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UNDERSTANDING MULTIPLE SCLEROSIS (MS) Symptoms, Causes, & Treatments

We're continuing our series on getting to know one another better at the Synaptic Neuro Rehabilitation Centre. We share many cross overs with different neuro conditions and injuries but our approach is client centric with unique and custom programming based on symptoms. The month of May is MS Awareness Month and in honour of this and of the partners in our community - let's get to know more together.

 

family or friend supporting a Parkinson's patient

Understanding Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a complex neurological disease affecting millions of people worldwide. From its elusive causes to its diverse array of symptoms, MS presents unique challenges to those living with it. In this post, we'll delve into the intricacies of MS, exploring its definition, prevalence, symptoms, diagnosis, treatment options, and resources for support.



What is Multiple Sclerosis (MS)?

Multiple Sclerosis MS statistics for the World and for Canadians

MS is a neurological disease of the central nervous system, encompassing the brain, spinal cord, and optic nerves. It is characterized by the immune system attacking the protective covering of nerve fibres called myelin. This leads to inflammation and damage to the myelin, disrupting the transmission of nerve impulses and causing a wide range of symptoms.



Let's Explore Multiple Sclerosis (MS) Symptoms

MS symptoms can vary widely and may include neurological manifestations like weakness, numbness, and tingling, as well as cognitive impairments, sensory issues, and motor disturbances. Some of the most common symptoms include dizziness, fatigue, bladder dysfunction, cognitive impairment, depression, gait difficulties, heat intolerance, and optic neuritis.


Dizziness can be challenging to manage. Because it affects balance, the increased risk of falling requires extra care when ambulating.


Fatigue is a pervasive symptom in MS, affecting up to 90% of individuals, significantly impacting daily functioning.


Bladder dysfunction caused by lesions interfering with brain-to-bladder signals, leading to issues like urinary urgency and incontinence.


Cognitive impairments are common in MS, impacting up to 70% of individuals, and often appear early in the disease course.


Depression is prevalent in the population of those with MS, potentially arising reactively and persisting throughout the disease.


Gait difficulties stem from muscle weakness, spasticity, balance issues, fatigue, and pain, necessitating comprehensive management.


Heat intolerance is brought on by an increased sensitivity to heat by demyelinated fibres in the central nervous system. These nerve fibres are sensitive to even the smallest temperature increase resulting in conduction delays or blockages.


Optic neuritis, or inflammation of the optic nerve, is characterized by sudden vision loss or blurring in one eye.



Prevalence and Incidence Rates

Canada boasts one of the highest rates of MS globally, with an estimated 90,000 Canadians living with the disease, roughly equating to 1 in 400 individuals. Worldwide, approximately 2.8 million people live with MS, with a mean age of diagnosis at 32 years. Females are twice as likely to be affected as males, with ratios reaching 4:1 in certain regions.



Types of Multiple Sclerosis (MS)

Clinically Isolated Syndrome (CIS)

Single episode of neurological symptoms suggestive of MS


Relapsing-remitting MS (RRMS)

Unpredictable but clearly defined relapses (attacks/exacerbations/flare-ups) - new symptoms appear or existing ones get worseIn the period between relapses, recovery is complete or nearly complete to pre-relapse function


Secondary progressive MS (SPMS)

Most people with RRMS will eventually transition to this phase - progressive worsening and fewer relapses


Primary progressive MS (PPMS)

Slow accumulation of disability, without defined relapses12% of people diagnosed with MS have PPMS, 5% of people diagnosed with PPMS experience occasional relapses with steadily worsening disease



Multiple Sclerosis (MS) Causes and Environmental Triggers

Despite extensive research, the exact cause of MS remains elusive. Evidence suggests that a combination of genetic, environmental, and lifestyle factors contribute to its development. Studies funded by MS organizations aim to unravel the interplay of these factors and their impact on MS susceptibility.


That said, there have been promising research results in the past several years relating to new developments in understanding the cause of MS. As detailed by MS Canada: "research has provided some evidence as to the link between EBV and MS. We know that people with clinically diagnosed infectious mononucleosis have a more than two-fold increased risk of developing MS, and those diagnosed with MS have higher levels of EBV antibodies as a result of infection than people who do not have MS."


You can explore more about this research through MS Canada's review of Epstein Barr as a Risk Factor for MS, the Harvard "Epstein Barr may be the leading cause of Multiple Sclerosis" article and study, and the Stanford article "Study indentifies how Epstein-Barr virus triggers Multiple Sceloris".



Multiple Sclerosis (MS) Diagnosis

Diagnosing MS involves a comprehensive evaluation, including a medical history, neurological examination, and diagnostic tests such as Magnetic Resonance Imaging (MRI), evoked potential (EP) tests, and lumbar puncture. The presence of disease activity separated in time and space is crucial for an accurate diagnosis.

3 key ways to diagnose Multiple Sclerosis MS

MRI is a common medical imaging technique

used to visualize the body's internal structure and function. In MS, it reveals lesions in the central nervous system and detects brain volume loss.


Lumbar Puncture involves extracting a small amount of cerebrospinal fluid from the base of the spine to test for oligoclonal bands, indicating CNS inflammation.


EP tests measure nerve impulse speed in different CNS areas, aiding neurologists in assessing MS-related nerve fiber function.



Multiple Sclerosis (MS) Treatments and Lifestyle

Individual doing yoga to manage Multiple Sclerosis MS

While there is currently no cure for MS, various treatment modalities aim to alleviate symptoms, modify disease progression, and enhance quality of life. Disease-modifying therapies (DMTs) play a central role in managing relapsing forms of MS, while rehabilitation, lifestyle modifications, and emerging therapies offer additional options for comprehensive care.


Physical activity is increasingly recognized as a cornerstone in managing multiple sclerosis (MS), offering a spectrum of benefits from improved fitness to enhanced cognitive function.


Aerobic Fitness for MS

can be achieved through activities like walking, cycling, and swimming, benefits brain health in MS by reducing tissue degeneration and enhancing cognitive function.


Treadmill walking is great for improving mobility and cognitive function in MS. Even light walking yields cognitive benefits.


Cycling is a low-impact exercise beneficial for MS symptom management, especially when combined with interventions like functional electrical stimulation.


Aquatic exercises, such as Ai-Chi, help alleviate pain and fatigue in MS while reducing the risk of overheating.


Strength training for MS

shows promise in reducing fatigue and improving quality of life in MS patients, especially when combined with aerobic exercise.


Yoga for MS

improves pain, balance, and quality of life in MS, though optimal regimens require further study.


Exergaming for MS

offers an engaging alternative to traditional exercise for MS patients, improving balance and adherence to training.


Acupuncture for MS

holds promise for MS management but needs further study within Western medical contexts.



The Role of Support and Resources for Multiple Sclerosis (MS)

Living with MS can be challenging, but individuals don’t need to face it alone. MS organizations provide a wealth of information, support services, educational events, and resources to empower individuals living with MS and their families. From caregiver support to coping strategies and social networks, these organizations foster a sense of community and resilience among those impacted by MS.


circle of support for individual with Multiple Sclerosis MS


Conclusion

Multiple Sclerosis is a multifaceted disease that demands a holistic approach to management. By understanding its complexities, advocating for research advancements, and accessing available support systems, individuals living with MS can better navigate their journey.


You can explore MS Canada’s website to learn more about DMTs currently approved by Health Canada: Treatments for Multiple Sclerosis | MS Canada



References




CONTRIBUTED BY: Kyra Chmielewski - Rehabilitation Specialist

 

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