How to Treat Multiple Sclerosis

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What Is?
What is Multiple Sclerosis
How to Treat Multiple Sclerosis
Natural Treatments for Multiple Sclerosis

What is multiple sclerosis?

Multiple sclerosis (MS) occurs when the immune system attacks the central nervous system, which consists of the brain, spinal cord, and optic nerves. Some doctors believe MS is an autoimmune disease but others disagree because the specific target of the immune attack in MS has not yet been identified. Therefore, MS is known as an immune-mediated disease rather than an autoimmune disease.

Each nerve fibre consists of an axon and a myelin sheath, which is the fatty substance that surrounds and protects the axon. Myelin serves as insulation and aids efficient nerve fibre conduction.

In MS both the myelin and axon are damaged and scar tissue forms (sclerosis). As a result, nerve impulses travelling to and from the brain and spinal cord are distorted or interrupted. The location of the scarring determines symptoms, which vary greatly from patient to patient, because of the extensive nature of the central nervous system.

MS is a chronic condition, involving interplay between genetic and environmental factors that results in episodic and usually progressive demyel¬ination of nerve fibres of the central nervous system. In severe cases, progress can result in permanent axonal and neuronal death and severe neurological disability.

The incidence of MS varies with geographic latitude, occurring at greater frequency in northern European countries than in those closer to the tropics. Peculiarly, there also appears to be a residential time period for susceptibility, as northern European residents who emigrate to tropical countries before the age of 15 years exhibit a reduced prevalence of the disease compared with their home countries, whereas beyond 15 years of age, migration to tropical countries appears to confer no protective benefit.

Thus, it is hypothesised that genetic susceptibility to an environmental factor under¬lies the pathogenesis of this disease, triggering Th1 dominant autoimmune activity that operates via myelin-reactive T-cells, resulting in chronic cell-mediated toxicity, inflammatory and hypersensitivity reactions.

The time course and progression of MS varies considerably, from mild, episodic and non-progressive disease to persistent and rapidly progressive degeneration with severe neurological disability. However, neuronal degeneration usually advances to progressive disability and, long term, are resistant to medical therapy. Steroid therapy and interferon treatment may reduce the frequency and severity of demyelination episodes in acute episodes.

What are the symptoms of multiple sclerosis?

What are the symptoms of multiple sclerosis?

Deficits of the special senses
MS impacts the special senses and commonly involves the visual mechanism, causing double vision and visual loss secondary to weakness or paralysis of one of more extraocular muscles, or optic neuritis.

Eighth cranial nerve involvement
Occasionally involvement of the eighth cranial nerve may manifest as acute onset deafness, while acute brain stem demyelination causes severe positional vertigo, vomiting, ataxia, and headache. Taste and olfactory mechanisms may also be affected producing abnormal smell and taste sensations.

Brain stem damage
Extensive brain stem demyelination may disturb consciousness and respiratory drive and may also cause trigeminal neuralgia, sudden recurrence of difficult speaking, lack of coordination (ataxia), complex disturbances of sensation, hiccups, and tonic brain-stem seizures, which cause stiffening of the limbs. Other manifestations of brain-stem involvement include facial weakness, one-sided facial muscle spasm, or diffuse rippling of muscle fibres.

Motor symptoms and signs
Motor symptoms and signs of MS include impaired mobility and muscle paresis involving speech coordination, impaired gag reflex and swallowing, eye movements, and individual limb or trunk muscles causing problems with mobility and balance.

Sensory symptoms and signs
MS commonly affects the sensory nerve fibres, which alters sensory input and causes a reduced sense of touch or sensation (hypoesthesia), a tingling or prickling sensation (paraesthesia) or abnormal sensation (dysesthesia).

Damage to the posterior columns
Damage to the posterior columns in the cervical cord often produces painful sensations that are usually described as tight, burning, twisting, tearing, or pulling sensations. Associated loss of a person’s ability to sense body position (proprio¬ception) severely compromises balance and coordinated motor function, while demyelination of lumbar spinal cord segments commonly produces paraesthesia, numbness, and dysesthesia in the legs and lower trunk.

Autonomic nervous system
Autonomic nerve disturbance manifests as urinary or rectal problems, with either incontinence due to sphincter impairment or urinary and faecal retention related to bladder and bowel paralysis. In males, acute onset impotence is common.

Cerebral cortex
Cerebral cortex involvement usually occurs as the disease progresses and may cause cognitive deficits manifesting as impaired visual and auditory attention or processing, memory, and language skills. In addition, impaired emotional and affective problems may occur, ranging from depressive symptoms to those of severe anxiety, agitation, and mania.

Ten early signs of multiple sclerosis

Ten early signs of multiple sclerosis

Multiple sclerosis (MS) is a progressive autoimmune disorder that wears away at the myelin coverings that protect nerve cells. The damage impacts the brain and spinal cord and gradually weakens a person’s ability to function, and leads to problems with muscle control and strength, vision, balance, sensation, and mental function.

Ten early warning symptoms for MS:

  • Constant tingling or numbness, often in the face or extremities
  • Unexplained exhaustion
  • Vision problems
  • Loss of bowel and bladder control
  • Memory loss
  • Muscle spasm
  • Sexual dysfunction
  • Problems with balance and coordination
  • Epileptic-type seizures
  • Secondary depression
What causes multiple sclerosis?

What causes multiple sclerosis?

Following intensive research efforts for a pathogenic viral aetiology and to define the autoimmune mechanism involved, contemporary studies suggest there are multiple causes and environmental factors involved in multiple sclerosis (MS).

Possible causes of MS:

  • Chronic viral infiltration of brain tissue, particularly human herpes virus 6 (HHV-6). Chlamydia and mycoplasma are other infective organisms that have been implicated in the development of MS
  • Eating too much saturated fat and carbohydrate
  • Nutrient insufficiency, possibly related to increased genetic requirements, particularly of vitamins B, B6, B12, folic acid, vitamin D
  • Mineral insufficiency, particularly calcium, magnesium, selenium, copper
  • Food sensitivity reactions, particularly with gluten-containing grains, cows’ milk protein, chocolate
  • Heavy metal toxicity, particularly mercury from dental amalgams
  • Impaired digestion and intestinal dysbiosis have also been implicated in the development and maintenance of this disease
Risk factors for multiple sclerosis

Risk factors for multiple sclerosis

In 2005, researchers pinpointed a cluster of genes on chromosome 6 that play a major role in causing multiple sclerosis (MS).

A person who has the genetic defect will not definitely develop MS. However, having the defect makes a person more susceptible to MS.

Several factors increase a person’s risk for multiple sclerosis:

  • Age
  • Gender
  • Family history
  • Certain infections
  • Ethnicity
  • Geographic regions
  • Other autoimmune diseases

Multiple sclerosis can occur at any age, but most commonly affects people 20 to 40 years of age.

Women are twice as likely as men to develop MS. However, a woman with MS generally has a better outlook compared with a man.

Family history
If one of your parents or siblings has MS, you have a 1–3% chance of developing the disease (one tenth of 1%) compared with the general population. MS is not determined solely by genetics. If it were, identical twins would have identical risks. However, an identical twin has only a 30% chance of developing MS if his or her twin already has the disease.

Certain infections
A variety of viruses, such as Epstein-Barr virus and others, appear to be associated with multiple sclerosis. Researchers continue to evaluate how some infections may be linked to the development of MS.

White people, particularly those whose families originated in northern Europe, are at highest risk of developing MS. People of Asian, African, or Native American descent have the lowest risk.

Geographic regions
MS is far more common in areas such as Europe, southern Canada, northern United States, New Zealand, and south-eastern Australia. Researchers are studying why MS appears to be more common in certain geographic regions.

If a child moves from a high-risk area to a low-risk area, or vice versa, he or she tends to acquire the risk level associated with his or her new home area. But if the move occurs after puberty, the young adult usually retains the risk level associated with his or her first home.

Other autoimmune diseases
You may be slightly more likely to develop multiple sclerosis if you have thyroid disease, type 1 diabetes, or inflammatory bowel disease.

From the Mayo Clinic website

Certain factors indicate a higher risk for more severe symptoms:

  • More than 40 years of age at the time of the initial onset of symptoms
  • Initial symptoms affect more than one area of your body
  • Initial symptoms affect mental functioning, urinary control, or motor control
How is multiple sclerosis diagnosed?

How is multiple sclerosis diagnosed?

No specific test is available for multiple sclerosis (MS) and the range of tests available that do help doctors diagnose MS are not 100% accurate.

Often MS patients are misdiagnosed or misunderstood during the early stages of disease. A person with early MS usually presents with a set of vague signs and symptoms, which occur intermittently over time. MS or other medical conditions could be responsible. Often these subjective symptoms don’t show classic signs that enable a straightforward diagnosis.

Once classic symptoms emerge a neurologist must assess the patient using the McDonald Criteria to define which part of the central nervous system is affected and the extent. MRI is used to demonstrate areas of demyelination of the central nervous system.

Prognosis and complications of multiple sclerosis

Prognosis and complications of multiple sclerosis

No cure is available for multiple sclerosis (MS), which is not considered a fatal disease. Ninety percent of people with MS have the same life expectancy as the general population. Approximately 5% of people with MS will experience severe disability that leads to premature death from infections such as pneumonia.

Approximately 25% of people diagnosed with MS will need a wheelchair to get around 20 years after first being diagnosed. Unfortunately, the pain, discomfort, and inconvenience can prevent a person enjoying life and so suicide rates are higher. Twenty percent of people with MS have no or mild symptoms and 20% will experience progressive disease. The majority will experience some disease progression over their lifetime.

In some cases, people with MS may also develop:

  • Muscle stiffness or spasms
  • Paralysis, most typically in the legs
  • Mental changes, such as forgetfulness or difficulties concentrating
  • Depression
  • Epilepsy

According to the US National MS Society tends to take one of four clinical courses, each of which might be mild, moderate, or severe:

  • A relapsing-remitting course characterised by partial or total recovery after attacks (also called exacerbations, relapses, or flares). This is the most common form of MS. Approximately 85% of people with MS initially begin with a relapsing-remitting course.
  • A relapsing-remitting course that later becomes steadily progressive is called secondary-progressive MS. Attacks and partial recoveries may continue to occur. According to some natural history studies, of the 85% who start with relapsing-remitting disease, more than 50% will develop SPMS within 10 years; 90% within 25 years.
  • A progressive course from onset without any attacks is called primary-progressive MS. The symptoms that occur along the way generally do not remit. Ten percent of people with MS are diagnosed with this type, although the diagnosis usually needs to be made after the fact, when the person has been living for a period of time with progressive disability without acute attacks.
  • A progressive course from the outset, with obvious, acute attacks along the way, is called progressive-relapsing MS. This course is quite rare, occurring in only 5% of people with MS.

MS patients have a better prognosis if they experience:

    • Few symptom attacks in the initial few years after diagnosis
    • A longer amount of time passing between attacks
    • A complete recovery from their attacks
    • Symptoms related to sensory problems, such as tingling, vision loss, or numbness
    • Neurological exams that appear almost normal five years after diagnosis


Drug side affects need to be carefully monitored by a doctor.

Some degree of cognitive impairment occurs in approximately 50–60% people with MS, with memory, information processing, and executive functions being the most commonly affected functions.

If you or someone you know is battling depression a number of organisations can provide expert advice and support.
Beyond Blue 1300 224636
Lifeline 13 11 14
Call 000 and ask for an ambulance if you believe a life is in danger.

Types of multiple sclerosis

Types of multiple sclerosis

Most people with multiple sclerosis (MS) do not have severe disability. Some people feel and seem healthy for many years following their initial diagnosis while others become severely debilitated very quickly.

A description for MS or type can classified as follows:
(Classification system described by Multiple Sclerosis International Federation)

Relapsing-remitting MS
In this form of MS unpredictable exacerbations or relapses occur and new symptoms appear or existing symptoms become more severe. This can last for varying periods (days or months) and there is partial or total recovery (remission). The disease maybe inactive for months or years. Approximately 85% of people are initially diagnosed with relapsing-remitting MS.

Primary progressive MS
Approximately 10% of individuals are diagnosed with this form of MS, which is not characterised by distinct attacks, but with slow onset and steadily worsening symptoms. There is an accumulation of disability, which may level off at some point or continue over months and years.

Secondary Progressive MS
Most individuals who initially have relapsing-remitting MS develop progressive disability later in the course of the disease, often with superimposed relapses and no definite periods of remission. Secondary progressive MS means a more steady progression of symptoms and disability with fewer or no relapses.

Progressive relapsing MS
Approximately 5% of people with MS show a steady neurologic decline with a clear superimposition of attacks. There may or may not be some form of recovery following these relapses, but the disease continues to progress without remissions.

Benign MS
People who live with MS for many years without accumulating disability have the mildest form, called benign MS. They have a minimal amount of physical disability after ten years or more of the disease. Early identification of benign MS is important in deciding who should, or should not, take lifelong disease-modifying treatments.

Benign MS cannot be diagnosed at the onset of the disease but only becomes clear over time. Long-term follow-up has found that many people with benign MS go on to develop progressive disease, and therefore labelling someone as having benign MS too early may be misleading.

Childhood MS
There are an increasing number of children diagnosed with MS around the world, but the incidence is rare. Neurologists are finding that MS in children has different characteristics. To date no therapies have been tested for being safe or effective for the treatment of children with MS.

While the first five years gives some indication of how MS will continue for that individual, predicting the course accurately is impossible. Prognosis is based upon the course of the disease over the first five years and the disease type. The level of disability reached at endpoints such as five and ten years can be used to predict the future course of an individual’s disease.

Age at onset and gender may indicate the long-term course of the disease. Research suggests that younger age at onset (less than 16 years of age) implies a more favourable prognosis. Even if symptoms are mild and disease progress is slow during the first decade, this must be tempered with the knowledge that living with MS for 20 or 30 years may eventually result in substantial disability. Late onset (more than 55 years of age), particularly in males, may indicate a progressive disease course.

Multiple sclerosis is a chronic, often disabling disease that involves an immune system attack against the central nervous system, which is made up of the brain, spinal cord, and optic nerves.

Managing your life with multiple sclerosis

Managing your life with multiple sclerosis

Impaired thinking
The clues that a person has impaired thinking due to multiple sclerosis (MS) can be very subtle. Symptoms might not become apparent or noticed until a friend, co-worker, or family member notices a change and wonders why.

Indicator of impaired thinking:

  • Difficulty finding the right words to say
  • Forgetting tasks that need attention or tasks that have been completed
  • Finding it hard to plan or set priorities
  • Having trouble concentrating, particularly when several things are happening at once

MS usually does not harm intelligence or long-term memory. It won’t change a person’s ability to read or carry on a normal conversation, on the phone or face-to-face.

If MS is to blame for poor memory or poor concentration, you may want to try some mental exercises to sharpen your thinking. Mental exercises are now available online and include memory exercises.

Feeling competent and in control can have wide-ranging benefits and reduce stress levels. At home or work you can implement strategies to assist with remembering things. Use notebooks, an organiser, a good filing system, or create and attempt to complete daily to-do lists.

Face your fears and plan for the unpredictable. If you are worrying about how you will manage with work or caring for a family down the track, tackle the problem head on, instead of over worrying, which can make a situation much worse. Build a support network and learn to ask for help when you need it.

Investigate your health, life insurance, or income protections policies to check whether medical costs will be covered, or whether you are eligible for a pay out. Allied health treatments such as physiotherapy and occupational therapy usually have annual limits, so make sure you know what these are.

Reach out for help when you need it. Talking to loved ones, people at work, and neighbours can help. Other people often want to help but don’t understand what kind of help you need. Be specific when you ask for help so people understand exactly what you need. Don’t assume you’re imposing, because allowing people to help makes them feel worthwhile.

Getting to know other people with MS who share your frustrations can help and support groups can provide connections. And you might be able to provide support for someone else, which can be very rewarding.

The many doctors’ bills can quickly add up and create more worry. Check your entitlements with your local support group, Medicare, or Centrelink. Meet with a financial advisor or an accountant to discuss how your income might be affected. An expert can advise how much to save for future expenses.

Your home will require modifications for when mobility becomes impacted. Rails along staircases, an entrance ramp, and handrails in the toilet and bathroom will improve safety and aid mobility. However, a person with MS needs to be realistic and assess whether moving to a single level home close to doctors, shops, and transport may be the best option.

If your work is physically demanding, make early enquiries about relocating to work that is less physically demanding. Consider training in a more appropriate career if you believe you would benefit in the long term. Take adequate time to consider all your options and think about talking to someone in HR for advice.

Multiple sclerosis key facts and statistics

Multiple sclerosis key facts and statistics

Multiple sclerosis (MS) is the most common disabling neurological diseases in adults and young adults. MS is a mysterious, often frustrating disease. In healthy people, nerve fibres are wrapped in a protective coating called myelin. But MS inflames or destroys myelin, disrupting the flow of nerve impulses.

In Australia, more than 23,000 people have MS and some 2.5 million people are affected by MS worldwide. Some degree of cognitive impairment occurs in approximately 50–60% people with MS. Memory, information processing, and executive functions are the most commonly affected functions.

Conventional medical treatment for multiple sclerosis

Since multiple sclerosis (MS) was first identified the disease has been the subject of much research worldwide. While much has been learnt about the disease process, the exact cause remains unknown and no cure has been found. MS is not directly hereditary, although genetic susceptibility plays a part in its development.

Medical treatment can’t cure MS, but treatments are available that can modify the course of the disease. These treatments may help to reduce relapses, relieve symptoms, and improve day-to-day functioning.

In the absence of a definitive cure and as new drugs become available, the decision to treat or not treat MS, and how to treat, is becoming increasingly complex. Treatment with medication must be tailored to the individual’s MS type and stage. A person who has relapsed just once each year is treated differently to a person with highly active disease.

Immunomodulating drugs aim to prevent disability by modifying the immune system response. Trials show success in modifying the severity of the disease by reducing inflammatory injury to the central nervous system.

A number of first-line disease-modifying treatments have been shown to reduce relapse rates and disease progress in the short-term. Depending on the dosage, immunomodulating drugs, such as interferon beta 1b (betaferon), interferon beta 1a (Rebif, Avonex, Cinnovex) and glatiramer acetate, are injected each week, every few days, or daily.

Interferon beta-1a and beta-1s are antiviral agents that fight tumours, but are also effective in treating and controlling MS. Glatiramer acetate may reduce progression of disability by acting as a decoy for the immune system.

If these drugs don’t work then monthly IV infusion of natalizumab or oral finglomod might be prescribed. Natalizumab reduces the ability of inflammatory immune cells to attach to and pass through the intestinal wall and blood–brain barrier. Natalizumab is usually prescribed when a person has a high level of disease activity.

Mitozantrone, an anthracenedione antineoplastic agent, may be prescribed for more aggressive cases of MS, in particular if natalizumab is not well tolerated.

Fingolimod absorbs lymphocytes in lymph nodes, which prevents lymphocytes from contributing to an autoimmune reaction.

The majority of people with multiple sclerosis have mild, slow progressive symptoms and do not become severely disabled.

Nutritional medicine treatment for multiple sclerosis

Dietary-nutrient prescription is dependent on a thorough assessment of the patient’s individual nutritional status, genetic susceptibility, specific nutrient requirements, and social and environmental habitat.
Following careful assessment, synthesis and prescription of a dietary and nutrient supplement program should proceed systematically, correcting for disturbances of a number of contributing factors.

Optimisation of digestive capacity should be diligent because of the known relationship between maldigestion, bowel dysbiosis, and immune system activation. This is particularly important in view of the reported benefit of proteolytic enzyme therapy in improving the clinical condition and reducing disease progression in MS patients.

Saturated fat consumption and excessive carbohydrate intake have been associated with increased prevalence of MS. Adherence to a low-fat diet is reported to benefit clinical symptoms and retard disease progression, while non-adherence resulted in disease activation.

Essential fatty acid balance
Both omega-3 and omega-6 fatty acid supplementation is reported to retard disease progression and reduce the frequency and severity of episodes. Doses need to be quite high and used in conjunction with a diet low in saturated fat diet. Essential fatty acid balance suppresses immune system activity and cytokine production, which promote inflammation.

Antioxidant status
As is the case with all immune-mediated chronic disease conditions, adequate antioxidant capacity should be ensured, with particular emphasis placed on glutathione and selenium status, particularly in the presence of suspected mercury exposure.

Gut flora imbalance
Normalisation of bowel dysbiosis (glut flora imbalance) is important with respect to reducing gut-associated lymphoid tissue (GALT) activation and hepatic chemical load.

Specific disease treatment
Perhaps the most specific therapy is to identify the presence of mercury toxicity, followed by the removal of dental and tissue mercury if detected. Additional supplements of selenium, calcium and zinc will help to displace tissue mercury, while thiol-containing nutrients and ascorbate may facilitate mercury chelation and removal. In addition, specific nutrients docu¬mented to enhance axonal regeneration may confer additional benefit.

Liver detoxification problems
Though no specific research is available, the known increased levels of oxidative damage that derives from autoimmune and hyperactive immune disease, particularly as documented in Parkinson’s disease and Alzheimer’s disease, suggests that hepatic detoxi¬fication pathways require assessment, and need to be corrected if found to be compromised.

Hormone adequacy
Again, no specific research relating to MS is available, apart from the immunosuppressive benefit associated with corticosteroid therapy. However, if anabolic steroid hormone levels (DHEA, pregnenolone, and testosterone) are compromised on appropriate testing, then judicious supplementation to improve anabolic protein synthesis is a logical corollary.

Neurotransmitter balance
Enhanced brain serotonin status, with supplements of 5-hydroxytryptophan (check Mel added 5-) or L-tryptophan, may reduce hypothalamic-pituitary dysfunction, which is associated with MS-induced depression and stress, and is reportedly beneficial in alleviating mood disturbance and cerebellar ataxia.

Nutritional medicine assessment for multiple sclerosis

Nutritional medicine assessment for multiple sclerosis

Nutrition is the single most important factor in treating MS. While a typical neurologist might consider this statement with scepticism, thousands of people with MS have noticed improvement on a regime of optimised diet and supplements.

From a nutritional perspective, the practitioner should attempt to identify all antecedent trigger factors and mediators that are present in each patient, so as to apply appropriate corrective treatment, if possible.

As is the case with all multifactorial disease states, emphasis is placed on identification of dietary and environmental factors that may be responsible for enhancing immune system activity (food allergens, gluten reactivity, heavy metal toxicity) or exacerbating inflammatory eicosanoid and cytokine production (essential fatty acid imbalance, antioxidant depletion).

Particular attention should be directed to determining the degree of mercury toxicity, as significant clinical and research evidence implicates mercury exposure as a causal agent in the immune disturbance and neuronal degeneration that characterises the disease process. Of particular interest is the finding of mercury sensitised B-lymphocytes in MS patients with apparent clinical subsidence following mercury amalgam removal and mercury chelation therapy.

Suggested nutritional protocol for multiple sclerosis

Suggested nutritional protocol for multiple sclerosis

As in any chronic degenerative disease process, the integrated application of a comprehensive nutritional protocol is advisable to achieve long-term benefits.

Suggested nutritional protocol for multiple sclerosis

Supplement Daily dose
Alpha lipoic acid 300-500mg
N-acetylcysteine 1000mg
L-acetylcarnitine 2000mg
Methyl-cobalamin (Vit B12) 30 – 60 mg
Vitamin E (mixed tocopherols) 2000 units
Selenium 200 – 500 ugm
Vitamin C 3000 –5000 mg
Coenzyme Q10 200 – 400 mg
EPA 400-500 mg
DHA 300-400 mg
Linolenic & Linoleic acid 25 – 30 gm
Vitamin D 400 I.U


5-Hydroxytryptophan – an amino acid and metabolic intermediate in the biosynthesis of the neurotransmitters serotonin and melatonin from tryptophan.

Ataxia-lack of coordination

Benign MS – long-term MS without accumulating disability

Blood-brain barrier – semipermeable cell layer around blood vessels in the brain and spinal cord that prevents large molecules, immune cells, and potentially damaging substances and disease-causing organisms from passing out of the blood stream into the central nervous system.

Central nervous system (CNS) – the brain, optic nerves, and spinal cord. The nerves that leave the spinal cord and go to the rest of the body make up the peripheral nervous system.

Cerebral cortex – the outermost layer of the brain Chelation – removal of unwanted toxins from the body

Childhood MS – MS in a person less than 16 years of age

Cognitive impairment – changes in cognitive function caused by trauma or disease process.

Cytokine – small proteins released from a cell that affect the behaviour of other cells.

Demyelination – loss of myelin in the white matter of the central nervous system.

DHEA – dehydroepiandrosterone or androstenolone is an important endogenous steroid hormone.

Dysesthesia – distorted or unpleasant sensations when the skin is touched, typically caused by abnormalities in the sensory pathways in the brain and spinal cord.

Electroencephalography (EEG) – diagnostic procedure that records electrical activity generated by brain cells through electrodes placed around the head.

Electromyography (EMG) – a diagnostic procedure that records muscle electrical potentials through a needle or small-plate electrodes.

Epstein-Barr virus – the most common human viral infection and causes infectious mononucleosis or glandular fever.

Extraocular muscles – muscles that control eye movements

Hemiparesis – weakness of one side of the body, including one arm and one leg.

Hemiplegia – paralysis of one side of the body, including one arm and one leg.

Hypoesthesia – abnormal, decreased sensitivity to touch

Immune-mediated disease – when components of the immune system are responsible for disease either directly or indirectly.

Immunomodulating drugs – treatment agents that suppress the immune system, inhibiting lymphocyte functions, in particular T-cells and natural killer cells.

Interferon – group of immune system proteins, produced and released by cells infected by a virus, which inhibit viral multiplication and modify the body’s immune response. Interferon beta drugs are used to treat relapsing forms of MS.

L-tryptophan – an essential amino acid that converts into serotonin primarily in the brain.

Magnetic resonance imaging (MRI) – a diagnostic imaging scan that produces visual images of different body parts using magnetic fields. MRI is used to diagnose MS and count sclerotic lesions in the white matter of the brain and spinal cord.

Maldigestion – inadequate digestion of food

Myelin – soft, white coating of nerve fibres in the central nervous system composed of lipids (fats) and protein. Impaired bodily functions or altered sensations associated with those demyelinated nerve fibres are identified as symptoms of MS in various parts of the body.

Myelin-reactive T-cells – immune cells responsible for initiating the cascade of autoreactive immune responses leading to the development of MS.

Neurologist – a doctor who specialises in the diagnosis and treatment of conditions related to the nervous system.

Paraesthesia – abnormal tingling prickling sensation of the skin

Pneumonia – an inflammatory condition of the lungs usually caused by a viral or bacterial infection.

Pregnenlone – an endogenous steroid hormone manufactured from cholesterol in cells used to make other steroid hormones, such as progestogens, androgens, estrogens, and neuroactive steroids.

Primary progressive MS – clinical course of MS characterised from the beginning by progressive disease, with no plateaus or remissions, or an occasional plateau and very short-lived, minor improvements.

Prognosis – prediction of the future course of the disease.

Progressive-relapsing MS – clinical course of MS that shows disease progression from the beginning, but with clear, acute relapses, with or without full recovery from those relapses along the way.

Proprioception – a person’s awareness of body position and location of body parts.

Proteolytic enzyme therapy – a type of enzyme treatment used to breakdown scar tissue.

Relapsing-remitting MS – clinical course of MS characterised by clearly defined, acute attacks with full or partial recovery and no disease progression between attacks.

Remission – lessening in the severity of symptoms or temporary disappearance during the course of the illness.

Sclerosis – scarring of tissue in MS due to demyelination of the central nervous system.

Secondary Progressive MS – a more steady progression of symptoms and disability with fewer or no relapses.

Testosterone – a steroid hormone from the androgen group, a male sex hormone.

White matter – that part of the brain that contains myelinated nerve fibres, which are affected in a person with MS.