Multiple sclerosis (MS) is a disease of the central nervous system (brain and spinal cord).1 It is an autoimmune disease wherein the body considered self as the foreign body and destroys it. To understand the pathophysiology of multiple sclerosis, one should understand the nervous system functioning. Myelin sheath is the protective fatty layer present in the nerve fibers. In multiple sclerosis, the myelin sheath becomes the victim. This protective layer of nerve fibers is exposed to the environment and the messages which are to be transmitted from one neuron to another will slow-down or blocked. This can damage the nerve itself and the damages happen are permanent.
The factors responsible for multiple sclerosis are not known. Genetics and environmental factors are assumed to play a key role in causing the disease.
The symptoms of MS vary depending upon the extent of nerve damage. In severe form of the disease, people will not be able to stand or walk. There is no treatment for MS, there can only be a symptomatic treatment which helps in improving quality of life. Depending upon the location of the damaged fiber, the symptoms of the disease varies.
Is MS a Movement Disorder?
Multiple sclerosis (MS) is a movement disorder and symptoms of it vary depending upon the area affected. The numbness or weakness can happen in the legs or legs and the trunk. People with faulty myelin in the neck region experience Electric-shock sensations. There will be a lack of coordination between body parts and tremors with unsteady gait are quite common. Partial or complete loss of vision, double vision, and blurry vision can happen in people with MS. The myelin sheath deterioration progresses and there will be a tingling sensation in the body. MS is a relapsing-remitting disease where people often experience relapses and may also develop new symptoms. The condition can improve partially or completely. People who had MS can develop new symptoms or relapses that develop over days or weeks. The symptoms can improve partially or completely. The relapses are followed by remission of the disease. Depending upon the progression of the disease and relapses, it can be classified into two types-
MS with gradual onset and steady progression of the disease without any relapses is called as Electric-shock sensations.
Most of the people who suffer from relapsing-remitting MS will have a gradual progression of the symptoms, with or without periods of remission, this is secondary-progressive MS.
The progression of the symptoms and the disease can be assessed by analyzing mobility and gait.
MS results in physical disability and the muscle tends to become weak, tight and stiff. There will be a lack of coordination and involuntary muscle spasms which results in loss of balance. In MS, myelin sheath of neurons present in cerebellum and its connections is damaged. There will be impaired coordination of movements and it will also cause vertigo as lesions will develop in the neuronal pathway to coordinate visual, spatial and other input to the brain.
The movement disorder associated with MS can be controlled to an extent by physical therapy and exercise. Stretching of the affected muscles can help in improving coordination to an extent. Spasticity can be reduced with the help of baclofen, tizanidine, diazepam, and dantrolene.2 Ataxia and tremors in MS can be treated by medicines and few surgical options are also available. Vertigo and loss of equilibrium can be treated with the help of motion sickness medication.
Conclusion
In multiple sclerosis, the immune system attacks the myelin sheath of nerve cells present in the brain and spinal cord resulting in impaired signals. The damaged sheath impairs the transmission of information in the limbs, neck or arms. Depending upon the area affected, the functioning will be altered. It is a movement disorder. The patient’s early symptom is lack of coordination balance and unsteady gait. MS is a relapsing-remitting disease.
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