Multiple Sclerosis (MS) is a neurologic condition that affects the central nervous system (brain and spinal cord). It is described as an immune-mediated because the body’s own immune system attacks the myelin in the central nervous system
The myelin sheath is the fatty substance that surrounds the nerve fibres and the attack of the immune system damages the nerve fibres. When this happens, the messages in the CNS are interrupted or stopped completely. Often times, the damaged areas are numerous and it causes multiple scarring which is where the name multiple sclerosis comes from. Multiple Sclerosis is sometimes characterised by periods of impairment
Causes of Multiple Sclerosis
The cause of multiple sclerosis is not yet known. There is still on-going research as scientists believe MS may be triggered by a combination of factors which are:
- Immunology. This is the study of body’s immune system and in this instance, abnormal immune response in the body’s T and B cells causes inflammation and damages the myelin.
- Epidemiology. This is the study of patterns of disease in large groups of people. Multiple sclerosis has been established to occur more frequently in female Some of the suggested epidemiology factors are geographic gradient where multiple sclerosis is shown to occur more frequently in areas farther from the equator. Also, some evidence suggests that the role of Vitamin D is important in multiple sclerosis though scientists are not yet sure how. Also, smoking increases the risk of developing multiple sclerosis and even if one develops it, stopping smoking can slow the rate of progression. Obesity especially in girls also contributes to the risk of multiple sclerosis.
- Infectious factors
- Genetic factors. Multiple sclerosis is not hereditary but there is a genetic risk that may be inherited such that it increases
After a lot of studies, scientists specialising in multiple sclerosis have established that multiple sclerosis is NOT caused by environmental allergies, exposure to household pets, exposure to heavy metals and consumption of artificial sweetener aspartame.
Types of Multiple Sclerosis in Nigeria
To better explain MS, there are four ways Multiple Sclerosis typically presents and this has been categorised as the following courses.
Clinically Isolated Syndrome (CIS)
A Clinically Isolated Syndrome (CIS) is used to describe the first time neurologic symptoms caused by inflammation and demyelination in the central nervous system (CNS) appear. To be considered a CIS, the neurologic symptoms must last at least 24 hours but that does not mean the person has MS. If an MRI is done and the person has lesions similar to those seen in MS, then chances are high the person would have another episode and be diagnosed with MS. If however, there are no lesions seen in the MRI, then the chances of developing MS is lower.
Relapsing-Remitting Multiple Sclerosis
This is when there are periods of new neurologic symptoms followed by periods of recovery which may be complete or partial. The period of new symptoms are known as relapse while those of complete recovery are known as remission. During remission, all symptoms may disappear or some may continue and become permanent however, the diseases does NOT get worse during remission. Most courses of multiple sclerosis in Nigeria and in the world follow the relapsing-remitting pattern.
Secondary Progressive Multiple Sclerosis (SPMS)
The secondary progressive multiple sclerosis follows the RRMS mentioned above. In SPMS, there is a worsening of neurologic function over time and the person would have more disability and struggle more with movement and independence over time.
Primary Progressive Multiple Sclerosis (PPMS)
PPMS is characterised by worsening neurologic function (accumulation of disability) once the symptoms start. They usually do not have episodes of relapses or remissions and about 15% of people with multiple sclerosis in Nigeria and the world follow the Primary Progressive Multiple Sclerosis (PPMS)
Symptoms of Multiple Sclerosis
The symptoms of multiple sclerosis are unpredictable and vary widely amongst the affected population. Even if two people are diagnosed to be following the same course (or types) the symptoms can vary widely between the two and the intensity may also be vastly different.
Most common symptoms of Multiple Sclerosis in Nigeria
- Numbness or tingling: Numbness in the face, body or extremities is usually the first complaint people with multiple sclerosis have before a confirmatory diagnosis is made
- Fatigue: Tiredness is a common complaint affecting up to 80% of people with MS
- Gait (Walking) Difficulty: can be caused by several factors such as spasticity, weakness, loss of balance, fatigue, sensory deficit.
- Spasticity: this can range from stiffness and involuntary and painful muscle spasms in any limb but most commonly in the legs.
- Weakness: When the muscles are not used as before, weakness sets in and this can then perpetuate into a cycle that is difficult to break and can seriously impact the level of disability a person with multiple sclerosis will have. PhysioCraft has a track record in the treatment of multiple sclerosis in Nigeria for things like this.
- Vision Problems: blurred vision, double vision, painful eye movement are usually one of the early complaints of multiple sclerosis
- Dizziness and Vertigo: sometimes people with multiple sclerosis feel light headed or like their surroundings are spinning
- Bladder Problems: Leaking, dysuria (frequent urination), incontinence, incomplete or difficulty emptying the bladder can sometimes occur in people with multiple sclerosis
- Bowel Problems: Constipation is one of the most common complaints in bowel function when people are diagnosed with multiple sclerosis. This can be managed through diet, fluid management, physical activity and medication.
- Sexual Problems: Reponses to sexual stimulation can be altered due to the affected central nervous system.
- Pain and itching: Studies have shown that more than half of people with multiple sclerosis in Nigeria (up to 55%) would have one complaint of pain or the other.
- Cognitive changes: some people start struggling with learning and remembering new information, processing incoming information, organise and problem solve, focus attention and accurately discerning the environment
- Emotional changes: living with multiple sclerosis in Nigeria can be stressful as a result of the combination of neurologic, immune and physical infrastructure changes. There can be mood swings, depression, irritability, crying which can be difficult to navigate in Nigeria.
- Depression: Clinical depression which is the most extreme form of depression can be common in people with multiple sclerosis in Nigeria and other people living with chronic conditions.
Speech Problems: There can be slurring (dysarthria) or loss of volume (dysphonia) in people with multiple sclerosis in Nigeria. It can be even more pronounced during later stages or extreme fatigue.
Swallowing Problems: Dysphagia which is difficulty swallowing can also occur as a result of weakness of the small muscles of the mouth and throat.
Tremor: this can be described as uncontrollable shaking and it can happen in different parts of the body because the part of the body responsible for movement co-ordination may be affected.
Seizures: seizures happen as a result of abnormal electrical discharge and signal in the injured part of the brain. It can happen in 2-5% of people with multiple sclerosis compared with 3% of the general population
Breathing Problems: Respiratory problems can occur if the muscles responsible for breathing become fatigued or weakened because of damage to the nerves that supply them.
Hearing Loss: A minority of people who have multiple sclerosis complain of hearing loss as even the first symptom of the disease
Secondary and Tertiary Symptoms of multiple sclerosis
Secondary symptoms are those which occur as a complication from primary symptoms listed above. For example:
- The injured nerve or brain pathway can cause bladder dysfunction (primary symptom) which in turn causes repeated urinary tract infection
- Inactivity can cause of loss of muscle tone, weakness, poor posture, reduced bone fracture and shallow breathing.
- Immobility can cause pressure sores.
Tertiary Symptoms occur as a result of the impact of
Treatment of Multiple Sclerosis in Nigeria
There are effective strategies to modify or slow the progression of multiple sclerosis because right now, Multiple Sclerosis has no cure yet.
The care and treatment of multiple sclerosis in Nigeria requires comprehensive approach where there are several healthcare professionals each contributing to the management of multiple sclerosis in Nigeria. PhysioCraft provides a one-stop location where all the members of the team can be accessed.
The goal of treatment of Multiple Sclerosis in Nigeria at PhysioCraft is as follows:
- Modify the disease course where medications are prescribed by the neurologist to reduce the frequency and severity of relapses
- Treat exacerbation: Exacerbation can be mild or severe enough to interfere with a person’s ability to function and it is often caused by inflammation in the central nervous system.
- Managing Symptoms: The damage to the nerve and the resulting disruption in body functions, management involves the medications and rehabilitation or modifications that would make things easier.
- Encouraging Function: During all stages and all courses of multiple sclerosis, focus of care emphasises function. To enable you be as independent as possible and to engage productively at work, school or at home.
- Providing emotional support: Asides medications and physical rehabilitation, emotional and mental support during the journey of multiple sclerosis is also important and a goal for treatment at PhysioCraft for treatment of Multiple Sclerosis in Nigeria.
Rehabilitation Treatment of Multiple Sclerosis in Nigeria
There are multiple professionals involved in the treatment of multiple sclerosis in Nigeria. Below are the members of the healthcare team we have at PhysioCraft who support you during the journey of treatment of multiple sclerosis.
Neurologist: A neurologist is a physician who specialises in the treatment of brain, spinal cord and nerves pathologies which affects a person’s movement. A neurologist would typically prescribe the medications and work with you to determine the course of treatment best suitable in this journey of treatment of multiple sclerosis in Nigeria.
Physiotherapist: A physio examines and helps the body ability to move and function. Emphasis is often placed on walking, mobility, strength, balance, posture, fatigue and pain. PhysioCraft treatment of Multiple sclerosis in Nigeria consists of exercise programes, gait training, walking education, provision of mobility aids and any other devices. Physiotherapy focuses on maintaining independence, safety, preventing de-conditioning and secondary complications discussed here
Occupational Therapy: They are specialists who provide training in energy conservation techniques and use of adaptive tools to make everyday tasks simpler. They also work with physiotherapist to modify your home and work place to ensure safety and accessibility. Occupational therapist in Nigeria also help with thinking and memory problems
Speech-Language Pathology: They work with any difficulty having to do with speech or swallowing while on this journey of Multiple Sclerosis. Working with occupational therapists, they also help with problems relating to information processing, thinking and memory.
Psychologist: Emotional support, family support, coping strategies are a few of the things our clinical psychologist at PhysioCraft helps with during treatment of multiple sclerosis in Nigeria.
Complementary and alternative treatment of multiple sclerosis in Nigeria.
Asides from the route of regulatory approved medications and rehabilitation care for MS, some people want to try other types of intervention such as acupuncture, massage, diet and food and stress management. While we are not opposed to these, at PhysioCraft we encourage an integrated approach and want you to discuss all types of therapy you want to try but have to be careful so that people are not taking advantage of you. Many people make all sorts of claims which have no proof. We have a few complementary providers that we are happy to recommend during your journey with us. There are also guidelines about CAM therapy which we encourage you to read here
Prognosis of Multiple Sclerosis in Nigeria.
Global research has shown that people diagnosed with multiple sclerosis can have a good quality of life and expect to live long healthy lives depending on the type of medical help they receive. There are occasions when people diagnosed with multiple sclerosis do not seek help and isolate themselves from the society and this can lead to more complications making simple everyday tasks very difficult and energy consuming. This then leads to a lot of stress for the person and family members and makes the matter even more challenging.
Also, people are sometimes afraid and not sure of what to expect. At PhysioCraft we walk with you during the process and provide one-on-one care to make the client victorious. We understand the complexities of dealing with chronic conditions in Nigeria
Call us now to inquire about how we can support you during your journey with multiple sclerosis in Nigeria. Lagos: +2348171940921 Abuja: +2348188086900
image sources: shutterstock, national MS society