A Health Guide to Multiple Sclerosis!

In multiple sclerosis, the communication within the brain, and brain and body is disrupted. Multiple Sclerosis is a chronic, unpredictable and often a disabling disease which affects the central nervous system, spinal cord, and optic nerves. It is categorized as an autoimmune disease caused by the immune system attacking and damaging the nervous system.

Cause and Risk Factors

The cause of Multiple Sclerosis is still not known. However, there is an interaction of several factors that may be involved in Multiple Sclerosis. An extensive ongoing research is being carried out in the areas such as genetics, immunology (the science of body’s immune system), and epidemiology (the study of patterns of disease in the population). Keeping the research in mind, Multiple Sclerosis causes can be classified into four categories.

Immunologic Factors

Multiple Sclerosis occurs when the immune system attacks the nervous system. In recent years, researchers have identified the immune cells that initiate the attack and factors that cause the immune cells to attack.

Environmental Factors

Epidemiologists have found that Multiple Sclerosis is more prevalent in areas that are farther from the equator. There is enough evidence that shows that Vitamin D plays a significant role in strengthening the immune system and people who are exposed to more sunlight throughout the year have lesser chances of Multiple Sclerosis.

Genetic Factors

Multiple Sclerosis is not genetic. However, having a first-degree relative such as a parent or sibling with Multiple Sclerosis increases the chance of developing the disease. Researchers are studying common genetic factors in families where Multiple Sclerosis is present in more than one person.

Infectious Factors

Any initial exposure to certain viruses, bacteria, and other microbes during childhood can be a cause of Multiple Sclerosis in the future. Since viruses are well-recognized as being the triggers of demyelination – the removal of the myelin sheath from a nerve fibre can lead to Multiple Sclerosis.


Multiple Sclerosis can threaten the life of patient depending on the symptoms and severity of the condition. The symptoms vary from person to person, and there is no ‘standard’ set of indicators.

Multiple Sclerosis symptoms are broadly categorized into 3 types –

Motor Symptoms (Changes in Muscle Function)

  • Weakness
  • Tremor
  • Difficulty walking
  • Stiffness
  • Poor Coordination
  • Bowel/Bladder problems

Sensory Symptoms (Changes in Sensation)

  • Tingling
  • Numbness
  • Dizziness or Vertigo
  • Visual disturbances
  • Abnormal sensations

Other Symptoms

  • Fatigue
  • Heat sensitivity
  • Sexual symptoms
  • Cognitive changes
  • Emotional changes

Multiple Sclerosis differs from person to person, and each patient has their own set of symptoms. There are also individuals who have mild Multiple Sclerosis and may never know that they have it, while for others it can be severe. Basis the signs, symptoms and severity, Multiple Sclerosis is classified in the following ways –

Relapsing-remitting (RRMS)

Patients have occurrences of symptoms, with or without recovery, but between attacks, there is no interval worsening.

Secondary Progressive (SPMS)

This stage comes few years after relapsing-remitting and the pattern change from a relapsing one to a progressive one in between the attacks.

Primary Progressive (PPMS)

Gradual onset from the beginning with no attacks

Progressive-Relapsing (PRMS)

One of the rare forms of Multiple Sclerosis, it begins with a progressive course which later transforms into developing attacks.


A rare yet extremely severe and rapidly progressive Multiple Sclerosis

Diagnosis and Testing

Multiple Sclerosis is often difficult to diagnose because there is no single diagnosis or test for finding out if the person suffers from it or not. Since the symptoms vary from person to person, neurologists have to take the history of neurological symptoms into account.

A neurological examination may suggest problems with the spinal cord or brain. Imaging studies help to confirm a diagnosis of multiple sclerosis. MRI is the most common test done to help diagnose the disease since it can be used to image the brain and spinal cord.

Furthermore, a spinal tap or lumbar puncture is done to collect a small amount of cerebrospinal fluid which is used to confirm the presence of proteins, inflammatory markers or other substances. A spinal tap is generally not necessary if MRI scans are not abnormal.

When neurologists suspect multiple sclerosis in a patient, other tests are also conducted to check for diseases such as Lyme disease, lupus, vasculitis, HIV and process which can lead to multiple strokes.


Several considerations are taken into account for Multiple sclerosis treatments. Once MS is confirmed in a patient, modifying therapy is recommended which controls the occurrence of symptoms.

At Max Institute of Neurosciences, our goal is to control symptoms and help the patient maintain a healthy life by providing dedicated care and monitoring. The treatment includes drugs for controlling symptoms to prevent attacks in the future. At Max, we have an exclusive Multiple Sclerosis Clinic that offers consultation, comprehensive diagnosis and therapies for the condition.

Dr. Manoj Khanal is one of the Best Neurologist in Delhi. With more than 15 years of experience, Dr Manoj Khanal has treated more than 20k patients.

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