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Muscular Sclerosis

Muscular Sclerosis is a disease of the brain and spinal cord where there is inflammation of the myelin sheath covering their nerve cells. It is also known as Disseminated Sclerosis and Encephalomyelitis disseminata.

There is no established cause for Muscular Sclerosis, but it is thought to be due to failure or autoimmune disease of the myelinating cells. This destruction results in crippling of the nervous system, with both sensory and motor nerves being disrupted, which is the reason for development of symptoms in patients.

Signs and symptoms of Muscular Sclerosis

Signs and symptoms depend on where the lesion is in the nervous system, in addition to the common neurological symptoms. Specific symptoms include sensory, motor and psychological features. Parasthesia, ‘pins and needles’ sensations in skin, muscle weakness and spasms, hyperreflexia, gait disturbances, chronic fatigue and vague aches and pains, and bladder and bowel disturbances are common in Muscular Sclerosis. In addition, mood swings, depression, impaired decision making, spasms, chills, can also be seen. Some specific problems like optic neuritis, nystagmus, diplopia can occur. Relapses and periodic worsening also occurs, triggered by infections like gastroenteritis, and seasonal variations.

Types of Muscular Sclerosis

Four major disease progression paths are identified :

  • Relapsing/Remitting
  • Secondary Progressive
  • Primary Progressive
  • Progressive Relapsing

Diagnosis of Muscular Sclerosis

Diagnosis of Muscular Sclerosis is difficult initially, because of the disseminated symptoms. Clinical correlation with symptoms helps in diagnosis. MRI is especially useful as the plaques that occur in myelin sheaths can be visualised. Analysis of CSF also helps.

Cure for Muscular Sclerosis

There is no cure thus far accepted by the scientific community, with the only “solution” being put forward that management can be attempted to prevent the progression of disease as well as handle the pre-existing symptoms. During the acute attacks, high dose corticosteroids like IV Methylprednisolone are given, supplemented by oral corticosteroids.

Approved long term drugs for Muscular Sclerosis include Interferon beta-1a and 1b, Dimethyl Fumarate, Mitoxantrone, Naatlizumab, Fingolimod, Teriflunomide, and glatiramer acetate. The drugs have serious side effects like local destruction of fat at the site of injection, hypertension, liver damage, and high risk of leukemia, but they are the only approved viable treatment options that control the Muscular Sclerosis. Additonal management with neurorehabilitation helps in control of the disease.

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