Coping with multiple sclerosis: Expert warns of no definitive cure

Nearly 2.8 million people are estimated to be living with multiple sclerosis across the world. Although there is currently no definitive cure for MS, treatment options have expanded remarkably over the past two decades, writes Dr Pramod Krishnan

Multiple sclerosis (MS) is a chronic neurological disorder that affects the central nervous system, including the brain, spinal cord, and optic nerves. It is an autoimmune condition in which the immune system mistakenly attacks myelin which is the protective covering around nerve fibres. Damage to this sheath disrupts the transmission of nerve signals, leading to a wide range of neurological symptoms.

Globally, nearly 2.8 million people are estimated to be living with MS. The disease was once considered uncommon in India, but improved awareness and advances in diagnostic techniques have led to increasing recognition across the country. Multiple sclerosis is more commonly seen in young adults, particularly women between 20 and 40 years of age.

Contrary to common misconceptions, MS is not contagious, and many women with MS can have successful pregnancies under proper medical supervision. The exact cause remains uncertain, but both genetic susceptibility and environmental factors such as viral infections and smoking are believed to play a role. 

Multiple sclerosis is often called a disease with “many faces” because symptoms vary greatly from person to person. Common symptoms include blurred or painful vision, tingling or numbness in the limbs, weakness, imbalance while walking, and urinary disturbances. Fatigue is one of the most common yet under-recognised symptoms and can significantly affect daily life. Anxiety and depression are also frequently associated with MS and should not be overlooked.

There are different forms of MS. The most common is relapsing-remitting MS, in which patients experience episodes of new or worsening symptoms followed by periods of partial or complete recovery.

Over time, some individuals may develop gradual worsening of disability, known as secondary progressive MS. Another form, primary progressive MS, causes a steady progression of symptoms without distinct relapses.

Diagnosis of MS is based on careful clinical evaluation supported by radiological findings. MRI of the brain and spinal cord has revolutionised the diagnosis of MS, especially in the early stages when symptoms may be subtle or intermittent. In selected cases, a lumbar puncture may also support the diagnosis.

No definitive cure

Although there is currently no definitive cure for MS, treatment options have expanded remarkably over the past two decades. Steroids are commonly used to treat acute relapses. Long-term management involves disease-modifying therapies, which reduce disease activity and slow progression. Not every person with MS becomes wheelchair-bound, a myth that persists.

Living with MS involves more than medications alone. Rehabilitation, mental health support, regular exercise, adequate sleep, smoking cessation, and lifestyle modifications all play an important role in improving quality of life. With increasing awareness and continuing advances in treatment, many individuals with MS today are able to pursue education, careers, relationships, and personal goals. Early diagnosis and timely treatment are crucial for achieving better long-term outcomes.

(The author is HOD and consultant - neurology, epileptology and sleep medicine at a Bengaluru hospital.)