MULTIPLE SCLEROSIS

Multiple Sclerosis (MS) is a demyelinating disease affecting the central nervous system. It has an auto-immune origin in which the body’s own immune system attacks the myelin sheath of nerve fibers. This myelin sheath is a protective cover of the nerve and facilitates nerve conduction. Damage to the sheath results in disruption of conduction of nerve signals, which can produce a wide range of symptoms. The patient may present a single or combination of the symptoms listed below:

Unsteadiness or instability
Vertigo
Fatigue
Blurring or loss of vision
Clumsiness or difficulty in coordination
Slurring of speech
Cognitive problems like difficulty in concentration and changes in memory

Diagnosis

The following tests are conducted to accurately diagnose the disease.

MRI of the brain to detect the presence of plaques. The location of the plaques determines the staging of the disease.
Evoked potential tests: Stimulation of nerve pathways to map electrical activity within the brain. The evoked potentials used are visual, sensory and brainstem.
Spinal tap or lumbar puncture: This is done to check for auto-immune antibodies.
Videonystagmography (VNG): This test uses infrared cameras to track eye movements during different tests. MS patients may present with various eye signs like spontaneous nystagmus, ogular flutter, difficulty in holding gaze, hyperventilation-induced nystagmus and direction changing nystagmus.