Understanding disease that disrupts the nervous system

 Pauline Gatwiri, 26, their home in Chiara Village, Meru County. Gatwiri was diagnosed with Multiple Sclerosis. [Edwin Gitonga, Standard]

Multiple sclerosis, often referred to as MS, is a disease that affects how the brain and the rest of the body communicate. It is not widely known in Kenya, yet it is present and continues to affect many lives, often quietly and without early detection.

For many people, the condition only becomes clear after a long and confusing journey through the health system.

According to Dr Nshimiyimana Jules Fidele, a consultant neurologist at the Kenyatta University Teaching, Referral and Research Hospital (KUTRRH), multiple sclerosis is a condition where the body’s immune system mistakenly attacks the protective covering of nerves in the brain and spinal cord.

This protective layer, known as myelin, helps messages travel smoothly between the  brain and different parts of the body. When it is damaged, those messages are disrupted.

“When that covering is affected, communication between the brain and the body is interfered with,” he explains. “That is why patients present different symptoms depending on which part of the nervous system is involved.”

The exact cause of multiple sclerosis is still not fully understood. Doctors believe it is linked to a combination of factors rather than one single cause. The World Health Organization describes MS as an autoimmune condition, meaning the body turns against itself.

Dr Nshimiyimana notes that genetics may play a role, alongside environmental factors and certain infections. It is not a disease that can be passed from one person to another, and it is not caused by anything a patient has done.

Research from the Multiple Sclerosis International Federation also points to low levels of vitamin D, limited exposure to sunlight, and geographic location as possible risk factors. The condition is more common in parts of the world further from the equator, though cases in Africa are increasingly being recognised.

The signs and symptoms of MS can vary widely from one person to another, which often makes it difficult to diagnose. Some people experience weakness in the arms or legs, while others report numbness, tingling sensations, or what many describe as pins and needles.

Vision problems are also common, including blurred or double vision. Some patients struggle with balance and coordination, making walking difficult, while others experience extreme fatigue that does not improve with rest. Memory problems and difficulty concentrating can also occur.

“Some patients may feel numb on one side of the body. Others may have difficulty walking in a straight line or may develop vision problems,” Dr Nshimiyimana says. “It depends on the part of the brain or spinal cord that has been affected.”

One of the defining features of MS is that symptoms can come and go. A person may experience a period where they feel relatively well, followed by a relapse where symptoms return or become worse. This pattern can make the condition confusing for both patients and healthcare providers.

There is currently no known way to prevent multiple sclerosis because the exact cause is unclear, and prevention strategies remain limited. However, doctors advise maintaining a generally healthy lifestyle, including a balanced diet, regular physical activity, and avoiding smoking. Exposure to sunlight, which helps the body produce vitamin D, is also considered beneficial.

“Prevention is difficult because we do not fully understand the cause,” Dr Nshimiyimana explains. “What is important is early diagnosis and proper management.”

While there is no cure for MS, treatment options are available to help manage the condition and improve quality of life. These treatments aim to reduce the number of relapses, slow down the progression of the disease, and control symptoms.

Management may involve medications that regulate the immune system, drugs that relieve pain and other symptoms, physiotherapy to support movement and strength, and counselling to address emotional and psychological challenges.

According to the National Multiple Sclerosis Society, early treatment can significantly improve long-term outcomes for patients. Dr Nshimiyimana emphasises that MS requires ongoing care and regular monitoring.

“This is a lifelong condition. Patients need continuous follow-up and support to manage it effectively,” he says.

Certain groups of people are more likely to develop  MS than others. The condition is most commonly diagnosed in young adults, particularly those between the ages of 20 and 40. Women are also more likely to be affected than men. Other risk factors include having a family history of MS, smoking, and previous viral infections.

If not properly managed, MS can lead to serious complications. Over time, some patients may develop significant mobility challenges, including difficulty in walking or even a complete loss of movement. Vision loss can occur in severe cases. Chronic pain is also common, as are mental health conditions such as depression and anxiety.

Some patients may experience problems with bladder and bowel control, which can further affect their quality of life.

“Over time, the disease can reduce independence,” Dr Nshimiyimana says. “That is why early treatment and support are very important.”

Globally, multiple sclerosis affects millions of people. Data from the Multiple Sclerosis International Federation shows that more than 2.8 million people are living with the condition worldwide. In Africa, the reported numbers are lower, but experts believe this is largely due to underdiagnosis rather than the absence of the disease.

“Many cases are missed because there are few neurologists and limited access to diagnostic tools like MRI scans,” Dr Nshimiyimana explains.

The World Federation of Neurology has highlighted the shortage of neurological specialists across the continent, which continues to affect timely diagnosis and treatment. In Kenya and across East Africa, there is no comprehensive national data on MS, making it difficult to fully understand its true prevalence.

Misconceptions about MS remain common, especially in communities where awareness is low. Some people believe the condition is caused by witchcraft or supernatural forces. Others think it is contagious. There are also cases where individuals with MS are mistaken for being intoxicated because of difficulties with balance and movement.

“In some communities, people may think they have been bewitched, but that is not true. MS is a medical condition that affects the nervous system and cannot be passed from one person to another,” Dr Nshimiyimana says.