INDIA  :   Health

Multiple Sclerosis treatment in India

Saturday , 09 January 2016
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Multiple Sclerosis is an auto-immune neurological disease, which affects around 2.3 million people worldwide. It is generally associated with people in the age group of 20 to 30. TGI looks at the latest treatment options available for the disease in India

When Nazia Sayyed, 35, from the UAE, first experienced a blurred vision, she did not realise that she was suffering from multiple sclerosis (MS) – a neurological disorder which affects both the brain and spinal cord. After consulting many doctors, who failed to diagnose the disease, Nazia came to India along with her husband last month. In India, doctors confirmed that she was an MS patient.

Dr Rohit Bhatia, neurologist at the All India Institute of Medical Sciences-Delhi, said, “MS usually affects people in their late 20s or 30s and is more common among women than men. Being an auto-immune disease, the patient produces antibodies or proteins that damage the covering of nerve fibres. This process results in damage to the nerve.”

MS patients can suffer from blurred or double vision, memory loss or forgetfulness. Lack of coordination, loss of balance, numbness, tingling, weakness in the arms or legs are other common complaints of MS patients. “The most common symptoms are pins and needles, weakness in the limbs, numbness and sudden loss of balance, blurred vision and spasticity,” said Dr Bhatia. (Read box for early and severe symptoms of MS)

Diagnosing MS

Neurologists say that diagnosing MS is a challenge as it mimics other auto-immune ailments like neuromyelitis optica. Dr Sunil Narayan, neurologist at JIPMER College and Hospital, Puducherry, who is also a member of the Multiple Sclerosis Society of India (MSSI), said that while the exact cause of the disease is not known, genetics, environmental factors and deficiency of vitamins apart from viral infection can be the reasons behind infliction of MS.

Neurologists say that an MRI scan and history of symptoms can be of great help in the diagnosis of this disease. “You need an experienced team to pick up the symptoms and diagnose MS. Indian corporate hospitals are renowned for their systematic and accurate diagnosis of MS. This is also possible because of advanced MRI machines and improved diagnostic criteria,” said Dr Narayan.

Explaining the treatment options available for MS, Dr S Murali, consultant neurologist, Manipal Hospital said that the disease is managed medically. “MS does not have a cure. The disease is being managed by injectable disease-modifying drugs. The drugs are said to significantly lower the relapse rate and delay the time to progression of disability,” said Dr Murali.

Dr Murali further said that depending on the evaluation of an MS patient, the treatment is decided. “Many doctors avoid prescribing drugs if the symptoms are mild,” said Dr Murali.

MS management is divided into two parts – 1) to avoid attacks and 2) to modify progression of the disease. “To avoid attacks, we prescribe oral and intravenous drugs that reduce nerve inflammation. In some cases, plasma exchange (plasmapheresis) is also suggested where blood is removed, plasma separated from the blood cells. The blood cells are then mixed with a protein solution (albumin) and put back into the patient’s body. This treatment is helpful if the patient has severe symptoms and hasn’t responded to steroids,” said Dr Murali.

For slowing down the progression of MS, drugs like beta interferons, glatiramer acetate, dimethyl fumarate, fingolimod, teriflunomide, natalizumab and mitoxantrone are used. “The combination of these drugs are used to lower the relapse rate and reduce the rate of formation of new lesions. Muscle relaxants are also prescribed for people with painful and uncontrolled muscle stiffness or spasm,” said Dr Murali.

According to neurologists, MS treatment needs a multi-disciplinary approach. Apart from drugs, the patient needs to undergo physiotherapy, occupational therapy, follow a balanced diet etc to improve the quality of living. MS patients should also avoid exposure to extreme heat.

“MS patients have low heat tolerance levels and are therefore advised to stay in a cool place whenever possible. Exposure to heat aggravates the symptoms of MS,” said Dr Murali. Doctors say that international MS patients coming to India for treatment prefer staying in a suite provided by the hospital or book a hotel for a short period. “They regularly come for follow-ups, physiotherapy etc and are also part of our support group for MS. They remain in touch with us via social networking sites otherwise,” said Dr Murali.

Ayurvedic medicine option for multiple sclerosis

Often, people suffering from multiple sclerosis opt for ayurvedic or homeopathic treatment as they are considered safer than allopathic treatment because they do not cause any side-effects. “Symptoms of MS respond well to changes in diet and lifestyle, stress reduction and especially to the natural, traditional rejuvenation therapies of ayurveda, called Panchakarma,” said Dr Rajeshwar Reddy of Poddar Ayurveda Hospital in Mumbai.

Ayurveda considers multiple sclerosis as a Vata imbalance. Vata is the functioning mode in the body, controlling the nervous system. “This imbalance is responsible for many conditions and symptoms, including insomnia, pain, headaches, constipation, anxiety, worry and fear, fatigue, dry or rough skin, poor digestion, loss of weight and heightened sensitivity,” Dr Reddy explained.

There are numerous ayurveda centres in India, which offer various packages for multiple sclerosis treatment. These include a daily three-hour programme of herbalised oil massage, specialised treatments and mild internal cleansing over 5-21 days.

“Massage enhances circulation and helps cleanse the areas of toxins and impurities that could be contributing to the symptoms of multiple sclerosis. Also, multiple sclerosis can be aggravated through an improper diet so stress is laid on a toxin-free diet and internal cleansing,” said Harshjeet Kuroop, MD, Kerala Vaidyashala Pvt Ltd, Kerala.

Individualised packages are prepared during the treatment depending on the lifestyle and daily routine of the person. Appropriate herbs are also provided to patients to help in strengthening digestion and purifying the body.

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