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Multiple Sclerosis

Multiple Sclerosis

  • There is involvement of Brain, Spinal cord & optic nerves by multiple plaques.
  • Commonly patient may have recurrent attacks & in each attack there is combination of paralysis ,Sensory , Visual involvement. These attacks when recurrent then it is called Relapsing & Remitting (RRMS) type of Multiple Sclerosis. Frequency & Severity of attacks may vary from patient to patient.
  • As disease progresses RRMS gets converted to secondary Progressive type of Multiple Sclerosis (SPMS)
  • Uncommonly disease may gradually progress continuously from beginning. It is called primary progressive multiple sclerosis(PPMS)
  • Whenever a patient comes with first attack we investigate. But patient may have asymptomatic involvement of brain, Spinal cord & eyes, So extensive investigations are done.
  • Investigations include, blood tests, contrast MRI of Brain & Spinal cord / optic nerves.
  • Visual evoked potentials, Auditory evoked potentials & Somato – sensory evoked potentials are done to detect asymptomatic involvement. Commonly visual evoked potential is done.
  • Lumber puncture to study CSF is also done.
Treatment :

In Acute attack steroids are given & to prevent recurrence disease modifying drugs are advocated. These are costly drugs with variable efficiency (35-70%.)