Yeditepe University Kozyatağı Hospital Neurology Specialist Assoc. Prof. Dr. Emin Özcan shared important information about MS Disease (Multiple Sclerosis).

What is MS Disease? What Causes MS Disease?

MS (Multiple Sclerosis) is a disease in which our immune system attacks and damages nerve sheaths on its own. It belongs to the group of autoimmune diseases. So, MS is a disease in which our immune system attacks the body's own building blocks.

Although the exact cause is not known, we can say that many factors cause susceptibility to the disease. However, in general, we can define MS as a set of complaints that the body perceives the sheaths of the nerves in the brain and spinal cord as foreign substances and that our immune system attacks them, resulting in nerve damage.

What are the Symptoms of MS?

The most common finding in MS disease is vision loss. Especially painful vision loss or blurred vision in one eye is an important finding in terms of MS. In addition, all findings related to the central nervous system such as weakness in the arm, weakness in the leg, weakness in both arms or both legs, numbness on one side of the body, insensitivity, tingling, imbalance, and speech disorder can be seen in MS. But the most common complaints we see are a weakness on one side or blurred vision and double vision.

How to Diagnose MS Disease?

MS is a disease of the central nervous system. In a sense, it is also difficult to diagnose. It is a disease of the brain and spinal cord, and all complaints affecting the brain and spinal cord may suggest MS or be confused with MS. However, an experienced specialist can easily diagnose it. Therefore, it is necessary to consult a neurologist who is a specialist in MS and is experienced in this field. Because after the diagnosis of MS, effective treatment should be started as soon as possible. Then, the definitive diagnosis of the disease is made by using the necessary imaging methods and diagnostic methods.

When Does MS Develop?

MS is a disease of young adulthood, which usually occurs between the ages of 20 and 40. Its incidence decreases gradually over the age of 40-50. It is extremely rare over the age of 60-65. Again, before the age of 15, the incidence of MS decreases. However, there are also MS patients aged 8-9 years. This group is called Pediatric MS. However, it is extremely rare compared to other age groups. In general, MS is called a young adult disease that occurs between the ages of 20-40.

Is MS More Common in Women?

MS is about 3 times more common in women than men. It is more common in women between the ages of 20-40. Why is MS more common in women? Actually, there is no clear answer to this question. However, in general, it is known that autoimmune diseases, that is, diseases in which the immune system attacks the body's own building blocks, tend to be more common in women.

Is Urinary Incontinence a Symptom of MS?

Although urinary incontinence is counted as one of the symptoms of the disease, urinary incontinence is not an indicator of the stage of the disease. In other words, there is no certainty that urinary incontinence occurs in advanced stages. In some cases, it may occur at the beginning of the disease or during the disease. Therefore, even if urinary incontinence occurs during the disease, it does not indicate any stage. Should this problem occur, it should be treated appropriately.

How is the Definitive Diagnosis of MS Made?

For a definitive diagnosis of MS, it is necessary to consult a neurologist experienced in MS. First of all, after the patient's history is received by the physician, a definitive diagnosis can be made with the necessary examinations related to MS, such as MRI, imaging, blood tests, and if necessary, fluid removal from the waist.

Are There Types of MS Disease?

There are different subtypes of MS disease. The most common type is the type that progresses with attacks and remissions, that is, exacerbations and extinctions. In addition, there are types of MS that progress with gradual worsening from the onset. There is also a type that starts with attacks and progresses with a gradual worsening. However, in general, most of the onset patients have the MS type with attacks and extinctions, namely the relapsing-remitting type.

How to Treat MS?

Anyone who has been diagnosed with MS must receive treatment. Treatment in MS progresses in 3 steps.

The first step of the treatment is the treatment for the complaints arising from the disease, the recovery of the newly emerging picture, and the elimination of the complaints. This treatment is defined as "Attack Treatment".

The second step of the treatment is the main treatment and treatments aimed at improving the course of the disease are included in this step. This is the main pillar of the treatment. Every patient diagnosed with MS must receive treatment according to his/her condition. The earlier the patient starts treatment, the lower the risk of future disability development. For this reason, it is very important to start the treatment early and to carry it out effectively.
The third step of treatment includes physical therapy and physiotherapy applications. MS patients may have complaints such as loss of strength, mild stiffness in the muscles, gait disturbance, and imbalance. At this point, physiotherapy and physical therapy applications, and rehabilitation applications provide very serious benefits. Currently, there is no treatment for MS to completely eliminate the disease. MS is a chronic and ongoing disease. However, it is possible to control and stop its progression with effective treatments and appropriate follow-ups. Therefore, all patients should receive treatment. Research into the treatment of MS continues.

What Should MS Patients Pay Attention to in Daily Life?

It is possible to list the issues that MS patients should pay attention to in daily life as follows:

Regular walking; Walking functions are one of the most impaired functions in MS. For this reason, it is important and necessary for MS patients to walk continuously and rhythmically, for at least 30 minutes a day. This gait need not be an intensive walk in the cardiac exercise style. It can be a slow walk. However, the important thing is to do it rhythmically and uninterruptedly.

Regular sleep; Regular sleep is a must for MS patients. For this reason, they should take care to get quality sleep in their daily lives.
Avoiding smoking; Smoking is a habit that MS patients should definitely avoid. Because smoking is one of the serious risk factors that cause the development of attacks, the worsening of the course of the disease, the development of new attacks, and the acceleration of the worsening picture, which we call progression, in MS patients. For this reason, MS patients who smoke should definitely quit it.

In addition, sometimes balancing exercises such as yoga and meditation can have serious benefits for one of the important symptoms defined as fatigue in MS. For this reason, regular sleep, regular exercise, and walking are the most important elements for the lifestyle of patients.

What Does an MS Attack Mean?

MS attack is a newly emerging neurological picture. In other words, the appearance of complaints such as loss of vision, double vision, speech disorder, weakness on one side, instability, numbness, and urinary incontinence and their persistence for more than 24 hours is defined as an attack.

What Does Relapse of MS Mean?

MS is a disease that progresses with attacks and remissions, that is, exacerbations and extinctions. Since MS is a disease that progresses with attacks, these attacks should be prevented. Despite the treatments that prevent the attacks from occurring, the disease may reveal new attacks. This situation is referred to as "relapse" among people. However, relapse in MS is different. The disease naturally progresses with attacks and remissions. Because of the risk of mild sequelae that can be left by these attacks, preventive treatments are applied. Treatments that prevent attacks prevent the accumulation of disability by preventing these attacks. Therefore, patients need to receive treatment.

Does Vitamin D Deficiency Cause MS Disease?

One of the most blamed conditions for the development and emergence of MS is vitamin D deficiency. Although vitamin D deficiency does not lead to the emergence of MS from scratch, there are publications that chronic severe vitamin D deficiency paves the way for the emergence of the disease in individuals with a genetic predisposition. For this reason, vitamin D levels are kept at optimal levels in order to ensure a better course of the disease during treatment.

How Often Should MS Patients Go for Checkups?

Physician control times vary according to the patient. For example, if a patient has constant attacks despite medications and appropriate treatments, these patients may need to visit their physician more frequently.

Therefore, the physician should determine the frequency of control according to the patient's condition. However, in general, physician controls should not be neglected at intervals of 3-6 months. It is also important to perform MRI scans at the request of the physician, in terms of evaluating whether new plaques are formed and conditions such as progression of the disease and shrinkage in the brain.

When Does Loss of Movement Occur in MS Disease?

The situation defined as loss of movement in MS is the loss of power. In other words, it is also known as loss of muscle strength. Complaints such as weakness in the arm and weakness in the leg may occur. This may occur at the beginning of the disease, but it can also be seen with attacks in the later stages of the disease. However, this varies depending on the course of the disease, the type of person, and how the disease progresses in that person. Therefore, it may occur at the beginning of the disease and during the disease, or it may never occur.