.