Multiple Sclerosis

Multiple sclerosis is a relatively frequent autoimmune disease of the central nervous system. It is much more common in women, but it also affects the men.


Multiple sclerosis is caused by a pathological autoimmune response of our immune system that begins to attack the body tissues. In this case, the immune system affects the brain and spinal cord damaging the nerve fibers and particularly causing loss of their myelin sheaths (so-called demyelization). The reason of the pathological immune response is not know, but we assume that it is a combination of certain genetic predisposition and a triggering outer factor, which may be some banal viral infection.


They are many possible symptoms. In young women, the first symptom is often inflammation of the optic nerve manifesting with eye pain, seeing flashing lights, blurred vision or color blindness. The symptoms are usually only short-term.


Gradual deterioration of nerve fibers and loss of myelin sheaths causes disruption of signal transmission between the brain and the rest of the body resulting in variety of neurological disorders including movement disorders (muscle paralysis, reduced ability to move the limbs, difficult walking, tremor), sensitivity disorders (numbness of various parts of the body, tingling sensations in the extremities), sexual dysfunctions (erectile dysfunction in men and vaginal dryness in women) and urinary incontinence. In addition, multiple sclerosis is accompanied by bouts of severe fatigue and there may be present psychological changes. The above factors may seriously dampen the affected patient's life quality.


The course of the disease is individual. The typical course are periods of bouts (sudden deterioration) alternating with periods of stable condition or even with periods of slight improvement thanks to recovery of damaged myelin sheaths. Unfortunately, some forms are typical by gradually or rapidly progressing deterioration. The disease may worsen when combined with other diseases.


There is no known prevention. We do not know the cause and that is why we do not know how to protect from the onset. Patients with already diagnosed multiple sclerosis should at least try to avoid infections and situations of excessive physical or psychical load that may trigger sudden worsening of the symptoms.


Any patient with suspicion of multiple sclerosis should be carefully examined by a neurologist including imaging methods (computed tomography or magnetic resonance imaging), lumbar puncture with examination of cerebrospinal fluid and electromyography to evaluate the signal conduction in peripheral nerves.


The treatment is performed by neurologists. Very simply put, the basic means of therapy are immunosuppressive drugs such as the corticosteroids. The disease is incurable and the doctors try to decrease its symptoms and the frequency of the bouts. The prognosis is quite individual and depends on the form of the disease. The rapid forms may cause disability within years despite the best medical care.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources