Do you know someone who suffers with multiple sclerosis? Not to be confused with scoliosis, which deals with curvature of the spine, multiple sclerosis is a spontaneous inflammatory disease of the central nervous system due to an unknown cause.

According to Dr Sahir Patel, your body's own immune system attacks the protective sheath around your nerves. This in turn causes a breakdown in the communication between the brain and the rest of the body. This process can come and go with symptoms completely disappearing for months and then recurring. However, once the protective sheath is penetrated the underlying nerves are irreversibly damaged.

Why does it happen?

According to Dr Patel, researchers in the last 20 years have focused on disorders of the immune system and genetics for explanations. Due to the wide range and subtleties of symptoms, multiple sclerosis may not be diagnosed for months to years after the onset of symptoms. Physicians, particularly neurologists, take detailed histories and perform complete physical and neurological examinations.

Dr Patel said, "In general, patients complain of numbness or weakness in one or more limbs, loss of vision, double vision or blurring of vision, tingling sensation, electric shock sensations, electric shock sensations that occur with certain head movements, tremor, lack of coordination, fatigue and dizziness. These symptoms can vary depending on which site is affected."

According to www.medicinenet.com, diagnosis for the disease can include any or all of the following tests:

• Magnetic resonance imaging (MRI) scans that can in some instances date lesions in the brain.

• Electro-physiological test—carefully examines the impulses travelling through the nerves to determine whether the impulses are moving normally or too slowly.

• Examining the cerebral-spinal fluid that surrounds the brain and spinal cord may identify abnormal chemicals (antibodies) or cells that suggest the presence of multiple sclerosis. Collectively, these three tests help the physician in confirming the diagnosis of multiple sclerosis.

"Though not fatal, women are twice as likely to develop multiple sclerosis. Females aged 20-45, anyone with a family history for the disease; people who get mono also have a higher risk of developing multiple sclerosis for some unknown reason. Caucasians are most at risk while people of Asian and African descent have the least risk. Geographic location is also a factor. People who live in higher latitudes are at higher risk. Lastly, people with a history of other auto-immune illness such as thyroid disease, inflammatory bowel disease, and type 1 diabetes are at risk of developing the disease," Dr Patel said.

"When it comes to treatment, the mainstay is steroids during 'flare-ups'. There is also more specific immuno-suppressant that is being used to alter the disease process itself. Muscle relaxants will help with stiffness, as well as physical therapy. A significant amount of people that have multiple sclerosis also develop clinical depression so many patients are on anti-depressants as well," he said.

How prevalent is multiple sclerosis

in Trinidad and Tobago?

According to Dr Patel, a 10-year study was done in Port of Spain which revealed only 13 cases of Trinidad-born patients who developed multiple sclerosis. Of those, eight were of mixed race and had half European ancestry.

He said, "Given that caucasians in northern locations are at most risk, there would be a very low incidence of multiple sclerosis in this country. For those who are affected, unfortunately, there is no cure for multiple sclerosis but there are treatments that reduce the number and severity of relapses."

According to Dr Patel, though multiple sclerosis is not as common in Trinidad and Tobago, it is not something to take lightly.

He said, "It is a serious disease with real consequences. Even though the chances are less here for seeing this disease doesn't mean it is not present. The symptoms are vague and can be due to many causes, but many cases of multiple sclerosis may be misdiagnosed as it is not the first on the list here in Trinidad. Awareness of the symptoms is the most helpful way of finding this patient population. There are ways to diagnose the disease if it is suspected. So on an individual basis, I would recommend patients to seek medical attention if any of the above symptoms are present. Though most of these patients will have other illnesses, we may find cases that would have otherwise been missed. Also it would be useful to ask the doctor of the patient's concerns and mention the possibility of multiple sclerosis to them."

Dr Patel is originally from the

United States and recently moved

to Trinidad, where he practises

in San Fernando.