MS (Emes) disease is a disease of the myelin sheath that provides communication between the brain and spinal cord and other parts of the body in the central nervous system. As a result of the disease of the myelin sheath, arm or leg movements, vision, sensation and balance problems are experienced. This disease is called MS disease. MS disease develops in attacks and can be kept under control with appropriate treatment and regular follow-up. Multiple Sclerosis disease is known to generally affect people between the ages of 20 and 40.
What is MS Disease (Multiple Sclerosis)?
MS (Multiple Sclerosis), also known as Emes disease, is a disease of the central nervous system that causes sensory deficits such as weakness in the arm or leg and vision problems, gait disturbance, and balance and coordination difficulties. In MS, the immune system attacks the protective myelin sheath that covers nerve fibers, disrupting communication between the brain and the rest of the body.
In Multiple Sclerosis, the white matter structures in the central nervous system are primarily affected. This white matter consists of nerve fibers that provide communication within the central nervous system and between this section and other parts of the body.
In patients with MS, there are damaged areas called plaques or lesions in this white matter in the central nervous system. In these damaged areas, there is a loss of a substance called myelin that surrounds the nerve. Depending on the affected area in the nervous system and the degree of the damage, the type and severity of MS disease can vary from patient to patient. In MS, the immune system attacks the protective sheath known as myelin that covers the nerve fibers. This interrupts communication between the brain and the rest of the body. Eventually, the disease can cause permanent damage to the nerve fibers.
The symptoms and treatment of MS are specific to each individual. It is not possible to find two MS patients who develop in a similar way and have the same symptoms. The different course of the disease in the individual and among patients makes the timing of the disease, the location it takes in the brain and the severity of the symptoms different. In general, in MS cases, there is a complete or semi-complete loss of any function controlled by the brain or spinal cord.
What are the types of MS disease?
MS disease occurs in different types depending on the severity of the disease and the area it affects. These types can be explained as follows:
- Relapsing-remitting MS
- Secondary progressive MS
- Primary progressive MS
- Clinically isolated syndrome
- Radiologically isolated syndrome
Relapsing-remitting MS
Most people with multiple sclerosis have the relapsing-remitting type. They experience periods of relapses, or new symptoms, that develop over days or weeks and usually resolve partially or completely. These relapses are followed by periods of silent disease remission that can last for months or even years.
Secondary-progressive MS
At least 20% to 40% of people with relapse-remitting multiple sclerosis eventually develop a steady progression of symptoms. This progression may come with or without periods of remission and occurs over 10 to 40 years from the onset of the disease. This is called secondary progressive MS. The worsening of symptoms usually manifests itself as difficulty with mobility and walking. The rate of disease progression varies greatly among people with secondary progressive MS.
Primary-progressive MS
Some people with multiple sclerosis have signs and symptoms that have a gradual onset and steadily progress, without any relapses. This type of MS is known as primary-progressive MS.
Clinically isolated syndrome
Clinically isolated syndrome of MS refers to the first episode of a condition affecting myelin. After more detailed testing, clinically isolated syndrome may be diagnosed as MS or a different condition.
Radiologically isolated syndrome
In the radiologically isolated syndrome of MS, findings resembling MS are found on brain and spinal cord MRIs in a person who does not exhibit the classical symptoms of MS.
The three rare types of MS are:
- Tumefactive MS
- Balo concentric sclerosis
- Marburg variant MS
What are the causes of MS disease (multiple sclerosis)?
MS is a disease that occurs when the immune system attacks the protective structure called the myelin sheath of nerve cells in the brain, optic nerve and spinal cord. Although the cause of MS is still not fully known, it is known that environmental factors triggering certain genetic mutations are effective in the disease.
- Environmental factors: Exposure to organic solvents and mercury, exposure to pesticides and radiation.
- Ethnicity: The disease can be seen in people of Caucasian and North African origin. The protection is higher in yellow and partially black races than in white races. In addition, the disease is seen at a high rate in Northern Europe, America and northern Canada, and at a low rate in the equatorial region.
- Influence of viruses: Past exposure to “herpes”, “varicella zoster” viruses.
- Heredity: There are genetic factors that are influenced by environmental triggers.
- Genetic factors: The rate of the same disease in children of a mother or father with MS is 7-10 times higher than in people of the same age group in the society. However, genes are not the only factor in the development of the disease. For example; even if one of the genetically identical twins develops MS, the risk of the other developing it is 25%.
Apart from these factors, the causes of MS disease include;
- Damage to the barrier between blood and brain
- Biochemical events occurring in the womb
- Diet and vitamin deficiencies
- Allergic reactions can also be listed.
What are the symptoms of MS (Multiple Sclerosis)?
Symptoms of multiple sclerosis (MS) include loss of strength in an arm or leg on one side of the body, increasing numbness in the legs, difficulty walking, double vision or blurred vision, incontinence, fatigue, depression and speech problems.
Symptoms that indicate MS disease are:
- Tingling and numbness in different parts of the body
- Muscle stiffness, muscle cramps and pain
- Vision problems such as blurry, double, and low vision
- Electric shock sensation when the neck is bent forward
- Problems with thinking, learning and planning
- Depression and anxiety
- Difficulty speaking and swallowing
- Bladder problems such as urinary incontinence
- Fatigue and weakness
- Balance and coordination problems, such as difficulty walking
- Constipation
- Sexual dysfunctions
- Short-term memory problems
How is MS Diagnosed?
Diagnosing MS is not easy. A specific test that can diagnose MS has not yet been developed. Diagnosing MS actually means eliminating other possibilities. The tests used to diagnose MS are as follows:
- MRI: MRI films provide detailed information about the brain and spinal cord and are extremely important for diagnosing MS. MS lesions appear as pale areas on these films.
- Examination of cerebrospinal fluid: Lignal bands and myelin protein, which indicate the activity of the immune system, can be detected in this fluid.
- Evoked responses: These tests are techniques for measuring the speed of nerve conduction. Nerves with damaged myelin sheaths conduct signals more slowly. There are 3 main types:
- Visual evoked responses: Examines the nerves involved in vision.
- Auditory evoked responses: Examines the nerves involved in hearing.
- Smatsensory evoked responses: Examines sensory nerves in the arms and legs.
How is MS Disease Treated?
MS treatment should be personalized and should definitely start early. The disease is usually seen between the ages of 20-50. The earlier MS starts, the more severe the course. A patient who has an MS attack may not have another attack throughout their life, or they may experience attacks with varying frequency.
The continuously progressive forms that do not appear in attacks and do not allow for recovery are much more severe. There are also types of MS that start with attacks and then continue without a break. Treatment of MS should be started without delay during attacks. Early treatment of MS prevents the disease from causing damage in the future.
What are the findings that show that MS disease will follow a good course?
- Those whose first symptoms are sensory or visual
- Long interval between 2 attacks
- The disease occurred before the age of 25.
- Initially, very few lesions are seen on MRI (Magnetic Resonance Imaging)
- Few neurological compartments affected 5 years after onset
- Few neurological sequelae 5 years after onset
- Recovery is almost complete after the attacks
- Absence of myelin protein in the cerebrospinal fluid outside of attacks
- Starting from only one region
It should not be forgotten that it is also an advantage for the patient to be a woman.
What are the signs that MS will have a bad course?
- Initially, there are many affected areas
- Multiple MRI lesions at the beginning
- Initially, the parts of the brain related to strength, balance and sphincter functions are affected.
- Progressive course of the disease at the beginning
- Oligoclonal bands in the cerebrospinal fluid in the early course of the disease
- Onset of the disease after age 40
- Less than 1 year between 2 attacks
- Initial motor findings
- Initial brainstem findings
- The patient is male
Preventive treatments (vaccines) also play a major role in the treatment of MS. Seeing a specialist doctor as soon as MS attacks are felt is the first step in MS treatment. Brain and spinal cord MRIs that can diagnose MS attacks, tests performed by taking samples from the cerebrospinal fluid, and electrophysiological tests are decisive for the methods to be applied in the treatment. The number of plaques seen in the brain after the tests show the course and degree of MS disease. There is no complete cure for MS. Treatments are applied to reduce MS attacks and the effects of ordinary attacks. Preventive treatments (vaccines) that prevent attacks by 30-40% are applied to patients who have constant MS attacks. In addition, this preventive treatment reduces the risk of disability after attacks. Interferon treatment is applied to patients who have very frequent MS attacks to reduce the number of attacks.
An important point to note in the treatment of MS is that it is not recommended to apply preventive treatments that suppress the immune system in patients who are at risk of developing chronic MS and who have had a single attack. There are now treatment options for MS, especially for the rare and severe types of the disease. MS treatments can cause serious risks because they suppress the immune system. Therefore, MS treatment should be kept under close control and should be applied in specialized health institutions.
Frequently Asked Questions About MS
What kind of disease is MS?
Multiple Sclerosis (MS) is a disease in which the myelin sheath, the substance that covers most of the nerve fibers, is damaged in the brain, optic nerves and nerves below the spinal cord. In MS, the brain or spinal cord is affected, which can affect vision, arm and leg movements. It can also cause many problems, such as sensory problems and balance problems.
How is MS disease diagnosed?
Symptoms of MS include vision problems such as double vision and blurred vision, weakness and numbness in the arm or leg muscles, usually on one side of the body, difficulty walking, exhaustion, impaired bowel, bladder and sexual functions, mood swings, memory problems and exhaustion.
Does MS prevent pregnancy?
Contrary to popular belief, MS patients do not need to postpone their pregnancy plans. MS patients can easily get pregnant and give birth to their children in a healthy way. If MS attacks become severe, it is sufficient for patients to avoid heavy work. It should be known that MS is not a disease that prevents birth and fertility. In fact, pregnancy can even alleviate MS attacks in some cases. However, since attacks can reoccur after birth, close monitoring of MS is very important.
What should be done to keep MS disease under control?
MS can be controlled with the right treatment and lifestyle changes.
- Avoid activities and tasks that will tire you out too much.
- Take care to eat regularly and healthily
- Keep harmful substances such as alcohol and cigarettes out of your life
- Get moving!
- Choose warm water instead of hot environments such as Turkish baths and saunas, which may increase MS complaints.
- Try to stay away from depression .
What are the first signs of MS disease?
The first and early symptoms of MS are numbness and tingling. These numbnesses occur in certain limbs on one side of the body. Pain in the relevant limbs, muscle weakness, fatigue, imbalance, tremors, dizziness, difficulty walking and intestinal problems such as constipation are also among the symptoms of MS.
Does vitamin D deficiency increase the risk of MS?
As a result of the studies, it is evaluated that having low vitamin D levels, which occurs as a result of too little exposure to sunlight, may increase the risk of MS.
Are there natural methods that can be used to relieve MS symptoms?
If MS is at a low or moderate level, regular exercise programs can help alleviate and control symptoms. In addition, getting plenty of rest, ensuring that body temperature does not rise too much, eating a balanced diet, and staying away from stress as much as possible are also helpful.