Multiple Sclerosis (MS) — Diagnosis and Treatment in Hyderabad
Numbness in one limb. Vision loss in one eye. Weakness that comes and goes. Multiple sclerosis is diagnosed earlier and treated more effectively than ever before.
Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system in which the immune system attacks the myelin sheath protecting nerve fibres — causing episodes of neurological dysfunction (relapses) followed by partial or complete recovery (remissions). MS most commonly affects young adults aged 20–40 and is more common in women. While there is no cure for MS, disease-modifying therapies (DMTs) dramatically reduce relapse rates and slow disability progression when started early. Dr. Anand Karnam (DrNB Neurology) at Sri Anand Neuro Center, Chanda Nagar, provides MS diagnosis by MRI criteria and manages patients on disease-modifying therapy.
Key Points
- Modern MS therapies achieve near-remission in many patients — a revolution from even 10 years ago.
- High-efficacy DMTs (Natalizumab, Ocrelizumab) can reduce relapses by up to 90% vs placebo.
- Acute relapses are treated with IV methylprednisolone to speed recovery.
- Physiotherapy, bladder management, and fatigue strategies are essential alongside medications.
- Regular MRI every 6-12 months guides treatment decisions and detects silent activity.
90%
relapse reduction with high-efficacy DMTs
Source: NEJM / Lancet
6-12 mo
MRI monitoring interval recommended
Source: NICE / EAN Guidelines
Common MS Symptoms — The First Episodes to Recognise
Optic Neuritis (Pain and Vision Loss)
Painful vision loss in one eye — often the first episode of MS. Vision appears washed out or blurred. Usually improves over weeks. If you experience sudden one-eye vision changes, seek urgent neurology assessment.
Limb Numbness or Weakness
A patch of numbness or weakness in one or both legs — developing over hours to days. May feel like a band around the chest or abdomen (the 'MS hug'). Caused by a spinal cord demyelinating lesion.
Uhthoff's Phenomenon
Symptoms worsening in heat — a very characteristic feature of MS. Symptoms worsen in hot baths, during fever, or in summer heat, then improve when cool. Not a relapse, but a clue to the diagnosis.
Fatigue and Cognitive Slowing
MS fatigue is not ordinary tiredness — it is an overwhelming exhaustion disproportionate to activity, often worst in the afternoon. Cognitive 'fog' (difficulty concentrating, word-finding difficulty) affects up to 50% of MS patients.
Lhermitte's Sign
An electric-shock sensation running down the spine into the limbs when the neck is bent forward — caused by a lesion in the cervical spinal cord. Highly characteristic of MS.
How We Diagnose and Treat MS
MRI Brain and Spine (McDonald Criteria)
MS is diagnosed by the McDonald criteria — requiring demonstration of lesions disseminated in space (different locations in the CNS) and time (occurring at different times). MRI with contrast is the cornerstone investigation.
Lumbar Puncture (CSF Analysis)
When MRI findings are atypical, CSF analysis looks for oligoclonal bands — markers of CNS inflammation present in 90–95% of MS cases. Helps confirm the diagnosis in ambiguous cases.
Disease-Modifying Therapy (DMT)
First-line DMTs (interferon-beta, glatiramer acetate, dimethyl fumarate) reduce relapse rate by 30–50%. Higher-efficacy agents (natalizumab, fingolimod, ocrelizumab) reduce relapses by up to 80%. We initiate and monitor DMT based on MS subtype and activity.
Acute Relapse Treatment
High-dose IV or oral methylprednisolone (steroids) speeds recovery from acute relapses. Shortens the duration but does not affect long-term disability.
Symptom Management and Rehabilitation
Spasticity, fatigue, bladder problems, and pain are all managed with targeted medications and physiotherapy. Dr. Harisha (MPT) provides neurological physiotherapy for MS patients at Sri Anand.
Why Choose Sri Anand Hospital?
Treated by: Dr. Anand Karnam · DrNB (Neurology) · 12+ Years Experience · MS and Demyelinating Disease Specialist
"MS treatment in 2025 is fundamentally different from 10 years ago. We now have therapies that can effectively halt disease progression in many patients. Starting early, monitoring carefully, and adjusting treatment when needed gives the best long-term outcome."
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Sri Anand Child & Neuro Hospital · Open 24/7 · Chanda Nagar, Hyderabad