Multiple Sclerosis
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What is Multiple Sclerosis?
Multiple Sclerosis is a condition where the immune system attacks the protective cover of nerves called myelin sheath. This leads to problems with vision, walking, balance, memory, and daily activities. Disability in MS develops over time and can vary from person to person.
How many types of MS are there?
Multiple Sclerosis (MS) is generally classified into four main types:
Clinically Isolated Syndrome (CIS) : This is the first episode of neurological symptoms where MS-like symptoms last for more than 24 hours.
Relapsing-Remitting MS (RRMS): This is the most common type. In RRMS, symptoms suddenly worsen (relapses) and are followed by periods of partial or complete recovery (remissions). About 85% of people with MS are initially diagnosed with RRMS.
Primary Progressive MS (PPMS): In PPMS, symptoms gradually worsen from the beginning, with no early relapses or remissions. About 15% of people with MS are diagnosed with PPMS.
Secondary Progressive MS (SPMS): Many people who initially have RRMS eventually transition to SPMS. In this stage, neurological function gradually declines, and disability increases over time.
What are the symptoms of Multiple Sclerosis (MS)?
Mobility & Balance → Difficulty walking long distances or for extended periods, frequent tripping or falling, stiffness or tightness in the legs.
Vision Problems → Blurred vision, double vision, pain when moving the eyes.
Movement Problems → Difficulty writing, trouble buttoning clothes or cooking.
Thinking & Memory → Slower thinking, indecision, difficulty understanding conversations, forgetfulness, trouble multitasking.
Speech & Swallowing → Slurred speech, difficulty swallowing food or drink, or feeling short of breath.
Bladder & Bowel Issues → Sudden urge, inability to hold urine or stool, and constipation.
Fatigue → Feeling weak or exhausted even after adequate rest.
How is Multiple Sclerosis (MS) diagnosed?
There is no single test for MS. Doctors use a combination of medical history, physical examination, and specialized tests to confirm the diagnosis.
Magnetic Resonance Imaging (MRI)
Cerebrospinal Fluid (CSF) Test
Optical Coherence Tomography (OCT)
Evoked Potential Tests
Blood Tests
Neuropsychological Tests
Why should you see a Neurologist for MS Diagnosis?
Multiple Sclerosis (MS) is a complex neurological disease that shares symptoms with many other conditions. While a General Practitioner can help identify early signs, only a neurologist can confirm the diagnosis using specialized tests like MRI, lumbar puncture, and nerve studies, interpreted with the McDonald Criteria.
Early, accurate diagnosis matters—it ensures the right treatment, reduces relapses, and slows disease progression.
How to tell if MS is affecting your mobility and strength?
Disability may come from:
Relapses (attacks): sudden worsening of symptoms, sometimes with partial recovery.
Progression: gradual worsening over months to years.
When should you see a doctor quickly?
Sudden or new vision problems
Feeling muscle weakness or heaviness
Experiencing extreme fatigue
Difficulty in swallowing food or drink
Bladder dysfunction
How can physical disability be managed in multiple sclerosis (MS)?
Disease Modifying Therapy: Slow disability progression.
Physiotherapy & Exercise: Keeps muscles strong, improves balance, prevents stiffness.
Occupational Therapy: Helps adapt daily activities (special tools, home modifications).
Speech Therapy: Improves communication and swallowing.
Healthy Lifestyle: Balanced diet, enough sleep, stress management.
Mental Health: Counseling or support groups to cope with changes.
How to manage everyday life with MS?
Use mobility aids (cane, walker) if needed
Plan and pace activities to avoid fatigue
Keep your home safe (ensure adequate lighting and install handrails where needed)
Avoid isolation and stay socially active
What should you do?
Keep a record of each symptom: note the date, what happened, and how long it lasted.
If a symptom lasts more than 24 hours, contact your doctor promptly.
Never stop or change your medication without your doctor’s advice.
Follow your doctor’s instructions for blood tests and MRI (Magnetic Resonance Imaging).
Where can you get the treatment for Multiple Sclerosis?
National Institute of Neurosciences & HospitalCombined Military Hospital (Dhaka)References:
https://radiopaedia.org/articles/mcdonald-diagnostic-criteria-for-multiple-sclerosis-4
https://www.nationalmssociety.org/understanding-ms/what-is-ms/how-ms-is-diagnosed
https://journals.sagepub.com/doi/10.1177/1352458517751049?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed.
Mayo Clinic