Multiple Sclerosis (MS) is a commonly occurring disease of the central nervous system (CNS) that affects mostly young adults aged 20-40 years. Its causes are under-researched, and symptoms include multiple manifestations of CNS malfunctioning, including blurred vision, balance impairment, memory loss, and others. MS is one of the most prevalent causes of non-traumatic disability. The diagnoses and treatment are complicated due to the under-investigation of non-clear symptoms. Nonetheless, given the prevalence of the disease in the young population and the constraints for daily human functioning it imposes, it is important to research MS to cultivate developed diagnoses, treatment, and prevention measures.
Name of Disease
The name of the analyzed disease is Multiple Sclerosis (MS), which illustrates by its title the multiple inflammation zones or lesions in the CNS. These multiple disruptions in inter-cell connection cause improper physical, cognitive, and neurological functioning in a patient.
History of Disease
Patients with symptoms associated with MS have been observed since the fourteenth century. However, the disease was discovered and named in 1868 by French neurologist Jean-Martin Charcot (Multiple Sclerosis Association of America [MSAA], 2021). Since the time of its discovery, MS has undergone a series of diagnosis and treatment procedure inventions. In the 1950-s, the first effective cortisone-based steroid medication was introduced to manage the relapses of MS [MSAA, 2021). Within the past seven decades, MS has been vastly researched in terms of its causes, symptoms, prevention, diagnosis, and treatment.
Description of Disease
MS “is an autoimmune-mediated disorder that affects the central nervous system (CNS) and often leads to severe physical or cognitive incapacitation as well as neurological problems in young adults” (Ghasemi, Razavi, & Nikzad, 2017, p. 1). It is a chronic disease that occurs on a relapsing-remitting basis where the duration and severity of relapses are unpredictable (Tintore et al., 2017). Being a complex illness, MS affects multiple bodily and cognitive functions disabling the person. The disease is influenced and largely triggered by a combination of environmental and genetic factors. The environmental causes of MS are vitamin deficiency, excessive exposure to UV, diet, and exposure to viral and bacterial agents (Ghasemi et al., 2017). The disease is three times more likely to affect females than males and is commonly observed in individuals aged 20-40 years old (Dobson & Giovannoni, 2019). The onset of MS is characterized by damage in the CNS and might develop without visible symptoms.
Anatomy of the System
The functioning of the CNS of a healthy person is characterized by the undisrupted transmission of electric impulses between brain cells and neural centers for the proper functioning of the body. However, with the onset of MS, an inflammation of “the white and gray matter tissues in the CNS due to focal immune cell infiltration” occurs (Ghasemi et al., 2017, p. 2). Myelin sheath around nerves in the CNS becomes damaged, causing impairments in the transmission of the signals between brain cells and the peripheral nervous system. In particular, “periventricular area, pons, and spinal cord” are affected (Dobson & Giovannoni, 2019, p. 29). Thus, MS is a complex disease that might result in affecting multiple bodily functions due to the caused impairments to several body systems.
Effects on Other Body Systems
Since the analyzed disorder originates in the CNS, it consequently affects other body systems disrupting their healthy functioning. MS affects the musculoskeletal system by impairing movement and balance. Moreover, the disease might cause dysfunctions in the urinary system, digestive system, and reproductive body system. People with MS experience difficulty moving, speaking, memorizing, as well as are subject to impaired balance, fatigue, and other complex symptoms.
Signs and Symptoms
It is a common case that first signs and symptoms of MS are ignored or undetectable even when the disease develops. MS might be observed in several stages, namely “from being at risk, through the asymptomatic, prodromal and symptomatic phases of the disease” (Dobson & Giovannoni, 2019, p. 30). The first signs of the disease are impaired vision, brainstem, and spinal cord syndromes, impaired balance, and fatigue. Other symptoms of MS are tingling, difficulty walking, numbness, mood swings, muscle spasms, and other impairments caused to the CNS (Tintore et al., 2017). When untreated, ignored, or depending on the time and severity of the relapses, the disease might be subject to severe complications.
The complications to MS include disruption of the functioning of other body systems. Patients commonly experience digestive and bowel disorders, sexual dysfunction, tremor, speech problems, memory loss, paralysis, and epilepsy (Brownlee et al., 2017; Tintore et al., 2017). Also, since MS causes difficulty in social interactions and commonly imposes a disability on a patient, depression is one of the prevalent complications.
Diagnosis of the Disease
MS is commonly diagnosed based on the patients’ reported symptoms and with the exclusion criteria applied to the reported symptoms. Therefore, differential diagnosis plays an important role in the detection of the disease. It is especially applicable to population groups with MS symptoms but outside the prevalence group of individuals of 30-40 years (Dobson & Giovannoni, 2019). Over the years, special criteria for diagnosing MS have been developed. One of the most commonly used is McDonald criteria to identify symptomatic MS in patients (Brownlee et al., 2017; Dobson & Giovannoni, 2019).
There are multiple approaches to diagnosing MS given its neurological nature and physical and cognitive manifestations. In particular, clinical diagnosis operates the methods of
MRI, which accounts for the most effective way of detecting abnormal brain functioning or lesions (Brownlee et al., 2017). In addition to the standardized MRI protocol, spinal cord MRI and cerebrospinal fluid examination are used to provide evidence of MS. These diagnostic measures are capable of detecting lesions sufficient to validate a case of MS. In addition, serological investigations are commonly used to include anti‐nuclear antibodies, vitamin B12, and thyroid function (Dobson & Giovannoni, 2019). Depending on the severity of the symptoms, a combination of diagnostic methods and advanced differential diagnoses might be relevant.
Treatment and Side Effects
Throughout the course of MS research and investigation, several treatment approaches have been justified. Both pharmaceutical and non-pharmaceutical treatments are administered to cure and manage the condition. Several medications might be prescribed depending on the characteristics of the disease to mitigate the concurrence of several mechanisms in the CNS. In particular, “dimethyl fumarate (Tecfidera), alemtuzumab (Lemtrada), pegylated interferon‑β (Plegridy) and glatiramer acetate” effectively work to “reduce the relapse rate, ameliorate relapse severity and delay the progression of neurological disability” (Huang, Chen, & Zhang, 2017, p. 3165). As for non-pharmaceutical treatment, vitamin D exposure and lifestyle adjustment are practiced. Overall, both symptomatic and comorbidity treatment are commonly observed. As for the side effects of MS treatment, they might vary depending on the compatibility of drugs and individual acceptance but most commonly include fatigue, chest pain, changes in heart rate, and others.
Prognosis with Treatment
With timely diagnosis and due treatment, patients with MS are expected to lead a normal life with less severe symptoms during relapse phases. The overall duration of relapses shortens, and the frequency of relapse occurrence decreases. The risk for developing comorbidities and complications reduces with adequate therapy. Overall, physical morbidity and disability might be avoided, although full recovery is unlikely.
As the analysis of MS shows, this is a complex auto-immune neurological disorder that affects young individuals and results in a variety of physical, neurological, and cognitive impairments leading to disability. The abundance of diagnostic approaches and treatment options that deem effective provides the basis for positive prospects for the future (Smith, Cohen, & Hua, 2017). The current research contributes to the understanding of sell-based and neurobiological causes of the disease to enforce preventative measures and improve treatment.
Brownlee, W. J., Hardy, T. A., Fazekas, F., & Miller, D. H. (2017). Diagnosis of multiple sclerosis: Progress and challenges. The Lancet, 389(10076), 1336-1346.
Dobson, R., & Giovannoni, G. (2019). Multiple sclerosis – a review. European Journal of Neurology, 26(1), 27-40.
Ghasemi, N., Razavi, S., & Nikzad, E. (2017). Multiple sclerosis: Pathogenesis, symptoms, diagnoses and cell-based therapy. Cell Journal, 19(1), 1-10.
Huang, W. J., Chen, W. W., & Zhang, X. (2017). Multiple sclerosis: Pathology, diagnosis and treatments. Experimental and Therapeutic Medicine, 13(6), 3163-3166.
Multiple Sclerosis Association of America. (2021). History of multiple sclerosis. Web.
Smith, A. L., Cohen, J. A., & Hua, L. H. (2017). Therapeutic targets for multiple sclerosis: Current treatment goals and future directions. Neurotherapeutics, 14(4), 952-960.
Tintore, M., Alexander, M., Costello, K., Duddy, M., Jones, D. E., Law, N.,… & Wray, S. (2017). The state of multiple sclerosis: Current insight into the patient/health care provider relationship, treatment challenges, and satisfaction. Patient Preference and Adherence, 11, 33-45.