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