Multiple Sclerosis Treatment in Palamu
Expert diagnosis and comprehensive management of multiple sclerosis by Dr. Yuvraj Lahre, DM Neurology (AIIMS). From first attack evaluation to long-term disease-modifying therapy at Palamu Neuro & Eye Care, Palamu.
What is Multiple Sclerosis?
Multiple Sclerosis (MS) is an unpredictable, often disabling disease of the central nervous system. In MS, the body's immune system mistakenly attacks myelin—the protective sheath covering nerve fibers in the brain and spinal cord. This damage disrupts the smooth flow of electrical impulses, causing a wide array of unpredictable neurological symptoms. MS can present as relapsing-remitting (flare-ups followed by periods of recovery) or as a steadily progressive condition. Because MS symptoms can mimic many other disorders, accurate diagnosis requires the advanced expertise of a neurologist. Dr. Yuvraj Lahre provides comprehensive MS care, utilizing disease-modifying therapies to slow progression and manage symptoms.
Symptoms of Multiple Sclerosis
- •Numbness, tingling, or severe weakness, typically on one side of the body or the legs
- •Sudden, painful vision loss, usually in one eye at a time (optic neuritis)
- •Prolonged double vision or blurred vision
- •Electric-shock sensations that occur with certain neck movements (Lhermitte's sign)
- •Tremors, lack of coordination, or an unsteady, stumbling gait
- •Slurred speech and extreme, debilitating fatigue
- •Bowel, bladder, and sexual dysfunction
Clinical Observations at Palamu Neuro & Eye Care
At Palamu Neuro & Eye Care, Dr. Yuvraj Lahre is diagnosing MS more frequently in young Jharkhand women than historical data would predict. Despite abundant sunlight in Jharkhand, cultural practices of full-body clothing and limited outdoor time for women result in surprisingly high vitamin D deficiency rates — challenging the latitude-based assumption that tropical populations are protected from MS.
Standard medical literature states:
Multiple sclerosis is classically described as a disease of temperate latitudes with low prevalence in tropical regions. Vitamin D deficiency is a well-established risk factor.
We check vitamin D levels in every suspected MS patient and initiate aggressive supplementation where deficient. We counsel patients in Hindi about the importance of 15–20 minutes of morning sunlight exposure on arms and legs. We also maintain a low threshold for MRI brain with contrast in young women presenting with transient neurological symptoms.
— Dr. Yuvraj Lahre
Causes & Risk Factors
- •An autoimmune response where the body attacks its own myelin
- •Genetic susceptibility, though it is not directly inherited in a simple manner
- •Environmental factors, including low Vitamin D levels and less sun exposure
- •Viral infections, particularly the Epstein-Barr virus, which is strongly linked to MS onset
- •Smoking, which significantly increases the risk and severity of the disease
- •Age and gender—it most commonly begins between ages 20 and 40, and affects women much more than men
Diagnostic Tests
MRI Brain and Spinal Cord
MRI detects demyelinating lesions in characteristic locations — periventricular, juxtacortical, infratentorial, and spinal cord. Gadolinium contrast distinguishes active from chronic lesions. The McDonald criteria rely heavily on MRI demonstrating dissemination of lesions in space and time.
Neurological Examination
Comprehensive neurological exam assessing cranial nerves, motor and sensory function, coordination, gait, and reflexes to document clinical evidence of lesions.
Visual Evoked Potential (VEP)
VEP testing measures the speed of electrical impulse transmission along the visual pathway. Demyelination slows conduction, producing delayed VEP responses that confirm an optic nerve lesion.
Treatment Approach
Dr. Yuvraj Lahre provides evidence-based, comprehensive MS care following the latest international treatment guidelines:
- Disease-Modifying Therapies (DMTs)
- Initiating specialized immunomodulatory medications (oral, injectable, or infusions) to alter the course of the disease and prevent future relapses.
- Acute Relapse Management
- Using short, high-dose courses of intravenous corticosteroids to quickly reduce inflammation and accelerate recovery during severe flare-ups.
- Targeted Symptom Relief
- Prescribing specific medications to manage debilitating symptoms like muscle spasticity, neuropathic pain, fatigue, and bladder issues.
- Multidisciplinary Rehabilitation
- Coordinating with physiotherapists and occupational therapists to maintain mobility, strength, and independence.
When to See a Doctor
- !If you experience a first episode of neurological symptoms — vision loss, double vision, spreading numbness, or unexplained weakness — especially between ages 20 and 40
- !If diagnosed with MS and not on disease-modifying therapy — early treatment is the best predictor of good outcome
- !If MS symptoms are worsening or you suspect a relapse — prompt evaluation distinguishes true relapses from pseudo-relapses
- !If on a DMT and experiencing side effects — alternatives can be discussed rather than stopping treatment
- !For regular monitoring — clinical examination every 6 months and annual surveillance MRI
Frequently Asked Questions
What are the early signs of multiple sclerosis?
MS often begins with a clinically isolated syndrome (CIS) — a single episode of neurological symptoms caused by inflammation and demyelination. Common presentations include: optic neuritis (painful vision loss in one eye with reduced color perception), transverse myelitis (numbness, weakness, or band-like sensation around the trunk with leg involvement), brainstem symptoms (double vision, facial numbness, vertigo, or incoordination), or sensory symptoms (numbness and tingling spreading over hours to days). Because these symptoms can mimic many other conditions, expert neurological evaluation with MRI is essential. Dr. Yuvraj Lahre at Palamu Neuro & Eye Care provides timely diagnosis and distinguishes MS from its mimics — neuromyelitis optica spectrum disorder (NMOSD), MOG antibody disease, and other autoimmune or vascular conditions.
What disease-modifying treatments are available for MS?
Disease-modifying therapies (DMTs) are the cornerstone of MS treatment, aimed at reducing relapse frequency, slowing disability accumulation, and preventing new MRI lesions. Dr. Lahre discusses the range of DMTs — from injectable therapies (interferon-beta, glatiramer acetate) to oral agents (dimethyl fumarate, fingolimod, teriflunomide) and high-efficacy infusible treatments (ocrelizumab, natalizumab, rituximab). The choice is individualized based on disease activity, prognostic factors, comorbidities, family planning considerations, and risk tolerance. Dr. Lahre provides detailed counseling on each option's efficacy, safety profile, monitoring requirements, and coordinates therapy initiation.
How is an MS relapse managed?
An MS relapse is the new onset or worsening of neurological symptoms lasting more than 24 hours, separated from a previous attack by at least 30 days, in the absence of infection. Dr. Lahre evaluates suspected relapses promptly — not every symptom fluctuation represents a true relapse. For confirmed, functionally significant relapses, treatment typically involves a short course of high-dose intravenous methylprednisolone (3 to 5 days) to speed recovery. After the relapse is controlled, Dr. Lahre reassesses the DMT strategy — a relapse on current therapy may indicate the need to escalate treatment. Symptomatic treatments for residual issues (spasticity, neuropathic pain, fatigue, bladder dysfunction) are also provided.
Can people with MS lead a normal life?
With modern treatment, the outlook for people diagnosed with MS today is significantly better than a decade ago. Early diagnosis and initiation of effective disease-modifying therapy can dramatically reduce relapse rates, slow disability accumulation, and preserve brain volume. Many people with MS continue to work full-time and maintain active lives. The key is early, proactive treatment. At Palamu Neuro & Eye Care, Dr. Lahre emphasizes comprehensive care: disease-modifying therapy to control the immune attack, symptomatic management for daily challenges, lifestyle optimization (vitamin D supplementation, smoking cessation, exercise), and regular monitoring with clinical examinations and MRI surveillance.