Disease Info

Fibromyalgia

Multiple sclerosis (MS) is a disease in which the nerves of the central nervous system (brain and spinal cord) degenerate. Myelin (fatty substance that surrounds and protects the nerve fibres in the central nervous system), which provides a covering or insulation for nerves, improves the conduction of impulses along the nerves and also is important for maintaining the health of the nerves. In multiple sclerosis, inflammation causes the myelin to disappear. Consequently, the electrical impulses that travel along the nerves decelerate, that is, become slower. In addition, the nerves themselves are damaged. As more and more nerves are affected, a person experiences a progressive interference with functions that are controlled by the nervous system such as vision, speech, walking, writing, and memory.

Globally, the median estimated prevalence of MS is 30 per 100 000. Usually, a person is diagnosed with multiple sclerosis between 20 and 50 years of age, but multiple sclerosis has been diagnosed in children and in the elderly. Multiple sclerosis is twice as likely to occur in Caucasians as in any other group. Women are twice as likely as men to be affected by multiple sclerosis earlier in life. Symptoms may be mild, such as numbness in the limbs, or severe, such as paralysis or loss of vision. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another.

The Four Courses of MS

People with MS can typically experience one of four disease courses, each of which might be mild, moderate, or severe.

• Relapsing-Remitting MS
  People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks which are called relapses, flare-ups, or exacerbations are followed by partial or complete recovery periods (remissions), during which no disease progression occurs. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
• Primary-Progressive MS
  This disease course is characterized by slowly worsening neurologic function from the beginning with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
• Secondary-Progressive MS
  Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before the disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years.
• Progressive-Relapsing MS
  In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.

Since no two people have exactly the same experience of MS, the disease course may look very different from one person to another. And, it may not always be clear to the physician at least right away which course a person is experiencing.

Causes

The healthy body's immune system normally defends the body from attack by viruses or bacteria. But in the case of MS, the body's immune system attacks its own myelin, causing disruption to nerve transmission. It is thought that genetic and environmental factors are involved - but the actual trigger to the disease has not yet been discovered. Symptoms result when inflammation and breakdown occur in myelin, the protective insulation surrounding the nerve fibres of the central nervous system (brain and spinal cord). Myelin is destroyed and replaced by scars of hardened "sclerotic" patches of tissue. Such lesions are called "plaques," and appear in "multiple" places within the central nervous system. This can be compared to a loss of insulating material around an electrical wire, which interferes with the transmission of signals.

The risk of developing the disease seems to be genetic, and may also be related to environmental and climatic factors. One study shows that MS attacks in a group of people seemed to occur most often in March in the northern hemisphere. MS is more common in women than in men. In Ayurveda, this condition is seen as an energy disorder of the body. Improper digestion and assimilation of food leads to the formation of toxins and their accumulation in the body. These toxins cause blockages and obstruct the movement of certain body energies, resulting in neuro-muscular disorders.

Symptoms

Symptoms vary, because the location and severity of each attack can be different. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions). Fever, hot baths, sun exposure, and stress can trigger or worsen attacks. It is common for the disease to return (relapse). However, the disease may continue to get worse without periods of remission Because nerves in any part of the brain or spinal cord may be damaged, patients with multiple sclerosis can have symptoms in many parts of the body. The most common symptoms are:

Muscle symptoms

• Loss of balance
• Muscle spasms
• Numbness or abnormal sensation in any area
• Problems moving arms or legs
• Problems walking
• Problems with coordination and making small movements
• Tremor in one or more arms or legs
• Weakness in one or more arms or legs

Problems with gait (difficulty in walking) are among the most common mobility limitations in MS.

Numbness, tingling, or pain

• Facial pain
• Painful muscle spasms
• Tingling, crawling, or burning feeling in the arms and legs

Numbness of the face, body, or extremities (arms and legs) is one of the most common symptoms of MS, and is often the first symptom experienced by those eventually diagnosed as having MS.

Pain syndromes are common in MS.In one study, 55% of people with MS had "clinically significant pain" at some time. Almost half were troubled by chronic pain

Other brain and nerve symptoms

• Decreased attention span, poor judgment, and memory loss
• Difficulty reasoning and solving problems
• Depression or feelings of sadness: Depression is common during the course of multiple sclerosis. In fact, studies have suggested that clinical depression, the severest form of depression, is more frequent among people with MS than it is in the general population or in persons with other chronic, disabling conditions
• Dizziness and vertigo (balance) problems
• Hearing loss

Sexual symptoms

• Problems with erections
• Problems with vaginal lubrication

Sexual problems are often experienced by people with MS, but they are very common in the general population as well. Sexual arousal begins in the central nervous system, as the brain sends messages to the sexual organs along nerves running through the spinal cord. If MS damages these nerve pathways, sexual response-including arousal and orgasm-can be directly affected. Sexual problems also stem from MS symptoms such as fatigue or spasticity, as well as from psychological factors relating to self-esteem and mood changes.

Fatigue
Fatigue is one of the most common symptoms of MS, occurring in about 80% of people. Fatigue can significantly interfere with a person's ability to function at home and at work, and may be the most prominent symptom in a person who otherwise has minimal activity limitations. It is often worse in the late afternoon

Cognitive Dysfunction

• Decreased concentration
• Attention deficits
• Some degree of memory loss
• Inability to perform sequential tasks, or
• Impairment in judgment

Approximately 50% of people with MS will develop problems with cognition.

Emotional Changes
Emotional changes are very common in MS as a reaction to the stresses of living with a chronic, unpredictable illness and because of neurologic and immune changes caused by the disease. Bouts of severe depression (which is different from the healthy grieving that needs to occur in the face of losses and changes caused by MS), mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their family members.

Spasticity
Spasticity refers to feelings of stiffness and a wide range of involuntary muscle spasms (sustained muscle contractions or sudden movements). It is one of the more common symptoms of MS. Spasticity may be as mild as the feeling of tightness of muscles or may be so severe as to produce painful, uncontrollable spasms of extremities, usually of the legs. Spasticity may also produce feelings of pain or tightness in and around joints, and can cause low back pain. Although spasticity can occur in any limb, it is much more common in the legs

Less Common Symptoms

Speech and swallowing symptoms

• Slurred or difficult-to-understand speech
  Speech and voice problems occur in approximately 25-40 percent of people with MS, particularly during relapses or periods of extreme fatigue. The problems are of two types dysarthria refers to changes in the production of speech, including slurring, unclear articulation of words, and difficulty controlling loudness; dysphonia is the term used for changes in voice quality, including hoarseness, breathiness, nasality, poor control of pitch
• Trouble chewing and swallowing
  Swallowing problems referred to as dysphagia result from damage to the nerves controlling the many small muscles in the mouth and throat. When dysphagia occurs, food and liquids can pass into the airway and lungs, causing the person to cough and choke. Because particles that remain in the lungs can cause aspiration pneumonia a serious complication of MS prompt evaluation and treatment by a speech/language pathologist are essential.

Headache
Although headache is not a common symptom of MS, some reports suggest that people with MS have an increased incidence of certain types of headache.

Hearing Loss
Hearing loss is an uncommon symptom of MS. About 6% of people who have MS complain of impaired hearing. In very rare cases, hearing loss has been reported as the first symptom of the disease. Deafness due to MS is exceedingly rare, and most acute episodes of hearing deficit caused by MS tend to improve.

Seizures
Seizures, which are the result of abnormal electrical discharges in an injured or scarred area of the brain, are fairly uncommon among people with MS. Their incidence has been estimated at 2% to 5%, compared to the estimated 3% incidence of seizures in the general population.

Tremor
Many people with MS experience some degree of tremor, or uncontrollable shaking. It can occur in various parts of the body.

Respiration / Breathing Problems
Respiration problems occur in people whose chest muscles have been severely weakened by damage to the nerves that control those muscles. Aspiration pneumonia (resulting from the food particles and/or liquids passing into the lungs) can also make breathing more difficult. Breathing problems, which can contribute to MS-related fatigue and interfere with speech and voice production, should be evaluated and treated by nurses or rehabilitation professionals with expertise in respiratory problems.

Itching
Pruritis (itching) may occur as a symptom of MS. It is one of the family of abnormal sensations such as "pins and needles" and burning, stabbing, or tearing pains which may be experienced by people with MS. These sensations are known as dysesthesias, and they are neurologic in origin.

Heat sensitivity
Heat sensitivity (the appearance or worsening of symptoms when exposed to heat, like a hot shower) occurs in most people with MS.

Diet

Multiple Sclerosis can be aggravated because of improper diet. Some foods can make Vata extremely active and exacerbate multiple sclerosis symptoms. Therefore, a diet of fruit and vegetables is advised as part of ayurvedic remedy for multiple sclerosis.

• Avoid gluten rigidly. You should avoid all use of wheat, barley, oats and rye, all of which contain gluten, and this includes foods made from or containing these grains or the gluten from them. Opt for basmati rice, instead.
• Green Tea has a huge potential in the prevention and treatment of neuro-degenerative diseases. A major component of green tea is epigallocatechnin-3-gallate (or ECGG). This has been found to inhibit T cells- immune cells that attack their own tissue
• Eliminate refined sugar
• Avoid animal fats. Switch to fish and seafood instead.
• Avoid all dairy products and margarine.
• Avoid caffeine, alcohol and smoking.
• Use olive oil or coconut oil for cooking and salads.
• Whenever possible eat foods as fresh as possible, not refrigerated or frozen.
• Eat raw vegetables, such as shredded cabbage, raw grated carrots and beetroot
• Eat lots of dark green leafy salads, legumes, nuts, seeds and fresh fruits.

Ayurvedic Treatment for Multiple Sclerosis

The specific goals of the ayurvedic therapies are:

• Controlling the progression of MS
• Enabling the patient to lead a normal life
• Slow and stable recovery from MS

The Ayurvedic treatment of MS is aimed at treating the basic pathology of the disease, reducing the number of attacks, improving recovery from attacks, halting or slowing down the progression of the disease, and treating immune dysfunction. The treatment involves the removal of toxins and restoration of digestive fire with the use of herbal remedy. Proper diet and lifestyle changes are also recommended in addition to herbal concoctions to ensure proper functioning of the nervous system. Elimination of the toxins from the tissues and prevention of the toxins from being accumulated through improvements in metabolism and digestion is the main aim of ayurvedic treatment for MS. Aloe vera gel or aloe vera juice is used for the detoxifying process and improving the metabolism of the patient suffering from multiple sclerosis. Moreover, natural vitamins and minerals present in aloe vera strengthen the immune system. An important element of ayurvedic treatment in tackling MS is stress reduction therapies. Daily massage using herbal oils provides a soothing effect to the nervous system. The motion of massage creates heat and friction which in turn enhances circulation in the body. This herbal remedy cleanses and nourishes the tissues thereby speeding up the process of tissue development and repair.

The therapies recommended are:

Shirovasti: A leather hat is fixed over the head. Medicated oil depending upon the constitution and illness is allowed to remain for a specified time.

Shirodhara: This therapy is done on the forehead of the person. Medicated oil is gently allowed to flow through the following vital points (marmas).

Nasyam: Administering drops of medicated oil through the nostrils. This is done for disorders pertaining to Central Nervous System. Herbal extract, herbal powder, medicated oils, mediated milk etc., are used.

Other Therapies:

Kanjidhara: A steady flow of herbal decoction is gently moved to through the 108 different vital areas of the body at varying heights.

Medicines used in the treatment of MS are

Yograja Guggulu, Trayodashanga Guggulu, Kaishora Guggulu, Pancha Tikta Ghrut Guggulu, Vat Gajankush Ras, Maha Vat Vidhwans Ras, Agnitundi Ras, Vish Tinduk Vati, Yashtimadhuk (Licorice, Glycerrhiza glabra), Ashwagandha (Winter Cherry, Withania somnifera),Shatavari (Asparagus racemosus).

Yashtimadhu and Kuchla (Poison nut, Strychnos nuxvomica) form the mainstay of treatment for this disease.

Medicines which act on the 'Majja' Dhatu (tissue) of the body are also very effective in treating this condition and include medicines like Guduchi (Tinospora cordifolia), Amalaki (Indian gooseberry, Emblica officinalis) and Musta (Purple nut sedge, Cyperus rotundus).

Specific problems or complications have to be treated separately, in addition to the use of the above-mentioned medicines. Visual disturbances can be treated using medicines like Triphala Ghrut, Tulsi (Basil, Ocimum sanctum), Shatavari and Saptamrut-Loh.

Muscular weakness can be treated with medicines like Ashwagandha, Kuchla (Nux Vomica), Tapyadi Loh and Trayodashanga Guggulu.

Cognitive defects can be treated using medicines like Brahmi (Waterhyssop, Bacopa monnieri), Mandukparni (Centella asiatica), Shankhpushpi (Convolvulus pluricaulis), Vacha (Acorus calamus) and Ashwagandha.

Depression can be treated using Vacha, Laxmi Vilas Ras and Shrung Bhasma.

Psychotic symptoms can be treated using Jatamansi (Spikenard, Nardostachys jatamansi) and Sarpagandha (Snakeroot, Rauwolfia serpentina).

Medicines like Yashtimadhu, Vish Tinduk Vati, Bruhat Vat Chintamani, Tapyadi Loh, Abhrak Bhasma, Trivang Bhasma and Suvarna Bhasma can be given on a long term basis to bring about maximum recovery from this disease and prevent recurrence.

Counselling can also relieve emotional stress. Psychological support is vital for MS patients to maintain a positive outlook and prevent feelings of hopelessness.