| Multiple Sclerosis (abbreviated MS,
also known as disseminated sclerosis or encephalomyelitis
disseminata) is a chronic inflammotory demyelinating disease.
that affects the central nervous system(CNS).
Multiple sclerosis (MS) is a nervous system disease that affects
your brain and spinal cord. It damages the myelin sheath, the material
that surrounds and protects your nerve cells.
Signs and Symptoms of Multiple Sclerosis
This damage slows down or blocks messages between the brain and
body, leading to the symptoms of MS. MS can cause a variety of symptoms
including-
- Changes in sensation (in arms, legs or face). Sensations such
as numbness, prickling, or "pins and needles"
- Visual
problems (complete or partial vision loss and double vision)—optic
neuritis, nystagmus or diplopia.
- Muscle
weakness.
- Depression,thinking and memory disturbances.
- Difficulties with coordination and speech.
- Severe
fatigue.
- Cognitive
impairment.
- Problems
with balance (ataxia).
- Overheating,
and pain.
- Bladder
and bowel difficulties.
- Impaired
mobility and disability in more severe cases.
The initial attacks are often transient , mild(asymptomatic) and
self limited. The atacks are generally preceeded by infection, trauma
or sternous physical activities.
Multiple sclerosis affects neurons, the cells of the brain and
spinal cord that carry information, create thought and perception,
and allow the brain to control the body. Surrounding and protecting
some of these neurons is a fatty layer known as the myelin sheath,
which helps neurons carry electrical signals. MS causes gradual
destruction of myelin sheath (demyelination) and transection of
neuron axons in patches throughout the brain and spinal cord. The
name multiple sclerosis refers to the multiple scars (or
scleroses) on the myelin sheaths. This scarring causes symptoms
which vary widely depending upon which signals are interrupted.
The predominant theory today is that MS results from attacks by
an individual's immune system on the nervous system and
it is therefore usually categorized as an autoimmune disease.
There is a minority view that MS is not an autoimmune disease, but
rather a metabolically dependent neurodegenerative disease. Although
much is known about how MS causes damage, its exact cause remains
unknown.
Causes of Multiple Sclerosis
Although
many risk factors have been identified but no definite cause has
been found. MS most likely occurs as a result of combination of
both environmental and genetic factors.Some accept autoimmune expalnations
too.
Environmental
The
most popular hypothesis is that a viral infection or retroviral
reactivation primes a susceptible immune system for an abnormal
reaction later in life.
Since it seems to be more common in people who live farther from
the equator, another theory proposes that decreased sunlight exposure
and so decreased Vit – D production may help causing it.
An imbalance
between Th1 type of helper T- cells which fight infection , and
the Th2 type,which are more active in allergy and more likely to
atack the body provides other explanation.
Other
theories describe MS as an immune response to a chronic infection.The
association of MS with the Epstein-Barr virus suggests a potential
viral contribution.Chlamydophila and Spirochetal bacterias are often
found in association.
Severe stress may be a contributing factor.
Smoking has been shown to be an independent risk factor for developing
MS.
Genetic
MS is
not considered a hereditary disease . But scientiic evidence suggests
that genetics play a determining role in a person’s susceptibility
to MS. In a population at large , the chance of developing MS is
less then a tenth of one percent. However if one person in the family
has MS , that person,s first degree relatives – parents , children
and siblings – have a one to three percent chance of developing
it.
Studies
of families with multiple cases of MS and research comparing proteins
expressed in humans with MS to those of mice suggests that an area
related to MS susceptibility may be located on Chromosome 5. Other
regions on chromosomes 2 , 3 , 7 , 11, 17 , 19, and X have been
identified as possibly containing genes involved in the development
of MS.
These
studies strengthen the theory that MS is the result of a number
of factors rather then a single gene or other agent. Development
of MS is likely to be influenced by the interactions of a number
of genes, each of which (individually) has a modest effect. Additional
studies are needed to specifically pin point which genes are involved.
Disease sub-types of MS
The course is difficult to predict and the disease may at times
either lie dormant or progress steadily. Several sub types , or,
paterns of progression have been described.
Sub-types
use the past course of the disease in an attempt to predict the
future course.
Following four sub types are identified:
1) Relapsing – remitting
It describes the initial course of 85 – 90 % of individuals
with MS. It is characterised by unpredictable attacks (relapses
) followed by periods of months to years of relative quiet (remission
)with no new signs of disease activity. Deficits suffered during
may either resolve or may be permanent . When deficits always resolve
between attacks , this is referred to as benign .
2) Secondary progressive
Secondary progressive describes around 80% of those with initial
relapsing – remitting MS,who then begin to have neurologic decline
between their acute attacks without any definite periods of remission.
This decline may include new neurologic symptoms , worsening cognitive
function, or other deficits. Secondary progressive is the most common
type of MS and causes the greatest amount of disability.
3) Primary progressive
It describes the approximately 10 % of individuals who never have
remission after their initial MS symptoms . Decline occurs continously
without clear attacks. The primary progressive sub type tends to
affect people who are older at disease onset.
4) Progressive relapsing
It describes those individuals who , from the onset of their
MS have a steady neurologic decline but also suffer superimposed
attacks and is one of the less common types.
Factors triggering a relapse
Multiple sclerosis relapses are often unpredictable
and can occur without warning with no obvious precipitating factors.
Some attacks are however preeceded by common triggers. In general
, relapses occur more frequently during spring and summer than during
autumn and winter.Infections such as common cold , influenza and
gastroenteritis increase the risk of the relapse.
Emoitional and physical stress may also trigger an atack. Stastistically
there is no good evidence that either trauma or surgery trigger
the relapses.People with MS can participate in sports but they should
avoid extremely sternous exertion as heat can increase symptoms..This
is known as Uhthoff’s phenomena.This is why some people avoid saunas
or even hot showers if suffering from MS.
Pregnancy can directly affect the susceptibility for
relapse. The last three months of pregnancy offer a natural protection
against relapses. However during the first few months after delivery
,the risk for a relapse is increased 20 % - 40 % .Pregnancy does
not seem to influence long term disability . Children born to mothers
with MS are not at increased risk for birth defects or other problems.
Prognosis of Multiple Sclerosis
For a person with multiple sclerosis the prognosis
depends on the sub type of disease , the individual’s sex , race
, age and initial symptoms.; and the degree of disability the person
experiences.The life expectancy is high due to improved methods
of limiting disability like physical therapy , occupational therapy
and speech therapy.
Individuals with progressive sub types , particularly
primary progressive have a more rapid decline of functions. In the
primary progressive subtype , supportive equipment as wheel chair
or standing frame is often needed.
The earlier in life MS occurs , the slower disability
progresses.Individuals who are older than fifty when diagnosed are
more likely to experience a chronic progressive course.
Those diagnosed before age 35 have the best prognosis.
Females generally have beter prognosis than males.
Initial MS symptoms of visual loss or sensory problems
such as numbness or tingling are markers for a relatively good prognosis
but difficult walking and weakness are signs of poor outcome.
Diagnosis of Multiple Sclerosis
Currently there are no clinically established laboratory
investigations available that can predict prognosis or response
to treatment. However some promising approaches have been proposed.
These include measurement of the two antibodies anti-myelin oligodendrocyte
glycoprotein and anti-myelin basic protein .
In addition to a complete medical history and physical examination,
a neurological examination, your doctor may order blood tests and
refer you to a neurologist (a doctor with specialized training
in diseases of the nervous system). Your doctor may also order an
MRI scan of your brain and/or spinal cord to look for the characteristic
patches of MS and may perform a lumbar puncture ("spinal
tap")—sampling of the cerebrospinal fluid (the fluid
that surrounds the brain and spinal cord)—to analyze for proteins
associated with the disease.
Treatment for Multiple Sclerosis
Currently there is no cure for MS in conventional medicine. However,
there are treatments available that may slow its progression
and alleviate associated symptoms. Some cures are
reported in alternative medicine literature.
Drug therapies—Medications that target the body's immune system
may decrease the frequency and duration of attacks. These medications
can be used on a long-term basis and also to treat specific
attacks. Additional medications may be prescribed for other
symptoms, such as pain or depression.
Additional therapies—Because MS may affect the patient's
ability to perform self-care and other activities
of daily living, treatment may also include referral
to specialists for physical and occupational therapy
Many patients do well with no therapy at all, especially since
many medications have serious side effects and some carry significant
risks. However, three forms of beta interferon (Avonex, Betaseron,
and Rebif) have now been approved by the Food and Drug Administration
for treatment of relapsing-remitting MS.
Beta interferon has been shown to reduce the number of exacerbations
and may slow the progression of physical disability. When attacks
do occur, they tend to be shorter and less severe.
The FDA also has approved a synthetic form of myelin basic protein,
called copolymer I (Copaxone), for the treatment of relapsing-remitting
MS. Copolymer I has few side effects, and studies indicate that
the agent can reduce the relapse rate by almost one third. An immunosuppressant
treatment, Novantrone (mitoxantrone), is approved by the FDA
for the treatment of advanced or chronic MS.
While steroids do not affect the course of MS over time, they can
reduce the duration and severity of attacks in some patients.
Spasticity, which can occur either as a sustained stiffness caused
by increased muscle tone or as spasms that come and go, is usually
treated with muscle relaxants and tranquilizers such as baclofen,
tizanidine, diazepam, clonazepam, and dantrolene.
Physical therapy and exercise can help preserve remaining
function, and patients may find that various aids -- such as foot
braces, canes, and walkers -- can help them remain independent
and mobile. Avoiding excessive activity and avoiding heat
are probably the most important measures patients can take to counter
physiological fatigue.
If psychological symptoms of fatigue such as depression or apathy
are evident, antidepressant medications may help. Other drugs
that may reduce fatigue in some, but not all, patients include amantadine
(Symmetrel), pemoline (Cylert), and the still-experimental drug
aminopyridine. Although improvement of optic symptoms usually occurs
even without treatment, a short course of treatment with intravenous
methylprednisolone (Solu-Medrol) Followed by treatment with oral
steroids is sometimes used.
Main conventional drugs used are -
Avonex.
Betaseron.
Betaferon.
Copaxone.
Rebif.
Main side effects of these drugs:
A) Avonex
Anaphylaxis.
Autoimmune disorders.
Cardiomyopathy.
Congestive heart failure.
B) Rebif
Anaphylaxis.
Autoimmune disorders.
Depression and suicide.
Flu like symptoms.
Hepatic injury.
Hepatitis.
Injection site reactions.
Pregnancy.
Psychiatric disorders.
Seizures.
Thyroid malfunctions.
C) Copaxone
Adverse effects.
Anaphylaxis.
Flu like reactions.
Menstruation and abnormal bleeding.
Seizures.
Decreased peripheral blood counts.
D) Betaseron
Renal and urogenital dysfunctions.
Homeopathic Treatment
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.
Reportorial rubric:
Boericke – Nervous system {Degeneration-Sclerosis-multiple}
Homeopathic Remedies
Causticum, Gelsemium,
Natrum-mur, Phosphorus, Arg-n, Con,, Plumbum, ,
Cann-ind , Nux-vom , Ox – ac , Sulph , Tarent, Zinc.
Materia medica
Causticum-
Multiple
sclerosis with chronic paralytic affections indicated by tearing,
drawing pains and severe weakness. Local paralysis, paralysis of
vocal cords, tongue, eyelids, face, bladder and extremities. Paralysis
of single parts of extremities with dull, tearing pains and
loss of sensation. Impaired vision with sparks and dark spots
before eyes. Ptosis and paralysis of extra ocular muscles
after exposure to cold. Restless legs at night with weak ankles.
Better by warmth especially heat of bed. Paralysis of bladder with
involuntary urination on sneezing and coughing. Expelled sometimes
very slowly or sometimes retained.
Gelsemium
It centers its action on nervous system and brain and thus causes
varying degrees of motor paralysis. General prostration with dizziness,
dullness, trembling and drowsiness. Paralysis of various
groups of muscles about eyes, throat, larynx, extremities etc. Muscular
weakness and complete relaxation. Lack of muscular co-ordination.
Ptosis, eyelids heavy, patient can hardly open them with
double vision. Vision blurred and smoky. Dim sighted with orbital
neuralgia. Cramps in muscles with profuse, clear, watery urine and
chilliness and tremulousness. Partial paralysis of bladder.
Oxalic acid
Multiple cerebral and posterior spinal sclerosis. Lancinating,
shooting and jerking pains in various parts. Myelitis. Muscular
prostration. Numb, weak and tingling sensation. Backache with numbness.
Muscular prostration. It causes multiple sclerosis and thus results
in motor paralysis with pains very violent and in small spots
worse motion and thinking about them. Periodical complains
with numbness and tingling. Drawing and lancinating pains shooting
down the extremities.
Phosphorus
Produces softening and atrophy of brain and spinal cord causing
marked prostration and trembling, numbness with complete paralysis
– locomotor ataxia. Ascending sensory and motor paralysis from ends
of fingers and toes. Weakness and trembling from every exertion.
Arms and hands become numb. Can scarcely hold anything. Great susceptibility
to external impressions as light, sound, touch, thunders. Black
points seem to float before the eyes. Fatigue of eyes and head
with hands. Green halo about candlelight. Paresis of extrinsic muscles.
Degenerative changes where soreness and curved lines are seen in
old people. Ascending sensory and motor paralysis.
Natrum muriaticum
Multiple sclerosis with painful contractions of hamstrings.
Ankles weak and turn easily. Coldness of legs with congestion of
head, chest and stomach. Eyes feel bruised and headache in school
children. Eyelids heavy. Muscles weak and stiff. Letters
run together. Sees sparks. Fiery zigzag lines running. Asthenopia
due to insufficiency of internal recti muscles. Emaciated patient
with great weakness and emaciation. Oversensitive to all impressions.
Psychic causes of diseases and ill effects of grief, fright and
anger. Consolation aggravates.
Argentum nitricum
The neurotic effects in this drug are very marked, many brain
and spinal symptoms are present. Symptoms of inco-ordination,
loss of control and want of balance every where. Trembling
in affected parts with great desire for sweets. Splinter like pains
and free muco-purulent discharge in the inflamed and ulcerated mucus
membrane. Sensation as if parts are expanding with inability to
keep eyes fixed on an object. Spots before eyes. Eye strain from
sewing worse in warm room. Blurred vision. Cannot walk with eyes
closed. Trembling with general debility. Paralysis with mental symptoms.
Rigidity and debility of calves. Walks and stands up UN steadily.
Worse warmth, night, cold food, eating, emotions.
Better eructation, fresh air, cold and pressure.
Conium
It is an excellent remedy for old age problems of weakness, languor,
local congestions and loss of strength where difficult gait, trembling
and painful stiffness of legs are often found. It corresponds to
debility, urinary troubles, weakened memory and eye troubles. Eyes
– dim sighted worse artificial lights. Paralysis of ocular muscles.
Heavy, weary, paralyzed and trembling unsteady hands. Numbness of
toes and fingers.
Worse – lying down, turning or rising in bed, cold, body or mental
exertion.
Better - fasting, darkness, letting limbs hang down, motion and
pressure.
Plumbum metallicum
This is a great drug for sclerotic conditions causes paralysis chiefly
of extensor, forearm or upper limb from centre to periphery with
partial anesthesia or excessive hyperesthesia preceded by pain.
Localized neuralgic pains with neuritis. Infantile paralysis and
progressive muscular atrophy. Contractions and boring pains. Eyes
– sudden loss of sight after fainting. Paralysis of single muscles.
Cannot raise arms, can’t lift anything. Extension is difficult.
Paralysis from overexertion of extensor muscles in piano players.Locomotor
ataxia.
Cannabis indica
It inhibits higher faculties and stimulates the imagination to
a remarkable degree. Multiple sclerosis with typical mental symptoms
of exaggeration of duration of time and extent of space. Very forgetful
and sensation as if top of head were opening and closing. Shocks
through brain. Involuntary shaking of head. Eyes – fixed, letters
run together when reading. Spectral illusions without terror. Pain
across shoulder and spine, must stoop. Entire paralysis of
lower limbs. Pain in soles and calves. Sharp pains in knees
and ankles. Very exhausted after a short walk.
Nux vomica
Nux is chiefly suited to people with zealous, fiery, quick, nervous,
irritable, spare, thin, intelligent temperament. It causes convulsions
with consciousness worse by touch and motion. Nux patients are
easily and chilled, avoid open air. Multiple sclerosis with vertigo
and momentary loss of consciousness. Scalp sensitive and frontal
headache. Eyes – Photophobia worse in morning. Optic nerve
atrophy and infra orbital neuralgia. Irritable bladder with spasmodic
sphincter. Bad effects of sexual excess. Skin – Burning hot
especially faces yet cannot move or uncover without feeling chilly.
Constipation with frequent ineffectual urging, incomplete and
unsatisfactory, feeling as if part remained unexpelled.
Worse – morning, mental exertion, eating, touch, stimulants, dry
cold weather.
Better – evening, rest, damp wet weather.
Zincum mettalicum
It provides a picture of typical cerebral depression. The
word Fag covers a large part of its action. Defective vitality
and impending brain paralysis. Spinal affections. Convulsions with
pale face and no heat. Marked anemia with profound prostration.
Very sensitive to noises and averse to talk. As if head would
fall to left side. Forehead cool but base of brain hot. Bores
head in pillow. Eyes – Ptosis. Squint. Rolling of eyes. Blurring
of half a vision. Lameness, weakness, trembling and twitching of
various muscles. Feet in continued moion.Cannot keep them still.
Convulsions. Transverse pains.
Worse – at menses, touch, 5-7 pm, after dinner.
Better – eating, discharges and appearance of eruptions.
Tarentula Hispania
Remarkable nervous phenomena, hysteria and chlorosis. Bladder tenesmus.Extreme
restlessness, must keep in constant motion even though walking aggravates.
Destructive impulses with moral relaxation. Sensitive to music.
Weakness of legs. Numbness of legs. Multiple sclerosis with trembling.
Twitching and jerkings.Extraordinary contractions and movements.
Worse – motion, contact, noise.
Better – open air, rubbing.
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