Multiple Sclerosis: What It Is, Who It Affects, and How It Is Treated

Multiple sclerosis (MS) is often misunderstood — feared as a rapidly progressive disease that quickly leads to disability. Modern medicine has transformed this picture dramatically. Here is what MS actually is, how it presents, and what treatment looks like today.

What Is Multiple Sclerosis?

MS is a chronic inflammatory disease of the central nervous system (brain and spinal cord). The immune system attacks the myelin sheath — the protective coating around nerve fibres — causing patches of damage called lesions or plaques. This interrupts or distorts the nerve signals travelling through the affected pathways.

MS predominantly affects young adults (typically diagnosed between ages 20–40), and is more common in women (3:1 ratio). It is less common in India than in Western countries, but its incidence is rising with urbanisation.

Common Symptoms

Symptoms depend on where in the nervous system the lesions occur:

• Vision problems: Sudden pain with eye movement and blurred or lost vision in one eye (optic neuritis) — often the first symptom of MS
• Numbness or tingling in a limb or one side of the body
• Weakness in arms or legs
• Balance problems and walking difficulties
• Fatigue: MS fatigue is unique — overwhelming and disproportionate to activity
• Bladder problems: Urgency, frequency, or difficulty emptying the bladder
• Cognitive difficulties: Brain fog, memory issues, slowed thinking
• Lhermitte's sign: An electric shock sensation down the spine and limbs when bending the neck forward — a characteristic MS symptom

Types of MS

• Relapsing-Remitting MS (RRMS): Most common type. Distinct attacks of symptoms (relapses) followed by partial or complete recovery (remissions)
• Secondary Progressive MS (SPMS): After years of RRMS, some patients enter a phase of gradual worsening without clear relapses
• Primary Progressive MS (PPMS): Gradual worsening from the onset, without clear relapses

Diagnosis

The McDonald Criteria are used for diagnosis — requiring evidence of lesions "disseminated in space and time" (lesions in different parts of the nervous system, occurring at different time points). MRI brain and spinal cord is the key investigation. Lumbar puncture and visual evoked potentials may also be used.

Treatment

Modern disease-modifying therapies (DMTs) have transformed MS outcomes:

• Multiple injectable, oral, and infusion treatments are available in India
• High-efficacy treatments significantly reduce relapse rates and disability progression
• Acute relapses are treated with high-dose IV steroids
• Symptom management: physiotherapy, bladder medications, fatigue management, antidepressants as needed

"MS is no longer the disease it was 20 years ago. With early diagnosis and the right treatment, the majority of patients with RRMS can live active, productive lives with very low relapse rates and preserved function."

Dr. Anand Karnam provides MS consultations and manages demyelinating conditions at Sri Anand Child and Neuro Center, Chanda Nagar. Call +91 90633 66983.