Also abbreviated as MS, disseminated Sclerosis or encephalomyelitis disseminated. It is an inflammatory(a protective response by the organism to the stimuli that causes injury and thus initiate the healing process) disease in which myelin sheath (usually layer around the neuron that is essential for the proper functioning of CNS) around the brain and spinal cord get damaged leading to demyelination (removal of myelin sheath) and scarring occurs.
MS affects the ability of nerve cells in the brain and spinal cord to communicate with each other. Nerve cells communicate by sending the electrical signals through long fibres called as axons which are wrapped in an insulating substance called myelin. In MS , body’s own immune system attacks and damages the myelin. When myelin is lost, the axons can no longer conducts signals.
MS refers to scars(commonly called plaques or lesions)particularly in the white matter (one of two components of CNS) of brain and spinal cord
Causes of multiple sclerosis.
Most commonly MS are result of some combination of Genetic
Environmental and possibly vascular factors .
It is not a hereditary (cannot pass from parents to their offspring’s) disease. However, a number of genetic variations have been shown to increase the risk factors of developing this disease. Apart from this specific genes have been linked with MS. Difference in human leukocyte antigen(HLA system) , a group of genes in the chromosome 6 that serves major Histo compatibility complex. (i.e. a large gene family found in vertebrates, that encodes MHC molecule. MHC molecule plays an important role in immune system and auto immunity.) , in humans that increase the probability of suffering MS.
MS is common in people live farther from equator, although exceptions exist. Decreased sunlight exposure and decreased vitamin-D production is also linked with high risk of MS. Stress, smoking, occupational exposure and toxins mainly solvents has been evaluated for the cause of MS. Vaccinations may be the casual factor for MS.
Gout may be expected in people with MS to some extent.
Signs and Symptoms of multiple sclerosis
A person with MS can suffer any neurological symptom or sign, including changes in sensations, such as loss of sensitivity, pricking and numbness, hypoesthesia( reduced sense of touch) , paraesthesia( feeling of pricking needle of a limb when falling asleep), weakness of the muscles, difficulty in moving and there is problem in maintaining balance and coordination., difficulty in speech(dysarthria) and swallowing(dysphagia). visual problems including nystagmus(involuntary eye movements), optic neuritis(inflammation of optic nerve that may cause partial or complete loss of vision.), diplopia( double vision means perception of two images),
Fatigue, bladder and bowel difficulties. Depression and change in mood is commonly seen. Uhthoff’s phenomena is common which means an increase in symptoms occurs due to exposure to slight increase in temperature. Lhermitte’s sign( bending of the neck leads to pain in the back) is commonly observed.
Types of multiple sclerosis
There are different types of multiple sclerosis
1) Relapsing MS
2) Benign MS
3) Secondary progressive MS
4) Primary progressive MS
This means that symptoms disappear and then reappear.
After having multiple sclerosis your condition hasn’t worsened.
Secondary progressive MS
It means when the person develop multiple sclerosis second time the symptoms become worst this time.
Primary progressive MS
This is when initially being diagnosed with multiple sclerosis that the symptoms get worse at time goes on.
Physiotherapy treatment for multiple sclerosis
Neurological physiotherapist will work with people suffering from multiple sclerosis to set goals and help to meet the aims of that person. This help to improve the quality of their life . treatment plan include———
a) Improve muscle strength
b) Improve balance , posture and core stability
c) Gait re-education
d) Reduce risk of falls
e) Re-train normal pattern of movement
f) Help to motivate and increase energy level
g) Improve circulation
One of problem with MS is that muscles can weaken and joints can become stiff. Therefore physio will work on preventing this through use of exercises and stretching techniques. Exercise programme will be specific and work on strengthening the muscle used in daily activities. Passive stretching is another physiotherapy intervention to prevent stiffness in joints.. physiotherapist work to obtain maximal range of movement. Physiotherapist incorporate certain relaxation techniques in programme like breathing exercises which provide a good way of relaxation.