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Multiple Sclerosis in India: Symptoms, diagnosis, treatment, cost explained

Multiple Sclerosis (MS) is a chronic disease where the immune system mistakenly attacks the protective covering (myelin) of nerve fibres in the brain and spinal cord. This disrupts nerve signals, causing fatigue, numbness, vision issues, balance problems, and cognitive difficulties. We spoke to leading neurologists, Dr M V Padma from Paras Health and Dr S Mohandas from KIMS Hospital, Secunderabad, to under the disease on World Multiple Sclerosis Day 2025. 'While MS is still considered rare in India, we're now seeing a shift toward moderate prevalence,' said Dr Padma. 'Currently, an estimated 150,000 to 200,000 people live with MS in India, most of them women between 20 and 40 years old.' Vitamin D deficiency, genetic predispositions, lifestyle changes, and higher stress levels may contribute to this increasing prevalence, according to Dr Padma. 'Indians also show a higher frequency of certain HLA-DRB1 gene alleles associated with MS compared to Western populations,' she added. What are the first signs of Multiple Sclerosis, and when should you see a doctor? MS symptoms can be different for each person. Early signs may include: Fatigue Muscle weakness or numbness Vision problems Loss of balance Cognitive difficulties 'If you experience these symptoms, especially more than one, you should consult a neurologist right away,' advised Dr Padma. Left untreated, MS can lead to irreversible disability. How is Multiple Sclerosis diagnosed in India? Diagnosis combines clinical assessments and tests, using the McDonald criteria. The key diagnostic tools include: Magnetic Resonance Imaging (MRI) scans: Identify lesions in the brain and spine Cerebrospinal fluid analysis: Detects immune system markers like oligoclonal bands (OCBs) Evoked potential tests: Measure nerve response times Blood tests: Rule out similar conditions 'A correct diagnosis often hinges on piecing together history, neurological exams, and imaging results,' Dr Padma explained. What treatment options are available for Multiple Sclerosis in India? The mainstay of MS treatment is Disease-Modifying Therapies (DMTs), which help reduce relapses and slow down progression. 'There are injectable, oral, and high-efficacy infusion-based therapies (HETs) available in India,' said Dr Padma. 'HETs are particularly effective and should not be reserved for later stages, starting them early can significantly improve long-term outcomes.' Despite their benefits, HETs are underused in India. 'Only about 10 per cent of Indian MS patients currently access HETs,' she added. Along with this, Ocrevus, a high-efficacy, FDA-approved drug, is now available in India. 'Roche Pharma India launched it in December 2023,' said Dr Mohandas. It's the first and only drug approved for both Relapsing-Remitting MS (RRMS) and Primary Progressive MS (PPMS) in India. It's given twice a year as an IV infusion, making it easier to adhere to than daily or weekly medications. What does Multiple Sclerosis treatment cost in India? The cost varies widely. 'You can't evaluate treatment just by the price of the drug,' said Dr Mohandas. 'You must consider the total cost, consultations, physiotherapy, diagnostics, and missed work days.' Annual costs for MS treatment, especially with HETs like Ocrevus, can be substantial. However, many pharmaceutical companies offer patient assistance programs. 'Roche's Blue Tree Program, for instance, offers services and sometimes free drug support to eligible patients,' he noted. Are there any insurance or government schemes to help Multiple Sclerosis patients? Insurance coverage for chronic conditions like MS remains limited in India. 'We need more inclusive insurance policies tailored to MS,' said Dr Mohandas. The process of getting disability certificates is also challenging due to a lack of standardised assessment for MS-specific impairments like fatigue or cognitive issues. Some pharma companies are stepping in with patient support programs, but systemic reforms are needed. Does Ayurveda or alternative medicine help with Multiple Sclerosis? Ayurveda, homoeopathy, and other alternative treatments are often used in India as complementary therapies. 'Ayurveda focuses on lifestyle regulation and herbal formulations for managing symptoms,' Dr Padma noted. However, scientific evidence supporting their effectiveness remains limited. 'While culturally significant, these should be seen as adjuncts and not replacements for evidence-based therapies,' she emphasised. How important are physiotherapy and rehab in Multiple Sclerosis? Very. 'Physiotherapy plays a crucial role in maintaining mobility, strength, and independence,' said Dr Mohandas. Tailored exercise routines, balance training, and gait improvement can greatly enhance quality of life. Supportive care options like occupational therapy, counselling, and speech therapy are also valuable. What lifestyle changes can help Multiple Sclerosis patients? Here's what both doctors recommend: Diet: A balanced, anti-inflammatory diet rich in vegetables, whole grains, lean proteins, and omega-3s Exercise: Gentle activities like walking, swimming, or yoga Mental health: Counseling, mindfulness, and support groups like MSSI 'Patients should also ensure good sleep, reduce stress, avoid smoking and alcohol, and involve supportive family and caregivers,' said Dr Mohandas. How do you recognise and manage a Multiple Sclerosis relapse? A relapse is defined as new or worsening symptoms lasting at least 24 hours, separated by 30 days from a previous episode. 'Patients should contact their neurologist immediately if they suspect a relapse,' said Dr Mohandas. Early intervention can reduce the severity of attacks and improve recovery. How often should patients get check-ups or MRIs? Monitoring disease activity is essential. 'MS patients should have a clinical neurological exam every 6 to 12 months,' said Dr Padma. MRI scans are typically done annually or when new symptoms appear. What is the long-term outlook for Multiple Sclerosis patients in India? Thanks to modern therapies, MS is no longer as disabling as it once was. 'With early diagnosis and the right treatment plan, many people with MS can lead productive lives,' said Dr Mohandas.