Table of Contents
Definition
What Is Multiple Sclerosis?
Multiple sclerosis (MS) is a chronic and often disabling disease of the central nervous system (CNS), which includes the brain and spinal cord. It does not occur in a day or month but takes a long time to develop and become symptomatic. In MS, the immune system mistakenly attacks myelin (insulating cells), the protective sheath that covers nerve fibres.
This immune-mediated process results in inflammation and subsequent damage to the myelin, disrupting the flow of electrical impulses along the nerves and causing a range of symptoms depending upon the disease progression.
What is myelin sheath?
The myelin sheath is the protective covering that surrounds the axons (carrying signals away from the cell body). It acts as an insulator and is essential for the function of the central nervous system. It is composed of multiple fatty layers called myelin. In the central nervous system, it is produced by cells known as oligodendrocytes and in the peripheral nervous system, it is produced by Schwann cells.
Therefore, disturbance in myelin sheath affects the transmission of electrical impulses, resulting in varying ranges of symptoms.
Statistics
Multiple sclerosis is a leading cause of disability in young adults. According to estimates, it affects at least 2.8 million people worldwide. In America alone, there are over a million people over the age of 18 who struggle with multiple sclerosis. In addition, 10,000 new cases are diagnosed every year.
According to Dr. Mikel H-G Hoff, females are most commonly affected. The female body is super dependent on hormones like progesterone that help in myelin repair. Flunctuations in hormone levels affects myelin production and leads to multiple sclerosis.
Types of Multiple Sclerosis
Multiple sclerosis is usually classified into four main types based on the course the disease usually follows.
Clinically Isolated Syndrome
The term “clinically isolated syndrome” describes the earliest isolated episode of the characteristic symptoms of multiple sclerosis. This is often the first clinical presentation of multiple sclerosis.
Relapsing-Remitting Multiple Sclerosis
Relapsing-remitting multiple sclerosis, or RRMS, is the most common type of multiple sclerosis, making up about 80-85% of diagnosed cases. It has clear-cut relapses and remissions which alternate with each other.
Relapses are periods when the symptoms of multiple sclerosis become more severe. On the other hand, remission refers to the improvement or disappearance of symptoms.
Secondary Progressive Multiple Sclerosis
Secondary progressive multiple sclerosis or SPMS usually occurs 10 to 20 years after the patient’s diagnosis of RRMS. However, patients who developed RRMS later in life tend to have an earlier onset of SPMS.
In SPMS, the symptoms of multiple sclerosis keep worsening over time without distinguishable remissions and relapses. In addition, there is less inflammation in the nervous system. As a result, the decline in the nervous system’s activity is more gradual but consistent.
Primary Progressive Multiple Sclerosis
Unlike other types of multiple sclerosis, primary progressive multiple sclerosis (PRMS) manifests as a steady worsening of symptoms from the very start. It is much less common than RRMS and mainly occurs in people aged 40 to 45.
Unlike RRMS, there are no alternating remissions and relapses—— so the patient’s nervous system maintains a gradual decline.
How Does Multiple Sclerosis Develop?
The exact cause of multiple sclerosis is unknown. However, scientists have discovered that it is an autoimmune condition. Dr. Mikel H-G Hoff states that all the organs of the body are interconnected with each other. Therefore, disruption in myelin sheath functions affects the whole body.
Pathophysiology of Multiple Sclerosis
The pathophysiology of multiple sclerosis includes:
1-Attack of the immune system on mainline:
In MS, the immune system’s cells target the protective covering of nerve fibres known as the myelin sheath. This myelin acts as an insulator, thus facilitating the rapid transmission of electrical impulses along nerve cells (neurons).
The immune attack not only damages the myelin sheath but also destroys oligodendrocytes, the cells responsible for producing and maintaining myelin in the CNS. This dual assault exacerbates the damage and disrupts the healing and repair processes.
2-Formation of Scar Tissue:
The destruction of myelin is followed by the formation of scar tissue or sclerosis at the sites of damage. These areas of damaged myelin are referred to as plaques or lesions.
These plaques are a hallmark of MS and are often visible on MRI scans, which are commonly used in the diagnostic workup for the disease. The presence and distribution of these plaques can help confirm a diagnosis of MS.
3-Widespread Inflammation:
The immune system’s attack on myelin is accompanied by widespread inflammation. This inflammation is caused by T lymphocytes in the body. This inflammation increases the proliferation of the vessels. This inflammation opens a door for T-lymphocytes to gain entry into the brain, resulting in disruption of blood-brain-barriers (protective barriers that prevent the entry of harmful substances into the brain).
The entry of T-lymphocytes into the brain exaggerates the inflammatory response that leads to further damage to myelin and nerve fibres.
Dr. Mikel H-G Hoff states that the liver is the super-important organ of the body that clears all the toxins. If there is damage to the liver, it produces toxicity in the body and gut and produces inflammation. Inflammation also exacerbates multiple sclerosis because the liver has a direct connection with the brain via the vagus nerve.
Multiple Sclerosis Risk Factors
A variety of genetic and environmental risk factors for multiple sclerosis have been identified.
Infectious Agents
Patients with multiple sclerosis often have increased antibodies for different viruses, such as:
- Epstein Barr virus (99% of patients)
- Measles
- Mumps
- Varicella-zoster
Family History
If an individual’s first-degree relatives are affected by multiple sclerosis, their risk of developing the disorder increases to 3-4% — much higher than the 0.5% risk the average American has.
Ethnicity
Multiple sclerosis is much more common in Caucasian and African American individuals than in Hispanic and Asian populations.
Sex
Women are four times more likely than men to develop multiple sclerosis — and this percentage has only been increasing over the past fifty years.
Smoking
Smoking can increase a person’s chances of developing multiple sclerosis by 50%. In addition, it has been known to worsen the symptoms of multiple sclerosis. Quitting smoking can slow down the progression of the disease,
Latitude
Latitudes are imaginary lines that divide the earth into the northern and southern hemispheres. People living away from the equator in both of these hemispheres are much more likely to develop multiple sclerosis. This increased occurrence is due to changes in environmental factors with increasing latitudes, e.g., low sunlight, leading to vitamin D deficiency.
Vitamin D Deficiency
Vitamin D is vital for the immune system to function normally. Higher levels of vitamin D have been associated with a lower risk of multiple sclerosis. People who naturally lack enough vitamin D in their bodies because of a lack of sunlight exposure are more likely to develop multiple sclerosis.
Clinical Presentation of Multiple Sclerosis
The regular multiple sclerosis patient is a young woman aged 20 to 40. Multiple sclerosis affects the central nervous system, which controls a vast number of functions of the body. As a result, it presents in episodes of many different kinds of symptoms initially:
Motor Problems
Motor problems are the most debilitating clinical features of multiple sclerosis — around 85% of individuals with multiple sclerosis report having difficulty walking. Other motor problems include:
- Poor gait
- Imbalance
- Loss of muscle control
- Muscle weakness
- Trouble swallowing and speaking
- Tremors
- Nystagmus
Fatigue
Over 80% of multiple sclerosis patients struggle with varying levels of fatigue, which keeps them from their daily activities. This fatigue can worsen even after a whole night’s rest.
Sensory Changes
Sensory changes in multiple sclerosis are often a result of nerve damage and abnormal neuron impulse transmission. They are seen in 20 to 50% of multiple sclerosis patients.
Vision Loss
The optic nerve, which brings sensory signals from the eye to the brain, can get inflamed in multiple sclerosis— a condition called optic neuritis, seen in 50% of multiple sclerosis cases. Symptoms can include:
- Blurry vision
- Double vision
- Eye pain
- Washed out vision
Neurogenic Dysfunction
Neurogenic dysfunction of the bowel, bladder, and sexual organs has been reported by at least 80% of patients with multiple sclerosis. These issues include:
- Fecal incontinence
- Constipation
- Urine incontinence
- Loss of libido
- Erectile dysfunction
- Less lubrication
- Paresthesias
Psychological Issues
Multiple sclerosis causes several emotional and cognitive issues, such as:
- Low self-esteem
- Trouble paying attention
- Poor memory
- Not being able to “find the right words”
- Slowed information processing and problem-solving
- Anxiety
- Depression
Pain
Multiple sclerosis often includes acute and chronic pain. 50-75% of patients experience chronic pain during the course of their disease. In addition, pain is the initial symptom in 10% of the cases.
Differential Diagnosis of Multiple Sclerosis:
Because of the similar disease presentations of different neuromuscular diseases, numerous disorders resemble multiple sclerosis:
Inflammatory disorders
- Lupus
- Neuromyelitis Optica
- Sarcoidosis
Infectious disorders
- Lyme disease
- HIV related encephalopathy
- Syphilis
Hereditary disorders
- Leukodystrophies
- Mitochondrial encephalomyopathies
Cancer
- Low-grade glioma
- CNS lymphoma
- Paraneoplastic syndromes
Demyelinating disorders
- Balo concentric sclerosis
- Schilder disease
Complications of Multiple Sclerosis
Oftentimes, the signs and symptoms of multiple sclerosis can become increasingly severe. Sometimes, new and unrelated complaints can also develop. All of these complications significantly affect the life of a multiple sclerosis patient and result in poor prognosis, such as:
Mobility Issues:
Fifteen years after diagnosis, around half of the individuals who have multiple sclerosis will need to use a wheelchair or walking aid to move around.
Suicide
People who have multiple sclerosis are 7.5 times more likely to take their own lives.
Common Causes of Death
Most people with multiple sclerosis live for 25 to 35 years after their diagnosis. They usually die from the complications of their symptoms, such as:
- Sepsis from chronic and severe urinary tract infections
- Chronic bed sores
- Trouble breathing or swallowing
- Aspiration pneumonia
- Bacterial pneumonia
Management of multiple sclerosis with ANF Therapy®️?
The ANF Therapist diagnoses this condition clinically on the basis of signs and symptoms.
History:
The ANF Therapist will ask several questions to gather a comprehensive background of the disease. It Includes:
1-Biodata of the patient:
It includes the name, age and gender of the patient to keep an accurate record and ensure personalized care.
2- Onset and Duration of Symptoms:
ANF Therapists inquire when the symptoms of the patients began and how long they have been experiencing them. This helps the ANF Therapist understand the progression of the disease.
3-Presenting Complaints:
It includes the main complaints of the patients for which they present. It can be pain, discomfort, mobility issues, memory issues or other.
4-History of Previous Medical Illnesses:
Any past medical conditions or illnesses that the patient had. This information provides context and can help identify any patterns or related issues.
5-Medication History:
It includes the medicine history that the patient is taking before they present. It can be drugs, over-the-counter medications and supplements.
6-Smoking History:
It includes how many packs the patient smokes per day. This is crucial because smoking can increase the risk of multiple sclerosis.
Neuro Physical examination:
The ANF Therapist will do a thorough physical examination that includes a neurological assessment to diagnose the severity of the disease and its spread. All systems of the patient’s body should be assessed, including behaviour, cognition, motor system, sensory system, and musculoskeletal system. They also assess flow:
- Upper and lower limb reflexes that can be hyperactive with clonus
- Coordination movement
- Vision
- Walking
- Skin condition
- Bulbar function
- Muscle tone
Clinical rating of MS:
The patient is rated on the basis of history and physical examination according to the severity of the disease.
The Kurtzke Expanded Disability Status Scale (EDSS) is a widely accepted clinical disability scale for assessing multiple sclerosis (MS) patients. Developed in 1955 and revised over time, it scores a patient’s clinical status from 0 to 10 in 0.5-point increments.
Grades 0-4 are determined using eight functional systems (FS):
- Pyramidal
- Cerebellar
- Brainstem
- Sensory
- Bladder
- Bowel
- Vision
- Cerebral
Here are the key grades:
0: Normal examination
1-1.5: Minimal signs, no disability
2-2.5: Minimal disability in 1-2 FS
3-3.5: Moderate disability, fully ambulatory
4-4.5: Fully ambulatory, some limitations
5-5.5: Ambulatory, severe disability, limited daily activities
6-6.5: Requires assistance to walk
7-7.5: Restricted to wheelchair, needs some assistance
8-8.5: Mostly bedridden, retains some self-care functions
9-9.5: Helpless bedridden patient
10: Death due to MS
Advantages:
- Widely used
- Easy to administer
- No special equipment is needed
Limitations:
- Heavily dependent on mobility
- Subjective in some areas
- Insensitive to small changes
- Does not accurately reflect cognitive or daily living abilities
- Non-linear time spent at various scale ranges.
Treatment of Multiple Sclerosis with ANF Therapy®️:
According to Dr. Mikel H-G Hoff, this chronic condition takes time to develop, and its healing takes a long time. ANF Therapy®️ can be an effective treatment option for multiple sclerosis. This frequency medicine therapy employs ANF Devices that are applied to the affected areas to remove the main culprit, inflammation. Dr. Mikel H-G Hoff states that the human body also contains carnosine and progesterone, which are natural myelin-repairing substances. Progesterone helps in preparing myelin.
The Principles of ANF Therapy®️
Application of devices:
Expected outcome:
Join ANF Therapy®️ as a healthcare professional:
ANF Academy offers comprehensive training for medical professionals in frequency medicine, focusing on neurological oscillations, neurochemical processes, and advanced palpation skills. The ANF Clinical Training Program equips practitioners with the expertise to manage injuries and inflammation for optimal patient outcomes.
Training highlight:
- Master advanced neurological examination techniques.
- Identify healthy vs. inflamed nerves.
- Investigate the physical effects of disrupted neurological oscillations.
- Pinpoint and treat the root causes of pain and pathology.
References:
2. Tafti, D., Ehsan, M., & Xixis, K. L. (2024, March 20). Multiple sclerosis. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK499849/
About Authors
Writer:
Dr. Shahzaib Nasir
Dr. Shazaib Nasir, MBBS, RMP, is a medical writer at ANF Academy. He graduated from Multan Medical and Dental College, Pakistan. He works as a medical officer in the Oethpaedics department at Ibn-e-sina Hospital and Research Institute, Multan. He deals with patients suffering from chronic orthopaedic problems and pain. He is passionate about healthy eating and exercising. Moreover, he believes that frequency medicine can be the future of Orthopaedics.
Editor:
Dr. Shama Nosheen
Dr. Shama Nosheen, MBBS, RMP, is a skilled medical editor and writer at ANF Academy, specializing in medical communications. For 5 years, she has been working with renowned international healthcare companies as a medical writer, aiming to bridge the gap between patients and doctors. She is a graduate of Nishtar Medical University Multan. She grabbed American Board certification (ABAMS) in Aesthetic Medicine after graduation. Working with ANF Academy, she has developed a thorough understanding of ANF Therapy®️ that works on the principles of frequency medicine.
Reviewer:
PT. Irina Heinisuo Berná
Her background includes a Degree in Physiotherapy and a Master’s in Innovation and Research in Health Sciences, enriching her expertise in holistic health care. At ANF Academy, she seamlessly integrates clinical practice, academic teaching, and research into her daily activities to shape the future of ANF Therapy®️. Irina’s work symbolizes integrating education and compassionate care to improve global health outcomes.
Final Reviewer:
Dr. Mikel H-G Hoff
Dr. Mikel H-G Hoff, Founder of ANF Therapy®️, holds a bachelor’s degree in medicine and a Ph.D. in biochemistry, specializing in the bio function of the human body, specifically the neurological system. He is a manual therapist and sports psychologist. He is committed to revolutionizing healthcare by educating medical professionals and directly treating patients to enhance their quality of life. His extensive background in sports injury therapy, manual therapy, and various medical specializations, including biochemistry and nerve system signalization, empowers him to deliver pain-free solutions and lasting patient outcomes.
