Multiple sclerosis is an inflammatory disease of the brain and spinal cord, affecting the protective cover (myelin sheath) of nerve cells. It is also known as encephalomyelitis disseminata or disseminated sclerosis. The damage alters the function of part of the nervous system resulting in a diversity of signs and symptoms including both physical and mental problems. The symptoms may either resolve completely or they may give rise to permanent neurological impairment. MS prevention is still yet to be fully defined since the causes of this chronic disease have not been clearly understood.
Environment and genes are the two most significant risk factors. Affected persons have been found to posses several genetic aberrations. Relatives of affected persons are at a very high risk of contracting the same. The closer the relationship one has with such a patient, the higher the risk. Identical twins have the highest risk in the event that one of them is affected. Next are fraternal twins and siblings in that order.
There is strong evidence to suggest that microbes may play a role in the aetiology. This is backed by two theories. The first of these theories is the hygiene hypothesis. In this theory, the disease occurs after a second exposure to a certain microbe. The first exposure to the microbe results in a protective reaction. The second theory is the prevalence hypothesis which purports that certain types of microbes are isolated in persons living in areas with a higher prevalence of MS as compared to those living in lower prevalent areas.
Several risk factors are thought to greatly contribute to worsening of MS. These factors include occupational exposure to toxins, smoking, hormonal treatments, stress, diet and vaccination among others. Avoiding these factors and behaviors is said to lower the risk of the condition significantly.
Pathologically, there are three main features of MS including formation of lesions, inflammation and damage to myelin sheaths. Interaction of these characteristics results in breakdown of nervous tissue and hence physical manifestation of signs and symptoms. Damage is also believed to be caused by an autoimmune reaction in the body.
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.
Whenever an attack occurs, the initial priority should be to restore the CNS function and to prevent subsequent attacks. Efforts to avoid permanent disability should also be made. A number of pharmacological agents have been found to be helpful in delaying the progression of disease. The leading agents are beta interferon and glatiramer. Prompt treatment of flu particularly in the months following delivery in women.
High temperatures have been found to be an exacerbating factor in these patients. They accelerate the deterioration of the nervous system especially for the components that have already been affected. It is recommended, therefore, that affected individuals use air conditioners whenever possible. They should avoid using hot tubs or hot swimming pools. As can be seen in all these situations, all MS prevention strategies revolve around avoidance of exacerbating factors.