NERVOUS SYSTEM

Onset of the disease occurs in early adulthood. Occasionally it can occur in childhood and after the age of 40. Females account for approximately 60% of cases. It is suggested that acute infections, emotional stress, pregnancy and trauma may precipitate the first attack. However, evidence to support this is not conclusive.

Early symptoms include disturbance of vision, either partial or total and usually in one eye. Pain can be felt on movement of the eye. In early cases mild colour vision may be disturbed and double vision may occur.

Tic Doloureux which is a painful spastic condition of one side of the face may be an indication of the disease in a young adult. Pins and needles can occur and muscle weakness can produce a clumsiness of movement. There may be associated bladder difficulties with bladder infections and chronic constipation. In the male, sexual impotence may occur.

Patients with Multiple Sclerosis may experience a sensation of an electric shock when flexing the neck. In severe cases of Multiple Sclerosis, depression and diminished intellect may eventually occur.

Late in the course of the disease the patient may deny any problems despite repeated attacks.

The clinical progress of Multiple Sclerosis is unpredictable. The disease may progress over the years. The first attack may have been so mild as to escape notice and may not be followed by another attack until 10 to 20 years later. Very occasionally there is a fatal outcome within weeks to months of the first attack.

In a typical episode of Multiple Sclerosis, symptoms worsen over a few days to 2 to 3 weeks. Recovery may be rapid in a matter of weeks but may be spread over several months. the frequency of further attacks is at its highest in the first 4 years of the disease and periods of good health in between attacks can vary from patient to patient. Most patients can survive for better than 30 years after the onset of the disease.

The severity of symptoms appears gradually to increase with each attack with eventual loss of vision, sensation and paralysis. No effective treatment is known. In acute attack corticosteroids may lessen the severity of symptoms and speed recovery. However, ultimate recovery is not improved.

The diet should be well balanced and nourishing and high levels of polyunsaturated fat is advocated.

Periodic checks on the bladder for infection should be carried out.

Drug medication can help the various symptoms including muscle spasicity.

Excessive fatigue should be avoided by the use of frequent rest periods and extremes of temperature should be avoided. Specialised physiotherapy will be needed to supervise mobility and to help in the learning of new movement pattens for walking and balance. Surgical aids to help mobility will be needed.

Finally, psychological support for the patient and family is essential and this support is available through the Multiple Sclerosis societies which have been set up in each state in Australia.