The aetiological factors of this condition are a combination of both genetic and environmental factors. Certain genetic variations have been shown to increase the risk of MS. The risk is higher in relatives of the affected individual with probability increasing among those very closely related. Identical twins have the highest chance of being victims, followed by fraternal twins, siblings and step siblings in that order. Predisposition is ten times higher when both parents are victims.
The role for microbes is backed by two theories namely the hygiene theory and the prevalent theory. In the hygiene theory, a microbe will only result into MS on a second exposure. The first exposure causes an immunological reaction that is protective. In the prevalent theory, it is said that certain microorganisms are associated with geographical areas known to have a high prevalence of the condition and thus are thought to play a role.
Certain lifestyle habits and situations have also been linked to MS. These include smoking, stress, vaccination, diet, hormone intake and occupational factors such as toxins. Though the clear role of uric acid as a protective factor is yet to be seen, it has been found out that gout occurs less commonly in people with MS.
Pathologically, there are three main features of MS including formation of lesions, inflammation and damage to myelin sheaths. Interaction of these characteristics results in breakdown of nervous tissue and hence physical manifestation of signs and symptoms. Damage is also believed to be caused by an autoimmune reaction in the body.
Four main clinical courses exist. These are the progressive relapsing, the relapsing remitting, and the primary and secondary progressive. All have varying features and varying degrees of severity. The secondary progressive is the commonest and affects about 65% of individuals with the disease. The relapsing remitting is characterized by recurrence after treatment.
Whenever an attack occurs, the initial priority should be to restore the CNS function and to prevent subsequent attacks. Efforts to avoid permanent disability should also be made. A number of pharmacological agents have been found to be helpful in delaying the progression of disease. The leading agents are beta interferon and glatiramer. Prompt treatment of flu particularly in the months following delivery in women.
High temperatures have been found to be an exacerbating factor in these patients. They accelerate the deterioration of the nervous system especially for the components that have already been affected. It is recommended, therefore, that affected individuals use air conditioners whenever possible. They should avoid using hot tubs or hot swimming pools. As can be seen in all these situations, all MS prevention strategies revolve around avoidance of exacerbating factors.