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Multiple Sclerosis: New disease modifying treatments allow patients to live a close to normal life

17 July 2023

Dr Natanya Fourie, Neurologist in private practice, in partnership with Novartis South Africa

Echoes of famous people like actresses, Selma Blair and Christina Applegate, have been diagnosed with multiple sclerosis in recent years; placing the spotlight on this little-understood disease. So, what is multiple sclerosis, how does it affect South Africans, and what are the warning signs?

Multiple sclerosis (MS) is one of the most common disabling neurological disorders in the world, severely impacts how people go about their daily lives – especially among young adults. It can be a challenging disease to live with and is generally a unique experience with widely varying symptoms among patients.

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An estimated one in 700 South Africans have multiple sclerosis. But that number could be a considerable underestimation.

These numbers aren’t accurate, because we don’t know what’s happening in the government sector. Diagnosis is missed there due to a couple of reasons, such as few resources, not many units with neurologists, and an initial belief that African patients don’t get MS.

To encourage potential MS patients to seek early diagnosis and treatment, a collaboration with leading healthcare company Novartis South Africa, advocates for all South Africans to educate themselves on some of the common signs and symptoms. Further education among general practitioners and pharmacists is also required.

Often, patients will go to a pharmacist to say that they have numbness in their hands or feet, and the pharmacist will say to use a vitamin B supplement. But MS can severely affect patients’ quality of life, which is why it’s important for more patients to obtain professional treatment as soon as possible.

If you cannot climb stairs and you work on a plant, for example, then you’re going to lose your job. If you can’t drive because you can’t feel the pedals, you can’t drive your kids. It has a major impact on all aspects of life – social and family life, and the ability to perform tasks.

Understanding MS red flags and risk factors

Because MS patients exhibit a variety of symptoms, it can be challenging to accurately and concisely define this complex disorder.

Typically, however, the onset of MS occurs around the age of 20 to 30 years, and the disease is more prevalent among women. Some environmental factors, such as an unhealthy diet, obesity, smoking, a vitamin D deficiency, and the Epstein-Barr Virus (EBV), also known as the “human herpesvirus 4”, can also play a role in heightening the risk of MS.

Signs and symptoms can include vision problems, either blind spots, blurry vision, or pain behind the eyes; new onset of motor weakness; weakness in the arm or the leg; sensory fallout; pins and needles; numbness, or waist-down sensory symptoms.

Occasionally, the diagnosis is missed, and we make a diagnosis at a later age. The problem then is that, most likely, there have been many relapses and the prognosis of getting somebody in remission or to prevent progression is worse.

There are several potential long-term complications or disabilities associated with advanced stages of MS.7 As multiple sclerosis advances, certain patients may experience a progressive decline in mobility, ranging from limited movement to complete immobility.7

If MS reaches more advanced stages, patients may develop a declining gait.

Patients may need the use of a cane, walker, or wheelchair, and experience loss of bladder control and bowel problems. Hopefully, in today’s day and age, we don’t get people who become bedridden, but we have seen that in the past in the era when we didn’t have proper medication and the diagnosis was missed.

Living positively with an MS diagnosis

In good news for patients diagnosed with MS, there are a variety of modern treatment options and therapies available to effectively manage the disease.

Adopting a well-rounded diet, quitting smoking, and engaging in an appropriate exercise regimen, within the patient’s specific capabilities, can also be beneficial. Likewise, patients may wish to consult a psychologist, physiotherapist, or occupational therapist for support and guidance dependent on their unique needs.

Finally, there has never been a better time to live with this disease, and it’s possible to have a positive mindset following a diagnosis. We now have plenty of available treatments.

If your attitude isn’t in the right place, if you are scared of medication, if you don’t ask for help, if you’re not honest that you need perhaps an anti-depressant or for pain, then these people do worse. People who say it isn’t going to change me, I’m still the same person, and I’m going to fight this with my doctor or specialist, they are the ones who do well.

 

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