Multiple sclerosis (MS) is a chronic condition that affects the Central Nervous System (CNS). It occurs when the immune system attacks the brain and spinal cord, leading to a mild or a 'worsening' form of disability over time.
According to the World Health Organization (WHO), over 10.8 lakh people are estimated to have MS worldwide. It typically manifests in individuals in their 30s or 40s and is less prevalent among older populations, says Dr Sinjan Ghosh, Consultant, Neurology, Fortis Hospital, Anandapur, Kolkata.
"While historically more common in Western countries, instances are now being observed in tropical regions like India as well. A significant contributing factor is often vitamin D deficiency,” the doctor tells the OnlyMyHealth team.
Moreover, it is important to note that the effects of MS may vary from individual to individual, including men and women.
Also Read: Multiple Sclerosis And Cardiovascular Diseases: Expert Explains The Connection Between The Two
Common Symptoms Of Multiple Sclerosis
MS is characterised by the demyelination of nerves, where the protective covering deteriorates, leading to impaired nerve conduction, says Dr Ghosh, adding that it can result in various kinds of symptoms depending on which part of the nerve is affected by the disease.
Some of the common symptoms of MS include:
- Weakness in one side of the body, especially in the arms and legs
- Vision problems due to optic neurosis
- Difficulty walking or keeping balance
- Difficulty thinking clearly
- Muscle stiffness
- Depression
- Problems with sexual function or urination
- Fatigue
Dr Ghosh says the condition can also present stroke-like symptoms, usually diagnosed from clinical history as well as brain MRI, spinal cord MRI, and optic nerve tests.
How MS Differs In Men And Women
Several studies suggest that MS is more common in women than in men. A 2020 study published in the journal Medicina even suggests that the ratio of MS between adult women and men is 3:1.
Although the exact cause behind this difference is yet to be determined, researchers believe there could be several factors at play, including differences in how male and female immune systems work, hormonal changes, genetics, and pregnancy.
Interestingly, while more women are diagnosed with MS, men may be more likely to develop primary progressive MS (PPMS), a type of MS that causes symptoms to worsen rather than having a relapse of symptoms.
On the other hand, women tend to experience more relapses during periods of recovery.
Research also suggests that MS might be diagnosed later in men compared to women.
Since men are less likely to seek help early on, they might be diagnosed during the more advanced stage of the disease. This could explain why men are more commonly diagnosed with the progressive form of MS and why MS seems more prevalent in women overall, the study notes.
Treatment And Management Of MS
When it comes to treating MS, there is no distinction between men and women, says Dr Ghose.
Diagnosing MS is a complex process involving several steps. It begins with your doctor discussing your medical history and understanding your symptoms in detail.
This could be followed by a neurological exam, which will assess things like your vision, strength, coordination, and reflexes.
Various tests can be used to confirm or rule out MS. These include an MRI scan, which creates detailed images of the brain and spinal cord to detect potential damage; blood tests, which look for other conditions; and a spinal tap that might be used to analyse cerebrospinal fluid for abnormalities.
If you're diagnosed with the condition, steroids are initially administered, followed by disease-modifying agents. "A variety of injectable options and oral medications are available. While injections were once the only choice, the availability of oral medications has expanded, making compliance easier for patients," Dr Ghosh shares.
When asked whether MS is curable, he explains, "The notion of a cure for Multiple Sclerosis is a complex subject. While we don't label it as such, there's a concept known as NEDA (No Evidence of Disease Activity), which hinges on how many years patients remain free from further attacks. Sometimes they can be free of symptoms or attacks for 10 years. However, it wouldn't be accurate to term this a cure; rather, our target is to achieve NEDA. While complete eradication isn't feasible, you can prevent its occurrence for a period of time so that the chances of developing progressive disease are less. The progression of this condition typically involves inflammation, followed by demyelination, and ultimately, degeneration. Once degeneration sets in, there's no means of reversal or improvement.”