Detection and treatment of multiple sclerosis

Written in association with: Dr Esmaeil Nikfekr
Published: | Updated: 05/12/2024
Edited by: Conor Lynch

Multiple sclerosis (MS) is a chronic neurological condition where the immune system mistakenly attacks the protective sheath (myelin) surrounding nerve fibers, causing communication issues between the brain and the rest of the body. Over time, this can lead to permanent nerve damage, affecting mobility, vision, and other vital functions. Early detection and treatment are key to managing the progression of MS and maintaining a better quality of life.

Detection of multiple sclerosis

The symptoms of MS vary widely among individuals and may include fatigue, numbness, tingling, muscle weakness, vision problems, and balance difficulties. Diagnosis typically involves a combination of clinical evaluation, magnetic resonance imaging (MRI) scans, and sometimes lumbar punctures to analyse cerebrospinal fluid.

 

The presence of lesions on the brain or spinal cord, as seen on an MRI, often indicates MS. Early diagnosis can be challenging as symptoms may be intermittent or mimic other conditions, underscoring the importance of specialist evaluation by a neurologist.

 

Treatment options

While there is no cure for MS, treatment aims to manage symptoms, slow disease progression, and reduce the frequency of relapses. Disease-modifying therapies (DMTs) are the cornerstone of MS treatment, working to suppress or modulate the immune system. These medications, available as injections, oral tablets, or infusions, can significantly decrease the activity of the disease.

 

For acute relapses of MS, corticosteroids are commonly used to reduce inflammation and hasten recovery. In advanced cases, physical therapy and occupational therapy play a critical role in maintaining mobility and improving daily function. Symptom management may also include treatments for spasticity, pain, bladder dysfunction, or fatigue.

 

Holistic care and research

Ongoing research continues to advance the understanding of MS, offering hope for improved treatments and potential cures. Lifestyle modifications, including regular exercise, a balanced diet, and stress management, can complement medical treatments and enhance overall well-being. Early detection and personalised care plans crafted by neurologists are pivotal in empowering patients to navigate the challenges of MS effectively.

 

Prompt diagnosis and appropriate treatment not only mitigate the progression of MS but also enable individuals to lead fulfilling lives despite the condition.

By Dr Esmaeil Nikfekr
Neurology

Dr Esmaeil Nikfekr is a consultant neurologist and specialist in multiple sclerosis (MS) and inflammatory conditions affecting the brain and spinal cord. His private practises include The Park Nottingham Hospital and Spire Leicester Hospital. He is working at Nottingham University Hospitals NHS Trust –UK (NUH) as part of a large and vibrant groups of neurologists and MS specialist nurses treating Multiple Sclerosis patients. He chairs the weekly regional Multiple Sclerosis Multi-Disciplinary meetings (MS-MDT).
 
In his previous role working in the University hospitals of Leicester NHS trust (UHL) from 2010 to 2017, Dr Nikfekr served as principal investigator (PI) for over 10 national and international clinical trials in MS. Currently at NUH Dr Nikfekr is engaged and participating in a national multi-centre Randomised Clinical Trial as a principal investigator exploring the use of aHSCT. He is planning to offer this innovative therapy to eligible patients next year, based on NICE criteria. With a PhD in Parkinson’s disease (PD) from Nottingham University, Dr Nikfekr also treats PD patients and offers specialised care for migraines and chronic headaches, including Botulinum toxin injections under NHS England licensing guidelines.
 
Dr Nikfekr manages a diverse range of neurological conditions, including epilepsy and neuropathy, ensuring a comprehensive approach to patient care. Currently, Dr Nikfekr runs general neurology and MS clinics within the NHS at Nottingham’s Queen’s Medical Centre and Mansfield’s King’s Mill Hospital, alongside his private practise. These clinics cater to a broad spectrum of neurological needs, reflecting Dr Nikfekr’s dedication to improving the quality of life for patients.
 
Dr Nikfekr is a Fellow of the Royal College of Physicians (FRCP-UK) and a member of the Association of British Neurologists (ABN) and American Academy of Neurologist (AAN). Dr Nikfekr has also practiced in the medico-legal field, offering expertise in cases involving personal injury and clinical negligence. As a member of The Faculty of Expert Witnesses for Doctors (FEW), he provides insights into complex medical cases.
 
Additionally, Dr Nikfekr has held membership with the UK Faculty of Medical Leadership and Management (FMLM) and has served as a registered Data Protection Officer with the Information Commissioner’s Office (ICO) since 2017.

This multifaceted career underscores a commitment to both clinical excellence and leadership in neurology.

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