And the beat goes on: there is life after multiple sclerosis

Ingy Deif, Wednesday 2 Nov 2011

Life is still life, even after being diagnosed with multiple sclerosis, says a modern day wonder woman and a doctor who lists MS treatment to Ahram Online

multiple sclorosis

"It took me a while, a short term of denial until I fully accepted that some lifestyle changes should be taken into consideration and alteration to my career. However, I am still the same person: I still have the same love for life and enthusiasm to live it to the fullest," says Mrs Iman Hammad, a 39 year-old mother of two and marketing expert.

She gladly shared with Ahram Online her experience."I first experienced tremours four years ago and paid no attention until the attacks became stronger. I was then diagnosed by neurologist by multiple sclerosis," she says, "at the beginning I thought my life was drawing to an end, but after a while I realised that I'm the same person and I still have a life that ought to be lived. Since then, armed with awareness, I began conveying the message of living within these guidelines:

·         Taking the medication as prescribed by the physician.

·         Not exposing oneself to a lot of stress.

·         Maintaining a healthy diet rich in vitamin D.

·         Keeping a positive attitude and perspective on life.


Towards a deeper understanding

Multiple sclerosis had been an issue kept in the dark for long, and time has come to shed more light on the outline of such a condition."

Multiple sclerosis (MS) is an autoimmune disease that involves the brain and spinal cord," says Dr Ahmed AbdelAlim, assistant professor of neurology, Cairo University,

"It attacks the fast conducting sheath that covers the nerve tracts, causing damage to the brain or spinal cord and impaired function of the damaged area. So far, the cause of MS remains unknown. Current knowledge suggests a combination of genetic and environmental factors (e.g. viral infection) to cause the disease. It affects young adults, especially females in childbearing ages.

Its prevalence varies according to geographic distribution and race. The most susceptible are white Caucasians and inhabitants of Europe and North America and the least are Asians and Blacks.

MS has no specific symptoms and may be frequently either misdiagnosed or accidentally diagnosed. Its course is characterised by attacks or 'relapses' followed by spontaneous, incomplete improvement or 'remission' and, hence, it has been named 'relapsing remitting MS.' Where or when the next attack will be is something that cannot be predicted.

About 85 per cent of MS starts in a relapsing fashion and may later change to a progressive form named 'secondary progressive MS.' MS commonly starts with visual and sensory symptoms but may involve any part of the brain or spinal cord."


Steps towards diagnosis

Furthermore, Dr Abdel Alim stresses that the diagnosis of MS depends basically on clinical suspicion and confirmed by many tests:

"The gold standard of the diagnosis of MS is the magnetic resonance imaging (MRI), which shows the areas of inflammation caused by MS or 'plaques' and helps to differentiate old from new lesions," he says. "

Other tests include laboratory test to confirm MS as the cerebrospinal fluid examination and others to exclude other autoimmune diseases. Another modality of diagnosis is the Visual evoked potential, which detects the slow velocity of conduction of nerve tracts caused by MS."


Treatment and prevention

Dr Abdel Alim pinpoints the methods of tackling the issue and lifestyle alterations that help in prevention as follows:

"Current treatment of MS includes an integrated programme of management and follow-up that includes medical treatment and rehabilitation.

Medical treatment is given in two occasions; first if a relapse occurs, in which a large dose of steroids is given as soon as possible; and second, in between relapses to prevent further attacks," he says.

"These preventive measures include drugs that modify immunity, such as beta interferon, which is so far the first-line for prevention and other more recent drugs and drugs under trials.

Immunosuppressant drugs are only given in severe aggressive disease courses.

Stem cell therapy is so far under trial and is not given routinely and is given only in specialised centres under a protocol of an experiment.

Rehabilitation is important to improve the patients’ quality of life and functional impairment caused by permanent damage. Lifestyle modification may be helpful through a healthy, low-fat diet, healthy sleep and avoidance of stress.

Vitamin D supplements have been shown to be helpful. Such an integrated management programme and early diagnosis allows MS patients to live a normal live. Current research carries great hopes that MS could be completely cured someday."

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