Multiple sclerosis is a demyelinating disorder affecting the brain and the spinal cord. In this disease immunological response is imparted against the myelin sheath, thus leading to defective transmission.
Due to damage to myelin sheath signals fail to get transmitted. The sensory, motor, as well as autonomic fibers are involved. Sensory fibers are first involved and the patient complains of paresthesia and tingling sensation in the area involved. Eventually, motor components get involved and paralysis sets in.
Eye muscles are usually involved. Diplopia is most frequently complained by the patient. Autonomic manifestation is also seen in a few cases.
Has Anyone Been Cured Of Multiple Sclerosis?
As per clinical reports, multiple sclerosis still remains an incurable disease. (1) Treatment only helps in preventing remission. Multiple sclerosis, even when diagnosed in early stage, remains incurable. Remission of disease is the only way by which patient get a relief free period. Even after the complete course of treatment there is a high recurrence rate.
Multiple sclerosis can be a primary progressive type or secondary progressive. In primary progressive cases, there is a gradual worsening of the patient. There is no improvement in symptoms in between. There is a steady decline in function without attacks.
In secondary progressive type initially, there is a period of relapsing and remission followed by steady decline without remission.
Mainly the treatment of multiple sclerosis is medical. There is no surgical treatment available. Steroids are a drug of choice in a patient with multiple sclerosis. Other drugs which are used are immune-modulators.
With all possible drug treatment still, there is no permanent cure of the disease. Drugs and rehabilitation can only reduce the number of attacks, slowing down the progression of a disease and providing symptomatic relief to the patient. Apart from steroid number of other drugs are available which includes-
Beta Interferon– these are given to reduce the severity. Once a patient is on beta interferon relapse rate is found to be reduced. The only side effect is flu-like symptom and deranged liver enzymes levels.
Glatiramer Acetate– this medication decrease immune reaction against myelin sheath. The side effect is irritation on the site of injection.
Natalizumab prevents immune cells from reaching the brain and spinal cord hence decreasing the damage. This can cause progressive multifocal leukoencephalopathy. This is the most dreaded side effect that’s why this is only used when all other medication fails.
Ocrelizumab is another monoclonal antibody used.
Fingolimod- this acts in leucocyte receptor and prevents binding to endothelium and hence migration of leucocytes.
All these drugs can only prevent relapse of disease. There is no permanent cure to date. Since there is no permanent treatment patient is usually treated symptomatically. Plus, patient usually complains of side effect associated with long-term consumption of steroids. Many patients start developing features of osteoporosis and diabetes in the long run. Therefore, regular monitoring of blood sugar and blood calcium level is necessary.
What Can Be Done If There Is No Permanent Treatment?
Symptomatic treatment includes-
Physical exercise to increase the strength of muscle. Physiotherapy is recommended in such patient as this provides symptomatic relief.
If a patient complains of the stiffness of joints then muscle relaxants are given to get rid of distressing symptoms.
An important thing which should be kept in mind is that patient of multiple sclerosis is highly sensitive to raised temperature. Uhthoff’s sign is a condition when a patient suffered an episode of diplopia when exposed to raise temperature. So while prescribing medication counseling the patient about such phenomena. Ask him to stay in the cool surrounding.
Stress reduction and practicing yoga provide relief in symptoms seen. The patient tends to ignore these basic things and consider these as insignificant. Hence, proper explanation should be given to the patients regarding the benefits.
Still, research is going on and presently many medications are under trial for the treatment of multiple sclerosis. Biotin is under phase third clinical trial for primary and secondary multiple sclerosis treatment. Similarly, stem cell transplantation is the latest trial going on to date.
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