MS, Multiple Sclerosis

Clinic

• MS is a demyelinating autoimmune disease of nervous system.
• Specific symptoms:
  • Double vision / Blindness in one eye
  • Muscle weakness
  • Trouble with sensation
  • Incoordination
  • Cognitive disturbance

Related disease

• GBS
• Acute disseminated encephalomyelitis
• Subacute sclerosing panencephalitis

MS Sub types

I think MS is an umbrella covering a list of demyelinating disease. I suggest a new classification Considering sign / Symptoms which equals the localization of demyelination.

• Autonomic
• Visual
• Motor
• Sensory
• Vestibular
• Cerebellar

In order to find appropriate miasm, I need to know series of miasms which could cause Encephalomyelitis. Then the localized involvement could specialized the miasm. ADEM could be a good choice.

	Pathology	Sign / Symptoms	Entities	Miasms	Suggested Remedies
Vestibular MS: Vestibular system dysfunction are observed in 49–59% MS	Intra-pontine 8th nerve fascicle involvement= Acute Vestibular Syndrome (AVS).	Vertigo, dizziness and/or imbalance. These impact on functional ability, contribute to falls and significant health and social care costs	ADEM Ataxia Vertigo or Dizziness	VZV for vertigo STLE for dizziness	Gels Alum
Autonomic MS	Impairments in the autonomic control of cardiovascular and thermoregulatory function during exercise Hypothalamus temperature regulation disorder.	Uhthoff's phenomenon: Agg from higher than usual temperatures Attenuated elevations in blood pressure during exercise can negatively impact blood flow to skeletal muscle. Diminished sweating during exercise may impair heat dissipation likely limiting the exercise intensity that can be performed before detrimental core temperatures are reached.	ADEM / SSPE Thermoregulation impaired	RBOL
	Bowel MS		Constipation Involuntary stool	HSV-1 HSV-2	Alum: Constipation
	Spastic (overactive) Urge Incontinence bladder MS (8%)	Incontinence : Unable to hold urine Frequency / Urgency Hesitancy / Difficulty in starting urination	ADEM / Brain-stem Incontinence Frequency / Urgency	HTLV-1 STLE	Caust
	Overflow Bladder MS	Bladder does not empty properly (retains some urine in it)	ADEM Bladder/Atonia	HSV-1	Caust
Upper motor neuron MS	Corticospinal tract involvement		ADEM Spasticity Paralysis/Weakness: Hyper Reflexia Reflexes, Primitive	HTLV-1 HIV	Arg-n Lat-s Plb Pic-ac
Cerebellar MS			ADEM Tremor Cerebellar Ataxia Dysarthria	CXB VZV	Alum Con
Visual MS	Sudden visual loss		ADEM / SSPE Optic neuritis/Atrophy	EBV WNE HTLV-1 RBOL	Gels Phys
Cognitive MS	40-65 % Cognition skills such as Cognitive miasms: VZV, EBV, HHV-6, CMV, HSV-2, RBOL, HSV-1 Aphasic Miasms: VZV	Memory Attention span Information processing (Decision making, Problem solving) Visual-Spatial Abilities Verbal Fluency: Word-Hunting or mixing words	ADEM / SSPE Cognition Concentration Memory Aphasia	VZV EBV INFL MMP
Painful MS			Hyper Stasia Dysesthesia	HSV-1 HSV-2 HTLV-1	Ox-ac Pic-ac

Its sign/ symptoms are

• Spastic and hyperactive bladder (repetition, urgency)
• Impaired urination
• Inability to hold urine
• Inability to completely empty urine
• Nocturia

Two types: It clearly refers to two types of Urge and Overflow

2.1 Urge incontinence Bladder MS

• Sign/ Symptoms
  • Spastic (overactive) bladder that is unable to hold the normal amount of urine,
  • Frequency / Urgency
  • Hesitancy / Difficulty in starting urination
  • Incontinence (the inability to hold in urine)
• Rubrics:
  • Incontinence
  • Urging
  • Myoclonus
  • Jerking
• Miasms: HTLV-1

2.2 Overflow

• Sign/ Symptoms
  • Bladder that does not empty properly (retains some urine in it)
  • Nocturia
  • Inability to empty the bladder completely
• Rubrics:
  • Transverse Myelitis
  • Bladder, Enuresis
  • Bladder/ Atonia
• Miasms: HSV-1 , HSV-2

2.5 Bowel MS

• Constipation due to Decreased or slowed Bowel motility.
• Bowel accidents can happen for a variety of reasons. Its most common cause of is constipation. When a hard plug of impacted stool builds up in the back passage, a loose, watery stoo can leak out. This is known as overflow incontinence.

• Bowel accidents can also be caused by reduced sensation in back passage, so he dose not recognize the urge to go to the toilet, and reduced control of the muscles at the bottom of his anus.

• Rubrics
  • Constipation:
  • Involuntary stool

• Miasms: HSV-1, HSV-2

2.6 Painful MS

There are two different form first Central sensitization and second Hyper Stasia. It seems that both of them havw same maiasmatic origin. Therefore Painful (Central sensitization) and sensory MS could be explained commonly.

• Rubrics
  • Hyper Stasia: HSV-1, HSV-2
  • Dysesthesia: HTLV-1

Related disease

RBD

• Rapid eye movement sleep behavior disorder (RBD) is a parasomnia characterized by brief recurrent episodes of loss of muscle atonia during rapid eye movement sleep, with enacted dreams that cause sleep disruption.
• MS patients have an increased risk compared with the general population to be affected by a sleep disturbance, including RBD. Patients affected, however, uncommonly can present RBD as the first clinical manifestation of MS without other neurologic deficits. These clinical presentations have usually been attributed to inflammatory lesions in the pedunculopontine nuclei, located in the dorsal pons. We present a case of RBD in a 38-year-old woman who was later diagnosed as having MS due to imaging findings and development of focal neurologic deficits. MS should be considered among the differential diagnoses in patients who present with symptoms of RBD, particularly if they are young and female.

Suggested remedies

Alum 200

• Alum is one of the best remedies for multiple sclerosis with lack of muscular coordination.
• Locomotor ataxia
• Staggers on walking. Spinal degeneration and paralysis of lower limbs
• Inability to walk, expect when eyes are open or in day time
• Totters if eyes were closed
• Legs feel numb
• Constipation

Arg-n 200

• Esp when the patient feels great weakness of lower limbs.
• With softening of spinal cord.
• Weakness, rigidity, or twisting in calf muscles.
• Walks and stands unsteadily. Legs feel as if made of wood or padded
• Trembling and numbness of limbs.

Caust 200

• Esp where it is associated with urinary incontinence (Involuntary passage of urine, on coughing , walking, blowing nose or sneezing)
• Weakness and progressive loss of muscular strength, causing paralysis of single organs or parts.
• Urine dribbles or passes slowly. Unsteady walking and easily falling.

Con 200

• It is best for multiple sclerosis with muscular weakness, especially lower limbs.
• Sudden loss of strength while walking.
• Positive Romberg test: Can walk straight and steadily with eyes closed, but staggers, becomes giddy is nauseated while walking with open eyes.
• Trembling of all the limbs.
• Numbness of fingers and toes.

Gels 200

• Suggested for MS esp with Optic neuritis or Orbital neuralgia
  • Double vision and lack of muscular coordination.
  • Vision blurred or smoky
  • Blurring and discomfort in eyes even after accurately adjusted glasses.
  • Contraction and twitching of muscles.
  • Dim sighted, pupils dilated and insensible to light.
• Muscular weakness. Loss of power of muscular control.
• Loss of balance while walking
• Dizziness, dullness, drowsiness and trembling is well marked.

Lat-s 3C

• MS with spastic paralysis of lower limbs.
• Reflexes are increased.
• Tremulous tottering gait.
• Excessive rigidity of legs, spastic gait.
• Cramps in legs, worse from cold. Cannot extend or cross legs while sitting.
• Gluteal muscles and muscles of lower limbs are emaciated.
• MS with softening of spinal cord.

Ox-ac 30

• It is effective remedy, where extremities are involved.
• Weak trembling hands and feet.
• Numbness and tingling in the limbs.
• Numbness extends from shoulders to finger tips.
• Pain starting from spine and extend through limbs.
• Drawing and sharp pains shooting down limbs.

Pic-ac 30

• Where the person feel pin and needle sensation in limbs.
• Worn out persons, both mentally and physically.
• Great weakness, tired, heavy feeling all over the body esp limbs.
• Worse from exertion.
• Burning sensation in many parts , especially along spine.

Phys 30

• Another best remedy for MS with trembling of vision.
• Pain over orbits, cannot bear to rise eyelids.
• Dim vision/ Partial loss of vision.
• Spasm of ciliary muscles with irritability after using eyes.

Plb 200

• An excellent remedy for MS with paralysis of lower limbs.
• Paralysis of single muscles.
• Pain in atrophied muscles with colic.
• Cramps in calves.
• Stinging and tearing pain in limbs, also twitching and tingling , numbness , pain, or tremor.
• Constipation