Twenty-six-year-old Priya (name changed) had just started her first job when she noticed blurred vision in her right eye. An eye examination did not reveal any major problem, and she was reassured. A few months later, she developed numbness in her left arm and leg, which gradually improved.
Nearly a year later, she experienced an imbalance while walking. After several consultations and investigations, an MRI scan of the brain and spinal cord finally revealed the diagnosis: Multiple Sclerosis (MS).
Like Priya, many people with MS experience a long and confusing journey before receiving the correct diagnosis. Yet, unlike in the past, MS is no longer a disease that inevitably leads to severe disability. Today, early diagnosis and modern therapies allow many patients to lead active, productive, and fulfilling lives.
What is multiple sclerosis?
Multiple Sclerosis is a chronic autoimmune disease in which the body's immune system mistakenly attacks myelin, the protective covering around nerve fibres in the brain, spinal cord, and optic nerves. This disrupts the transmission of nerve signals and produces a wide variety of neurological symptoms.
MS affects nearly 3 million people worldwide. Traditionally considered uncommon in India, it is now being diagnosed much more frequently due to greater awareness and improved access to MRI scans.
MS can occur at any age, but most commonly affects young adults between 20 and 40 years of age, the most productive years of life. Women are affected about two to three times more often than men.
Recognising the symptoms
One of the challenges in diagnosing MS is that its symptoms vary widely from person to person.
Common symptoms include:
• Blurred or double vision
• Sudden loss of vision in one eye (optic neuritis)
• Numbness or tingling in the limbs
• Weakness of an arm or leg
• Imbalance and difficulty walking
• Dizziness
• Fatigue and lack of stamina
• Bladder or bowel disturbances
• Cognitive difficulties such as poor concentration or memory problems
A characteristic feature of MS is that symptoms often appear suddenly, improve partially or completely, and then recur months or years later, affecting different parts of the nervous system.
How is MS diagnosed?
There is no single test that confirms MS. Neurologists rely on a combination of detailed clinical history and neurological examination, MRI scans of the brain and spinal cord and cerebrospinal fluid (CSF) examination obtained through lumbar puncture.
The diagnosis is based on demonstrating disease activity occurring at different locations within the nervous system and at different points in time.
Why is diagnosis often delayed?
Many early symptoms, such as numbness, fatigue, dizziness, or visual disturbances, may be attributed to stress, vitamin deficiencies, cervical spondylosis, or other common conditions. Symptoms often improve spontaneously, leading patients to postpone medical consultation.
In some regions, limited access to neurologists and MRI facilities further contributes to delays. Because MS is still perceived as uncommon in India, both patients and health care providers may not immediately suspect the diagnosis.
The consequence of delayed diagnosis can be significant, as untreated disease activity may cause irreversible damage to the nervous system.
The treatment revolution
The story of MS treatment has changed dramatically over the past two decades. Earlier, treatment options were limited, and many patients accumulated disability over time. Today, more than 20 disease-modifying therapies are available globally, with several accessible in India.
Treatment goals include reducing relapses, preventing new MRI lesions, delaying disability progression and preserving quality of life.
Modern therapies can substantially reduce disease activity and, in many patients, achieve long periods of disease stability. Acute relapses are usually treated with corticosteroids, while long-term disease control is achieved using disease-modifying therapies.
The concept of 'treat early and treat effectively' has transformed outcomes. Patients diagnosed today have a far better prognosis than those diagnosed two or three decades ago.
MS and women's health
Because MS predominantly affects women during their reproductive years, concerns about marriage, pregnancy, and motherhood are common.
The good news is that most women with MS can marry, conceive, and raise healthy children.
Pregnancy itself often reduces relapse rates, especially during the second and third trimesters. However, the risk of relapse may increase in the months after delivery, requiring close neurological follow-up.
Many disease-modifying therapies can be planned around pregnancy, and treatment decisions should be individualised. Breastfeeding is generally encouraged, although medication choices may need adjustment depending on the clinical situation.
Importantly, MS does not automatically mean infertility, inability to conceive, or inability to be a good parent.
Beyond the disease: Fighting stigma
Perhaps one of the greatest challenges faced by people with MS is not the disease itself but the misconceptions surrounding it. Patients may encounter stigma in educational institutions, workplaces, and even within families. Some face difficulties obtaining employment or are unfairly judged as incapable despite having minimal disabilities.
Greater public awareness is needed to ensure that individuals with MS are evaluated based on their abilities rather than their diagnosis.
A diagnosis of multiple sclerosis can be frightening, but it should not be viewed as the end of one's aspirations. With timely diagnosis, appropriate treatment, regular follow-up, physical activity, rehabilitation, and emotional support, many people with MS continue to work, pursue careers, raise families, travel, and achieve their goals.
The message on World MS Day is clear: MS is a lifelong condition, but it is also a treatable one. Knowledge, early intervention, and hope can make all the difference for patients as well as for the families who walk this journey alongside them.
