What bodily functions are affected by Multiple Sclerosis (MS) beyond speech?

Multiple Sclerosis Affects Multiple Bodily Functions Beyond Speech

Multiple sclerosis (MS) affects numerous bodily functions beyond speech, including mobility, cognition, vision, swallowing, and autonomic functions, significantly impacting patients' quality of life and increasing morbidity and mortality risks.

Neurological Functions Affected by MS

Mobility and Motor Function

• MS commonly affects lower limb function, causing balance disturbances, gait dysfunction, and increased fall risk 1
• 50-80% of MS patients experience balance and gait dysfunction, with over 50% falling at least once yearly 1
• Balance dysfunction in MS manifests as:
  • Decreased ability to maintain position
  • Limited movement toward limits of stability
  • Delayed responses to postural displacements
  • Impaired dual-task integration 1
• Walking changes include reduced gait speed, impaired walking balance, and reduced walking-related physical activity 1

Cognitive Function

• Cognitive impairment affects attention, visual memory, verbal memory, executive function, and psychomotor speed 2
• Cognitive dysfunction is a high-priority concern for patients, especially those with longer disease duration 3
• MS can cause frontotemporal dementia in 20-50% of cases 2

Visual Function

• Visual impairment is ranked as the second most important bodily function affected by MS from patients' perspective 3
• MS can cause unilateral optic neuritis and internuclear ophthalmoplegia 4
• Visual disturbances significantly impact quality of life and daily functioning 3

Swallowing and Nutritional Function

• Dysphagia (swallowing difficulty) is common in MS patients, with prevalence ranging from 10-90% 2
• Dysphagia typically results from brain stem involvement and is often accompanied by speech difficulties 2
• Dysphagia increases the risk of:
  • Dehydration
  • Aspiration pneumonia
  • Malnutrition
  • Mortality 2

Autonomic and Other Functions

• MS affects bladder function, causing urinary symptoms 4
• Sensory disturbances are common, affecting touch and proprioception 4
• Fatigue is a prevalent symptom affecting daily activities 4
• Depression and emotional changes impact mental health 5

Risk Factors and Disease Progression

• MS typically presents in young adults (20-30 years) and more commonly affects women (3:1 female-to-male ratio) 4
• Disease progression can lead to increasing disability over time 4
• Patients with bulbar onset (affecting speech and swallowing) and older age have the shortest life expectancy 2
• Mean survival of MS is 3-5 years, with 5-10% living longer than 10 years 2

Multidisciplinary Management Approach

• Early detection and treatment of MS symptoms by a multidisciplinary team is recommended 2
• Team should include neurologist, nutritionist/dietitian, speech and language therapist, physiotherapist, occupational therapist, and nurse 2
• Regular screening for dysphagia is recommended, especially in patients with cerebellar dysfunction 2
• Nutritional support is crucial for preventing malnutrition in MS patients 2

Monitoring and Prevention

• Regular assessment of nutritional status (BMI, weight loss) is recommended to detect early malnutrition 2
• Body composition analysis using DEXA or BIA should be performed if available 2
• Instrumental exploration of dysphagia should be performed in high-risk MS patients 2
• Regular screening for cognitive dysfunction using standardized tests is recommended 2

MS is a complex disease that affects multiple bodily systems beyond speech, with significant impacts on quality of life, morbidity, and mortality. Early detection and comprehensive management of these various symptoms are essential for improving outcomes in MS patients.