People with RRMS suffer may stay symptom-free for a period of time, only to end up with worsening symptoms when the next attack of MS hits them. New symptoms may also show up with every fresh relapse, which were not present before. The symptoms and severity of MS differs from individual to individual.
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Multiple sclerosis or MS, is an immune system disorder in which the central nervous system is affected. The antibodies produced by the immune system attack the brain and spinal cord as though they were foreign invaders. This destroys the covering of myelin on the nerves and impairs the ability of the nerves to transmit electrical impulses to the brain effectively.
Of the different types of MS, relapsing-remitting multiple sclerosis, or RRMS, is the most common one in patients of the disorder. Relapsing-remitting multiple sclerosis is a form of MS where a person goes through periods of remission interspersed with relapses. The person has phases of being healthy, followed with phases of being very ill.
What are the symptoms of relapsing-remitting multiple sclerosis?
No two individuals have the same symptoms. This is one of the reasons why doctors find it difficult to diagnose this illness at first sight. The intensity of symptoms may also differ even between individuals who have the same symptoms. The symptoms of MS may be divided broadly into two categories. These are:
1. Physical Symptoms: The common problems that occur in patients of MS include diminishing eyesight, loss of balance, poor coordination of movement of legs and arms, a sense of fatigue that lasts all day, spells of dizziness, spasms and leg cramps, to mention a few.
There may be double vision or loss of vision in one eye. Bladder inconsistency may also be a symptom, with the patients feeling urgency of urination for most of the time. Tingling sensations or numbness may occur. The feet are particularly prone to numbness.
2. Memory, Thinking and Emotions: There is a big impact on the memory and cognitive behaviour of the patient suffering from MS. Patients may find it difficult to think clearly. There may be issues with remembering things. Some may even feel depressed and anxious. Learning and remembering new things may become an issue.
Recognising certain objects or assembling things may become challenging. The patient may find it more difficult to exercise reason and logical thinking, and problem solving could become difficult. Multitasking or doing more than one thing at a time is likely to be problematic.
Relapses in multiple sclerosis
A person who is not experiencing any symptoms is in a phase of remission and may be said to have a relapse when they see a return of old symptoms and an addition of new ones for more than twenty four hours. Old symptoms may appear on different parts of the body. The average relapse lasts for about four to six weeks.
A severe relapse may require hospitalization. Mild relapses may be taken care of at home. About half the relapses fail to resolve fully, even after the severe symptoms reduce. This is because the damage caused to the nerves by the MS attack takes time to heal.
At times, damage continues to occur to the brain and spinal cord even when there are no physical symptoms being experienced by the person. In the period of remission following the relapse, some symptoms may reduce or disappear altogether.
There is no common factor governing the time and type of flare up, so it is difficult to predict relapses in individual patients. Studies in the UK have estimated that nearly 100 000 people in the country are afflicted with multiple sclerosis. The patients are primarily in their twenties and thirties, although symptoms may appear at any age. It is three times more likely to affect women than men.
Management of symptoms of multiple sclerosis
Medications are available to help reduce the number of relapses and to help deal with the resulting disabilities. Depending on the symptoms of the person, there are thirteen different types of medicines that are currently available to patients with multiple sclerosis. These can range from pills to injections which may have to be consumed daily or weekly depending on the condition of the person.
Physical therapy is used to help with the leg cramps and muscle spasms that often occur in MS. Since the symptoms are usually triggered by overheating and exertion, these patients are recommended to avoid overdoing things. Speaking with a counsellor can help patients who are struggling with the disease to keep a positive attitude and to cope with depression which is quite common among these patients.
Special attention needs to be paid to maintaining a healthy lifestyle. This may include adapting to a diet rich in omega-3 fatty acids, as these are anti-inflammatory in their action. These patients should also avoid substance abuse, including that of nicotine and alcohol. Adopting a healthier lifestyle may help reduce the number of relapses a person experiences.
Reviewed by Liji Thomas, MD.