Multiple Sclerosis (MS)

Multiple Sclerosis (MS)

Definition:

MS or Multiple sclerosis is a common neurology disease which is more common in young adults. This disease will destroy the neurons cover which will lead to different range of problems from loss of muscle control to vision difficulties. This disease is 3 or 4 time more on women. Moreover north Europe and America have higher rate. Research proved this disease outbreak is lower in the area near equator and the risk is almost 0 in 40 degree north and south. Also people who had a MS in their persistence are more likely to get it. It happens usually between 20 to 40 years old, but other range like below 20 and above 40 are also possible. White people have higher rate and after WHO report it said almost 4 million people suffers from this disease.

Transmission:

The transmission is unclear but it is suggested that it has some relation with autoimmunity. Something like virus stimulates the immune system and the body produce antibodies which attack friendly cells. This antibodies will attack the cover which names is Myelin and destroy them. This cover provides high speed neuron signals transfer. After myelin is destroyed a gap appears. By growing number of gaps in between the speed will be lowered over time and MS symptoms appear. Autoimmunity response without any foreign agent (like virus) for example genetic and environmental cause are also responsible for this disease. I want to add that this disease is not Contagious and all people can get it. Although the cause are remained unknown but scientist named 5 factor responsible in MS.

Vitamin-D shortage: The disease advancement are higher on people with low vitamin-D level. So it is important for patient to get it enough in their daily nutrition,

Smoking: MS rate are higher in smoking people than the nonsmoking one, but the period is not that 

important. MS chance is 3 time more on smoking men and 1.5 times more on smoking women.

Infectious mononucleosis: Also known as mono, glandular fever will be transmitted by mouth and the symptoms are like influenza (fever, Tiredness etc…)

Sodium (Salt) over usage: People who use more salt are more likely to get MS that people with moderate usage.

Obesity and high cholesterol level: People with diabetics or high sugar in their blood, fat and high cholesterol and blood pressure are luckier to get MS

Symptoms:

I should mention that this disease are divided to 4 different type:

Relapsing-remitting: This type will attack the patient and he will get the symptoms, but after that he will get healed and almost no symptoms.

Secondary progressive: The patients with type one might have get the symptoms after several years but no MS attack.

Primary progressive: In this type the patients has almost no symptoms and the disease progress slowly

Progressive relapsing: Patients here have progressive signs and also get relapsed.

Nearly 85% are in the first two groups and the time between disease start and diagnose is something between 4 to 5 years.

Symptoms usually starts with a massive and unexplainable tiredness and will be followed by weakness. This might occur only in one hand or one foot. Some can also have optic neuritis, blurred or double vision, Numbness and tingling of face, hands and feet, loss of balance, sudden tremor, dizziness, migraine headaches, total or partial paralysis of the body, trouble speaking or swallowing, difficulty in memorizing and remembering, and loss of bladder control. Many patients also reporting Chronic Pain and a few of them also experience acute pain and this pain usually happens around face or back. Between each attack might be a gap of months or years and after this period a new symptoms can occur or the old one can relapse and progress. Recurrence can happen after an infection like first 3 month after delivery in women. Research showed the percentage of symptoms are sensory loss (37%), gait disorders (35%), lower extremity weakness or imbalance (17%), vision loss (17%), weakness or incoordination of the upper extremities (10%) and diplopia (10%). Hot weather, stress and air pollution can cause symptoms to get worst. Many MS patient also get depressed although the scientist do not know whether this is an answer to this chronic disease or a symptoms.

Treatment:

There is no treatment, sorry! Today a combination of chemical and physical treatment are used to decrease symptoms or bring disease to a latent phase. MS treatment is implanted by a group of neurology and physician. Keeping general health and treatment must not be forgotten. Physical treatment and exercises are important but it must be prevented in Recurrence phase. Patients must remain cool and not use hot Jacuzzi and warm shower. He should not have stress and keep his weight balanced. He should not forget walking or jogging, exercise and swim in mild water and have a good sleep. Physical treatments helps patient to keep his their motion range, muscle strength and flexibility, learn methods to overcome the misbalanced movement to keep their productivity, enough rest, taking medicines and good rest plan are helpful. Medicine for MS are used to prevent and stop the symptoms or control the progression. Steroids medicine like Methylprednisolone, Dexamethasone, Prednisone, Betamethasone and Prednisolone can decrease Inflammation in the central nervous system if they are used in short period. Steroids also can help the vision difficulties. Other drugs like Interferon beta and Glatiramer acetate can decrease the amount of attacks. They are delivered by injection and prevent the body to attack myelin. For the first group, deep injection of Interferon beta 1a weekly or once every two days subcutaneous injection of Interferon beta 1b can decrease the attacks. Intravenous immunoglobulin (IVIG) can be also helpful but the information is incomplete. For depression, urinary problems, and muscle spasms are also several medicines. For example Baclofen for spasm. Also Botulinum toxin is helpful and will remove the pain. Patients with severe urinal problem should use Catheter to empty their urine. This medicines are approved by FDA against MS:

Gilenya: Generic name Fingolimod is developed to reduce relapses and delay the progression of MS patients

Ampyra: Generic name Dalfampridine is good for treating specific symptoms of MS in particular improve walking ability of patients.

Nuedexta: Antidepressant drugs for the treatment of MS patients who have lost their emotions control. Some MS patients have a severe emotional consequences that might be arise by uncontrollable cry or laugh.

Aubagio: with Generic name Dimethyl Fumarate will decrease body immunity to prevent attack against neurons cover.

Prevention:

Since the reasons are still uncovered and young peoples are target, scientist still could not find a way to prevent this disease. They mentioned several important measure mainly nutrition which will help to decrease the chance of getting MS.

-Reduction of total fat intake by eating food.
-Unsaturated fats, such as walnuts, sesame, olive and grape seed instead of saturated fats like hydrogenated oils, animal fats, coconut, butter and mayonnaise.
- Compounds containing omega-3 and omega-6 or fish and eggs because they have anti-inflammatory and immune-enhancing effect.
- Use a variety of fruits, vegetables, cereals and breads. Whole grains like whole wheat, brown rice, barley, maize and beans sprouts in the diet.
- Eating protein and low-fat dairy products such as low fat red meat, poultry, fish, beans and vegetable protein.
- Reduce consumption of sweet foods, cakes, biscuits and chocolates
- Reduce salty food intake.
- Consumption of caffeine free and alcohol-free beverages. 2 liters of fresh water and filtered (8 normal glass) per day
- Taking appropriate and necessary vitamins such as vitamins D, C, E and B and minerals such as manganese, magnesium, molybdenum, selenium, and zinc are essential for the patient health. However, excessive intake of vitamins such as vitamin A can be dangerous and inappropriate.
- It is better to consume less animal foods and if you want to eat them, they should be low-fat or no fat.
- You should not take large amounts of fat sausages.
- Preserved food should be removed as possible from the diet.
- Not a lot of acidic foods such as pickles, vinegar and yogurt

Other recommendations are: exercise such as swimming, walking, slow but constant jogging (at least 15-30 min daily), low-stress job, stress and anxiety reduction and sleep.

It is also necessary to mention that MS is not deadly but it is restrictive. Cause of death in most cases are infections, bed sores and etc.

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