Multiple Sclerosis is here but are doctors ready?

Multiple Sclerosis is here but are doctors ready?

Emmy Fitri, The Jakarta Post, Jakarta

A 30-year-old mother first noticed her legs felt numb. The next week she had bowl and bladder problems. Now she is wheelchair- bound and unable to take care of her children. She is nursed like an infant.

Six months earlier, she had a blurred vision in her right eye until she went nearly blind but then her sight miraculously returned. The same problem later occurred in her left eye but again disappeared after two weeks.

However, it was too late for the women when a doctor finally diagnosed her with Multiple Sclerosis or MS. The illness -- which is relatively uncommon here -- is a variable life-long condition, affecting multiple sites of the central nervous system, leading to lesions and scars -- sclerosis -- within the brain and/or the spinal cord.

MS is typically seen in people -- women are twice as likely as men to get the condition -- between the ages of 20 and 40. The average onset of the condition is at 30 years. Recent data shows that MS affects 2.5 million people worldwide, with most people in North America and Europe.

Senior neurologist with the University of Indonesia's School of Medicine, Jusuf Misbach, said MS was not often diagnosed here or in other Asian countries because it was generally thought of as a Caucasian illness. However, the disease did exist, he said.

"There is MS here, although we don't know yet what the figures are, due to a lack of public awareness and also the fact that many doctors do not go as far as to diagnose particular symptoms as MS."

Jusuf cited reports from Japan, Thailand and the Philippines where a number of MS patients were found, with the disease typically attacking their spinal cord. These reports opened the possibility that the disease would be found in Indonesia, he said.

"The woman is one of two cases I've been handling," he said.

"For Asians, the common symptoms of MS start with an optical neurotic attack on one of the eyes. The condition can improve in days or weeks but then reoccur in the other eye in the same pattern."

"This onset of symptoms can already be treated as MS. But most doctors sometimes diagnose it as other diseases so when the disease has spread to other parts of the nervous system, it is too late to do anything," Jusuf said to a gathering last week.

The common symptoms in people with MS include abnormal sensations -- some people with MS experience strange sensations, such as feeling cold, numbness, tingling or itching -- visual disturbances, motor dysfunction, problems with balance, bowel and bladder problems, sexual problems and pain.

"These symptoms can also lead to depression," Jusuf said.

Most of the symptoms could be alleviated by a range of therapies and drugs and people needed to contact their physicians to find the best possible treatments, he said.

While some symptoms are seen often, others are only rarely noticed. However, even when somebody was asymptomatic, MS might still be silently active, Jusuf said.

Although there has been a great amount of research into the disease, no one knows exactly what triggers MS.

While there is a hypotheses that viruses may be responsible for MS, there was no reliable scientific proof of this as yet, Jusuf said.

"Researchers nowadays are convinced that MS is most likely caused by a combination of factors such as climate, latitude, race, industrialization (related to toxic chemicals), age, genetic disposition, viruses and socioeconomic status," he said.

"Some people certainly seem to be more susceptible to MS because of their genetic disposition."

Because the disease could often be arrested if diagnosed early, it was important that the public and especially doctors learned to recognize it, Jusuf said.

When asked if he believed doctors here were currently able to quickly identify diseases like MS, he was hesitant to respond.

"I don't think we are ready. But we have to be ready," he said.

Jusuf pointed doctors and patients to a website www.ms- gateway.com, which is full of information about MS, and noted that Germany's pharmaceutical company Schering had also published 15-paged comic book Yang Harus Diketahui Semua Orang Tentang Multipel Sklerosis or What All People Must Know About Multiple Sclerosis, distributed free to all those who wanted to know more about MS.

"People can get this booklet at the neurology center in the Cipto Mangunkusumo Hospital, and some neurologists' clinics," the company's president director, Uwe Dalichow, said on the sidelines of the briefing.