About Multiple Sclerosis

Jan 07, 2024

What You Need to Know About Multiple Sclerosis in India

Introduction

Multiple Sclerosis (MS) is a progressive, chronic autoimmune condition that impacts the central nervous system (CNS), interfering with the smooth communication between the brain and the body. While MS is not as prevalent in India compared to Western countries, it is steadily emerging as a significant health concern. An estimated 1.5 to 2 lakh individuals in India, particularly women aged 20 to 40, live with MS.

One of the leading voices in MS care, Dr. Vinay Goyal, Chairman of Neurology at Medanta Neuroscience, emphasizes the importance of early diagnosis, holistic care, and advanced therapies in improving the quality of life for patients. His multidisciplinary approach is setting benchmarks for MS management in India.

What is Multiple Sclerosis?

Multiple Sclerosis arises when the immune system mistakenly attacks the myelin sheath—a protective covering of nerve fibers. This immune attack results in inflammation, disrupting the transmission of electrical impulses between the brain and the rest of the body. If untreated, MS can lead to irreversible damage, impacting physical and cognitive abilities.

Common Types of Multiple Sclerosis

MS manifests in various forms, each presenting unique challenges:

• Relapsing-Remitting MS (RRMS): The most common type, characterized by cycles of flare-ups followed by partial or complete remission.
• Primary Progressive MS (PPMS): Progressive worsening of neurological function from the onset, without distinct relapses.
• Secondary Progressive MS (SPMS): A progression of RRMS into a continuous worsening phase, with or without occasional relapses.
• Clinically Isolated Syndrome (CIS): A one-time episode of neurological symptoms that may indicate early MS but does not meet the diagnostic criteria.

Symptoms of Multiple Sclerosis

The symptoms of MS vary widely depending on the affected areas of the CNS. Common symptoms include:

• Motor Symptoms: Muscle weakness, spasms, coordination issues, and difficulty walking.
• Sensory Symptoms: Numbness, tingling, or burning sensations in the limbs.
• Visual Symptoms: Vision problems, such as optic neuritis, leading to blurred or double vision.
• Cognitive Symptoms: Memory impairment, difficulty concentrating, and reduced problem-solving ability.
• Fatigue: A persistent, debilitating tiredness that often worsens in heat.
• Other Symptoms: Issues with bladder control, sexual function, and mood changes.

Risk Factors for MS in India

While the exact cause remains unknown, certain risk factors have been linked to MS:

• Genetic Predisposition: A family history of autoimmune diseases increases susceptibility.
• Vitamin D Deficiency: Common in urban India due to limited sun exposure.
• Smoking: A known contributor to both the onset and progression of MS.
• Infections: The Epstein-Barr virus has a strong association with increased MS risk.
• Gender and Age: Women are disproportionately affected, with the peak onset between 20–40 years.

Diagnosis of MS in India

Early and accurate diagnosis is crucial for effective management. However, in India, limited awareness and access to advanced diagnostic facilities can delay treatment. Diagnostic techniques include:

• Neurological Exams: Assessing sensory, motor, and coordination functions.
• MRI Scans: Identifying lesions in the brain and spinal cord.
• Lumbar Puncture: Analyzing cerebrospinal fluid for abnormalities.
• Evoked Potentials: Measuring electrical activity in response to sensory stimulation.

Prevention Strategies for Multiple Sclerosis

While MS cannot be completely prevented, adopting a proactive lifestyle can significantly reduce its risk:

• Optimize Vitamin D Levels:
  • Spend 10–30 minutes in sunlight daily.
  • Include foods rich in vitamin D, like fortified milk and oily fish.
  • Consider supplements under medical supervision.

Quit Smoking

• Stopping smoking reduces the risk and slows disease progression.

Adopt a Balanced Diet

• Focus on a Mediterranean diet rich in whole foods, omega-3s, and healthy fats.
• Avoid processed foods and refined sugars.

Regular Exercise

• Engage in low-impact activities like yoga, swimming, and brisk walking.

Stress Management

• Practice mindfulness, meditation, and seek counseling when needed.

Infection Prevention

• Maintain hygiene, stay vaccinated, and avoid crowded spaces during outbreaks.

Treatment Options for MS in India

India offers diverse and advanced treatments tailored to the needs of MS patients:

• Disease-Modifying Therapies (DMTs):
  • Interferon Beta: Reduces relapse frequency and severity.
  • Fingolimod: An oral drug minimizing immune attacks on the CNS.
  • Ocrelizumab: A cutting-edge therapy available in India.
  • Dimethyl fumarate: Used to treat relapsing Multiple Sclerosis (MS) and psoriasis.

Symptom Management

• Pain relief and spasticity control through targeted medications.

Physical and Occupational Therapy

• Rehabilitation to maintain independence and improve motor functions.

Lifestyle Interventions

• Integrating healthy diets and regular exercise enhances outcomes.

The Role of Neurologists in MS Care

Specialists like Dr. Vinay Goyal of Medanta Neuroscience bring a holistic approach to MS treatment. His multidisciplinary care model focuses on addressing physical, psychological, and social challenges, ensuring a higher quality of life for patients.

Advances in MS Research in India

Indian researchers are contributing to global advancements in MS management:

• Stem Cell Research: Offering hope for CNS repair.
• Biomarkers: Helping with early detection and monitoring disease progression.
• Advanced Imaging: Revolutionizing lesion detection and tracking.

FAQs About Multiple Sclerosis

ConclusionMultiple Sclerosis, though life-altering, is manageable with timely diagnosis, innovative treatments, and lifestyle changes. Dr. Vinay Goyal’s expertise at Medanta Neuroscience offers hope and transformative care, empowering patients to lead fulfilling lives. Collaborative care and emerging research continue to pave the way for better outcomes in MS management in India.