MS & Demyelinating Diseases Clinic

• Training of patients on self administration
• MSFC Workshop (Multiple Sclerosis Functional Composite)
• EDSS Workshop (Expanded Disability Status Scale)
• MS disease and treatment analysis
• Recent update discussion among senior residents

Multiple Sclerosis or “MS” is a chronic disease where the covering of some nerves in the brain and spinal cord” (central nervous system), called myelin, becomes damaged.

• MS is a heterogenous disease, affecting every individual differently
• Affects people at a young, productive age, mostly female population
• ‘Multiple’ symptoms and problems
• Disease fraught with uncertainty (Physical, emotional, social, financial, psychological implications)
• No one size fits all, requires a personalised approach

The symptoms of MS vary greatly from person to person. There are no typical set of symptoms for MS. An individual’s symptoms depend upon which nerve fibres are affected. If the nerve fibres that carry sensory signals are affected, the individual will experience abnormal sensations and various other sensory symptoms. If the nerve fibres carrying signals to the muscles are affected, the person will have movement symptoms.

Doctors suspect MS in people who suddenly develop blurred or double vision, and/or abnormal sensations, such as tingling over their body, movement problems etc. Other symptoms include:

• Visual disturbances
• Problems with balance & co-ordination
• Extreme fatigue
• Mood changes
• Muscle stiffness or spasms
• Tingling and numbness
• Memory loss

Despite a great deal of research, we still do not know what triggers MS

• Genetic predisposition
• Infectious agents
• Environmental factors

MS presents differently in each person. It may mimic many other nervous system disorders. MS is typically diagnosed by observing symptoms over a period of time, combined with the results of medical tests.

• Review of person’s medical history and perform aneurological examination (to check the person’s nervous system) 
• Eye examination to determine whether the person’s optic nerve is inflamed or unusually pale
• Magnetic resonance imaging (MRI) a scan of the brain and spinal cord which in MS reveals areas of inflammation & scarring
• Evoked potentials measure the time it takes for the brain to receive and interpret messages from the body. If myelin damage has occurred, messages will take longer to get through
• Lumbar puncture or spinal tap is a test where a needle is inserted into the lower part of the back to get a sample of the fluid that surrounds the brain and spinal cord (cerebrospinal fluid) is removed.

A relapse is usually defined as a new symptom or deterioration of an existing symptom that lasts for more than 24 hours. Relapses are also often called exacerbations, flare ups or 1 ‘attacks’.

Remission defines the period during which a person’s MS is stable and there are no new symptoms. It is important to remember that, even during remission, individuals may have on-going symptoms related to previous MS relapses or problems.

Multiple sclerosis can only be treated, and never be cured. The effective treatment of multiple sclerosis includes drugs and plasma exchange (plasmapheresis). In addition to drugs, the doctors also advise on physical therapy, muscle relaxants and medications to reduce fatigue.

Physical therapy includes, stretching and strengthening exercises to perform daily tasks. Muscle relaxants help to control muscle stiffness or spasms, especially in the legs. Other medications may be advised to treat depression, pain, sexual dysfunction, and bladder or bowel control problems as seen in patients of multiple sclerosis.

Is everyone’s MS the same?

Both the symptoms and course of MS can vary considerably from person to person.

By assessing the pattern and frequency of your MS related symptoms, clinicians will be able to determine the type of MS you have and it’s likely course.

Relapsing remitting MS accounts for 80% of new diagnoses in people who are first diagnosed with MS.

“Remember there’s more to life than dealing with MS. Many people with MS can continue to live a full and active life. Look at your situation as a fresh beginning and focus on good thing in your life”

Learn about your condition

• The more you understand MS, the better informed you will be to make important treatment decision, and manage possible flare-ups as they occur.
• Please refer to your doctor to make determinations of suitability of treatment for your type of MS
• Research shows that MS therapy may help in reducing the number of flare-ups, slowing down physical disability, and reducing brain lesions