Multiple sclerosis is an inflammatory process that affects the components of the central nervous system namely the spinal cord and the brain. The condition preferentially affects the myelin sheath which is the protective covering of the spinal cord. Patients suffering from this condition will exhibit either psychological or physical symptoms or both. Fortunately, a number of patients will have a complete resolution of symptoms and will go back to normalcy. Others progress to chronic states. MS prevention should be aimed at stopping the onset of the symptoms.
The aetiology is believed to be a combination of both environmental and genetic factors. A number of genetic variations have been found in the individuals affected with the condition. Relatives of affected individuals have an increased risk of getting the condition. The closer one is to the affected individual, the higher the chances. Identical twins are said to be at the highest risk of suffering from the disorder if one of them is affected. These are followed by fraternal twins and siblings.
The role for microbes is backed by two theories namely the hygiene theory and the prevalent theory. In the hygiene theory, a microbe will only result into MS on a second exposure. The first exposure causes an immunological reaction that is protective. In the prevalent theory, it is said that certain microorganisms are associated with geographical areas known to have a high prevalence of the condition and thus are thought to play a role.
A number of lifestyle behaviors are thought to help in the propagation of the condition. Doctors say that modifying these unhealthy habits will significantly lower the risk. They include, among others, smoking, stress, diet, occupational factors (exposure to toxins), vaccination and hormone intake.
In terms of the pathologic presentation, there are three main features that have been identified. These include inflammation, damage and formation of lesions on myelin sheaths. These processes all contribute to the breakdown of the protective tissues and thus cause the characteristic symptoms. Autoimmune reactions at these sites are thought to play a prominent role.
Four main clinical courses exist. These are the progressive relapsing, the relapsing remitting, and the primary and secondary progressive. All have varying features and varying degrees of severity. The secondary progressive is the commonest and affects about 65% of individuals with the disease. The relapsing remitting is characterized by recurrence after treatment.
The priority after an episode of CNS attack should be to rehabilitate the affected individual and to prevent secondary attacks. Disability should be prevented if possible. Interferon beta and glatiramer are two drugs that have become very useful in the control of progression. There is a strong recommendation for prompt treatment of infections as these are a significant risk factor.
Elevated body temperature can worsen the symptoms of MS by causing the already affected nerves to function even more poorly. For this reason, air conditioners are recommended for affected persons. Victims should avoid hot swimming pools and hot bath tubs. In a nutshell, there is no known way of MS prevention other than minimizing the predisposing factors.
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