Multiple sclerosis is a disease of the central nervous system (CNS). It causes disability of the brain and the spinal cord. Our country sees more than one million cases of this condition every year, most of which are diagnosed in those above 18 years of age. This article talks about the types, causes, symptoms, and treatment options of multiple sclerosis.

Causes
Multiple sclerosis is a type of autoimmune disease. It is caused when the immune system attacks myelin – a protective layer that surrounds the nerve fibers in the brain and spinal cord. The attack on this protective layer causes swelling in the scar tissue and lesions, stopping the brain from sending signals to the rest of the body through the spinal cord. Certain genetic and environmental factors can lead to this condition.

Although it can occur at any age, multiple sclerosis is usually diagnosed between the ages of 20 and 40, and women are two to three times more likely to suffer from it. Certain infections, such as mononucleosis, caused due to the Epstein-Barr virus, increases the risk of suffering from the condition. Apart from this, low exposure to sunlight and vitamin D deficiency can also increase the risk of suffering from this type of autoimmune disease. Other autoimmune disorders such as thyroid disease, pernicious anemia, type 1 diabetes, and even inflammatory bowel disease (IBD) can increase the risk of developing multiple sclerosis.

Signs and symptoms
A person who has multiple sclerosis may develop unexplained muscle stiffness and spasms. They may also experience partial paralysis, typically in the legs. Signs of depression and other mental changes, such as mood swings and forgetfulness, may also appear. Other symptoms associated with multiple sclerosis include acute or chronic pain, tremors, and even cognitive impairment. The following signs can help detect the disease at an early stage:

• Numbness and tingling sensation in the arms, legs, or one side of the face
• Sensations similar to a pinprick that is usually experienced in the feet while sleeping
• Blurry vision in one eye, double vision, and partial vision loss

Based on the signs and symptoms mentioned above, the following are the types of multiple sclerosis:

• Clinically isolated syndrome
  CIS, or clinically isolated syndrome, is an early form of multiple sclerosis caused due to the demyelination of the CNS. It involves any one of the symptoms mentioned above, lasting at least for a day.
• Relapsing-remitting multiple sclerosis
  RRMS, or relapsing-remitting multiple sclerosis, is characterized by relapses or repeated occurrences of symptoms followed by remission. The symptoms during the remission period are mild or negligible, indicating there is no disease progression. When RRMS progresses into a more progressive form, it is termed as SPMS or secondary progressive multiple sclerosis.
• Primary progressive multiple sclerosis
  A person suffering from this type of the disorder might have progressively worsening symptoms with short periods of remission or non-activity.

Treatment
A person suffering from multiple sclerosis is usually suggested disease-modifying therapies aimed at slowing the progression of the disease and lowering its relapse rate. Some medications that can be used to treat RRMS include glatiramer acetate and beta interferons. Other oral medications such as dimethyl fumarate, teriflunomide, and diroximel fumarate are also used for managing the symptoms. Intravenous infusion treatments using medications like alemtuzumab, ocrelizumab, and mitoxantrone can also be used to treat multiple sclerosis.

Apart from this, a well-balanced diet and other contemporary therapies such as meditation, massage, and light exercises can be used in conjunction with other treatments to manage multiple sclerosis.