Basic Principles Concerning MS Prevention

By Andrea Davidson


Multiple sclerosis is an inflammatory disease of the brain and spinal cord, affecting the protective cover (myelin sheath) of nerve cells. It is also known as encephalomyelitis disseminata or disseminated sclerosis. The damage alters the function of part of the nervous system resulting in a diversity of signs and symptoms including both physical and mental problems. The symptoms may either resolve completely or they may give rise to permanent neurological impairment. MS prevention is still yet to be fully defined since the causes of this chronic disease have not been clearly understood.

The aetiology is believed to be a combination of both environmental and genetic factors. A number of genetic variations have been found in the individuals affected with the condition. Relatives of affected individuals have an increased risk of getting the condition. The closer one is to the affected individual, the higher the chances. Identical twins are said to be at the highest risk of suffering from the disorder if one of them is affected. These are followed by fraternal twins and siblings.

Microbial infection has also been implicated as an aetiological factor in MS. Two hypotheses have been developed to back the theory; hygiene hypothesis and prevalence hypothesis. With hygiene, disease presents after a secondary exposure to a given agent with primary contact being protective. In the case of prevalence, the disease is as a result of a microbe more common in areas where MS is outstanding with no symptom manifestation. Certain viral infections have been associated with MS including herpes, Epstein Bar Virus, mumps and measles.

A number of lifestyle behaviors are thought to help in the propagation of the condition. Doctors say that modifying these unhealthy habits will significantly lower the risk. They include, among others, smoking, stress, diet, occupational factors (exposure to toxins), vaccination and hormone intake.

Pathologically, there are three main features of MS including formation of lesions, inflammation and damage to myelin sheaths. Interaction of these characteristics results in breakdown of nervous tissue and hence physical manifestation of signs and symptoms. Damage is also believed to be caused by an autoimmune reaction in the body.

Four main clinical courses exist. These are the progressive relapsing, the relapsing remitting, and the primary and secondary progressive. All have varying features and varying degrees of severity. The secondary progressive is the commonest and affects about 65% of individuals with the disease. The relapsing remitting is characterized by recurrence after treatment.

The priority after an episode of CNS attack should be to rehabilitate the affected individual and to prevent secondary attacks. Disability should be prevented if possible. Interferon beta and glatiramer are two drugs that have become very useful in the control of progression. There is a strong recommendation for prompt treatment of infections as these are a significant risk factor.

High temperatures have been found to be an exacerbating factor in these patients. They accelerate the deterioration of the nervous system especially for the components that have already been affected. It is recommended, therefore, that affected individuals use air conditioners whenever possible. They should avoid using hot tubs or hot swimming pools. As can be seen in all these situations, all MS prevention strategies revolve around avoidance of exacerbating factors.




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