Multiple sclerosis (MS) is an autoimmune disease affecting the brain, spinal cord, and optic nerve. MS damages the nervous system so that the brain has difficulty communicating with the rest of the body, resulting in a host of symptoms that can vary significantly from person to person. Some people require little to no treatment due to the mildness of their symptoms, while others require assistance due to a loss of mobility. MS usually runs a relapsing-remitting course, with new symptoms affecting different parts of the body before disappearing –or, if untreated, resulting in permanent nerve deterioration. MS has no known cause or cure.
Despite prevalent mysteries about MS, researchers have identified several risk factors resulting from genetics and one’s environment. Individuals with a family history of MS are at an increased risk of developing it. Smokers are also at a higher risk than nonsmokers. MS has been linked to infections such as the Epstein-Barr virus, and people with particular autoimmune conditions such as type 1 diabetes, thyroid disease, or inflammatory bowel disease. Women are two to three times more likely than men to have MS. People of African, Asian, or Native American descent are at a lower risk than Caucasians; additionally, MS occurs frequently in countries with temperate climates –such as the northern United States, Canada, New Zealand, southeastern Australia, and European countries– and in individuals with low levels of vitamin D and sunlight exposure. People aged between 16 and 55 most commonly develop MS.
Although senior citizens with adult-onset MS have often received treatment that ensures healthy lifespans, those with late-onset MS have not been the subject of as much research. However, treatments nevertheless effectively alter the disease’s course and manage symptoms. This article explains how doctors identify and treat MS, so you or your loved ones can safely manage the condition.
Symptoms and Diagnosis
Multiple sclerosis symptoms most commonly impact mobility and gait. People affected often feel numbness or weakness in one or more limbs, often affecting only one side of the body. They may feel pain upon moving their neck, as well as tremors, unsteadiness, or loss of coordination. MS affecting the optic nerve frequently causes double vision, blurry vision, pain during eye movements, and/or partial or complete loss of vision (usually in one eye at a time). MS also frequently causes dizziness, fatigue, slurred speech, tingling, pain, muscle stiffness or spasms, paralysis, mood swings, depression, epilepsy, and bladder, bowel, or reproductive system dysfunction.
Due to the obscurity of MS’ causes and its resemblance to other conditions, doctors typically diagnose people with MS by examining their medical history and ruling out alternative diseases. Blood tests to differentiate MS from other diseases have been tentatively effective. MRI scans can reveal lesions in the brain and spinal cord associated with MS, often highlighted by an intravenous injection of contrasting fluid. A spinal tap, or removal of spinal fluid for testing, can reveal the effects of MS on antibodies. Evoked potential tests, or recordings of your nervous system’s electrical signals can reveal whether your nervous system responds healthily to stimuli or not.
Most patients easily receive their MS diagnosis through any combination of the above tests. However, repeat tests may be required for patients with progressive MS. In their case, the disease spreads throughout the body without relapse or remission; many people with relapsing-remitting MS enter into this stage over the disease’s course, but otherwise, experience remission lasting months or even years. The next section of this article will explain the treatments available for MS, depending on these stages and individual patient needs.
Treatment and Care
Treatments for multiple sclerosis typically manage symptoms, aid in recovery from attacks, and slow the disease’s progression. Doctors often prescribe medications based on your medical history, since they frequently have deleterious side effects. For instance, corticosteroids treat nerve inflammation with possible side effects of increased blood pressure, insomnia, mood swings, and fluid retention. Some may instead opt to treat attacks with plasma exchange, which can treat severe symptoms the medications do not affect. Your choice of treatments should depend on a variety of factors, such as disease severity, the effectiveness of past treatments, cost, and other health conditions.
Using medications upon diagnosis can slow MS progression by lowering the rate of relapses and halting the emergence of new lesions. Beta interferons are commonly prescribed, managing relapses through intravenous injection with the possible side-effect of flu symptoms. Glatiramer acetate blocks the attacks through an injection, possibly causing skin irritation. Infusion treatments include Ocrelizumab for relapse-remitting and progressive MS (at the risk of cancer, particularly breast cancer), Natalizumab for blocking damage (at the risk of viral infection), Alemtuzumab for depleting white blood cells (at the risk of autoimmune disorders), and Mitoxantrone for treating severe MS (at the risk of blood cancers). Oral treatments such as Fingolimod, Dimethyl fumarate, Teriflunomide, and Siponimod can treat relapses with various side effects worse considering before use.
As for symptom-specific treatments, physical therapy often helps MS patients regain mobility through strengthening, stretches, and the use of mobility aids. Muscle relaxants such as baclofen and tizanidine can reduce muscle spasms and stiffness. Dalfampridine can increase walking speed, although it is not recommended for patients with a history of kidney dysfunction or seizures. Antidepressants and medications such as Amantadine, modafinil, and methylphenidate can reduce fatigue; likewise, most symptom-based medications targeted at particular symptoms of MS can treat them effectively upon careful application.
While MS has proven a difficult disease to research and manage, treatments have improved enough to grant many patients relatively healthy lifespans near the average. Senior citizens often require particular attention to their comorbidities and complications, but MS often progresses more mildly within the older population. They often experience a lower rate of relapse. Many caregivers will already have experience helping older people with mobility and vision loss due to aging and other conditions already causing these effects in many seniors. Having the right forms of assistance and treatment can make a tremendous difference in the lives of MS patients, determining whether and how they live their senior years.
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