What is MS Disease (Multiple Sclerosis)? Its Symptoms and Treatment

Multiple sclerosis (MS) is a chronic disease that can affect the brain, spinal cord, and optic nerves. The disease causes issues with vision, balance, muscle control, and other essential bodily functions. The severity of the symptoms varies from patient to patient. Some people experience very mild symptoms that do not require treatment, while others may need help moving around or carrying out daily activities.

What is MS Disease (Multiple Sclerosis)? Its Symptoms and Treatment

Multiple sclerosis (MS) is a neurological disorder that affects approximately 3 million people worldwide, with about 50,000 to 60,000 cases in Turkey. The disease is twice as common in women as in men, and it is characterized by symptoms such as movement problems, weakness, balance issues, partial paralysis, and disturbances in speech and vision. MS occurs when the myelin sheath surrounding the nerves in the central nervous system (brain and spinal cord) is physically damaged. This damage can slow down or completely block the transmission of signals from the nerves to the central nervous system. Factors such as past infections, ethnicity, genetics, and environmental influences are thought to play a role in the development of the disease.

MS appears in episodes, and a diagnosis requires an examination by a neurologist. After neurological tests and radiological imaging, an MS diagnosis is made. The disease can appear at any age, but the earlier it begins, the greater the damage it can cause. Therefore, early diagnosis and treatment of multiple sclerosis can improve the patient's quality of life and minimize the impact of the disease. The treatment for MS is applied in various ways. Before discussing the treatment methods, it is important to answer the frequently asked question, "What is MS disease?"

What is MS Disease (Multiple Sclerosis)?

Communication between a person’s tissues, organs, and immune system is provided by the nerves in the nervous system. This nerve network, spread throughout the body, is surrounded by a layer known as the myelin sheath. The myelin sheath allows the electrical activity in the nerves to be transmitted rapidly and without loss. Multiple sclerosis (MS) is an inflammatory disease that affects many different areas of the central nervous system. In MS, the immune system of the person damages or completely destroys the myelin sheath tissue surrounding the nerves. This occurs because the immune system perceives the myelin sheath as a foreign substance. As a result, the transmission of data or electrical impulses sent through the nerves from different parts of the body may experience interruptions, distortions, slowdowns, or complete failure. Due to the inability to transmit data from different parts of the body to the brain and spinal cord, the central nervous system cannot perform its normal functions. Radiological tests for MS show plaques in the brain and spinal cord. A plaque refers to areas where the myelin sheath has been damaged. As a result, when plaques are present, electrical signals from the brain to the affected area or from the nerves to the brain are unable to reach their destination. MS symptoms may appear in the eyes and affect vision. Multiple sclerosis is a chronic disease that occurs in attacks, and the frequency, severity, symptoms, and signs of these attacks can vary between patients. In the presence of multiple sclerosis, symptoms can appear at unpredictable intervals, at any time. The commonly asked question "What is MS?" can be answered in this way. Another frequently asked question is "What are the symptoms of MS?"

What Causes MS Disease (Multiple Sclerosis)?

In multiple sclerosis, the body's own immune system cells attack the protective sheath called myelin, which covers the nerve cells. Myelin is responsible for protecting nerve fibers and ensuring communication between the brain and the rest of the body. As a result of this attack, the disease can cause damage or permanent harm to the nerves.

What are the Symptoms of MS Disease (Multiple Sclerosis)?

MS symptoms can vary between individuals and also depend on the subtype of multiple sclerosis. MS typically begins with relapsing-remitting multiple sclerosis (RRMS), which involves periods of attacks and improvements. Symptoms of multiple sclerosis can appear at any time. The complaints caused by symptoms may improve partially or completely. However, in some types of multiple sclerosis, the complaints caused by attacks may be permanent. For example, damage to the optic nerve sheath may lead to complaints such as reduced color brightness or permanent vision loss. MS is a highly individualized disease in terms of symptoms. Not every symptom will be present in every MS patient, nor will they cause the same severity of complaints. The question "What are the symptoms of MS?" can be answered in detail as follows:

• Tingling and numbness in the face area,
• Numbness, tingling, weakness, fatigue in the arms and/or legs,
• Loss of balance,
• Difficulty walking,
• Movement disorders,
• Sensory loss,
• Sudden mood changes,
• Constipation,
• Incontinence (urinary and/or fecal),
• Stiffness while urinating,
• Frequent urination,
• Memory and attention problems,
• Headaches,
• Hearing loss,
• Double vision,
• Vision loss,
• Dementia-like cognitive disorders and degeneration.

What Causes MS Disease (Multiple Sclerosis)?

One of the frequently asked questions by individuals diagnosed with MS or their loved ones is "What causes MS disease?" Although the exact causes of MS are not fully understood, research on the topic is ongoing. Multiple sclerosis, which can also be described as an autoimmune disease, is not related to lifestyle or diet. It is believed to be caused by immune system disorders, genetic factors, previous viral infections, and environmental and geographical factors.

How Do MS Disease (Multiple Sclerosis) Attacks Occur?

Multiple sclerosis is a neurological disease in which the myelin sheath surrounding the nerves is damaged. This damage to the nerve sheath leads to the formation of lesions. An MS attack can be described as a condition that results in neurological symptoms caused by these lesions. In other words, the worsening of pre-existing neurological symptoms due to MS, the emergence of new symptoms, and the persistence of these symptoms for at least 24 hours is referred to as an MS attack. Any symptoms that appear within a month are considered part of a single MS attack. Multiple sclerosis attacks can last for a few hours or continue for months. As a non-infectious disease that does not lead to death, it requires continuous medical monitoring. The frequently asked question "Is MS disease fatal?" can be answered this way. According to data from 2019, there are 50,000 to 60,000 MS patients in Turkey. Therefore, it can be said that the incidence of the disease in Turkey is moderate. There are also famous individuals with MS.

Diagnosis, Tests, and MS Diagnosis

The symptoms and signs of MS can mimic many other neurological diseases. For this reason, detailed medical history, physical examination, tests, and imaging methods are necessary for differential diagnosis. There is no specialized test for diagnosing the disease. To make a diagnosis, the possible other causes of the symptoms must first be ruled out.

A detailed neurological examination by a neurologist is valuable for diagnosis. MRI can reveal whether there is any damage to the myelin sheath in the brain and spinal cord. Thus, MRI is one of the most significant aids in confirming the diagnosis.

Blood tests are usually performed to differentiate vitamin deficiencies or a very rare condition known as neuromyelitis optica, which is potentially very similar to MS.

A lumbar puncture is a procedure where a sample of cerebrospinal fluid is taken from the lower back with a needle. Cerebrospinal fluid surrounds the brain and spinal cord, and changes in this fluid may indicate problems with the nervous system.

Multiple Sclerosis Treatment

There is no specific test for diagnosing multiple sclerosis. The diagnosis is made by ruling out other diseases. In other words, while some people exhibit prominent symptoms and signs of MS, others may experience them much less frequently. Therefore, MS diagnosis can be easily made in some patients based on clinical findings, laboratory tests, and radiological imaging methods, while in some cases, diagnosis is more challenging. In such cases, it is crucial to monitor the patient closely. Currently, the 2017 McDonald criteria are applied for MS diagnosis. The doctor first takes a detailed medical history of the patient, then performs a neurological examination. If the findings from laboratory tests and radiological imaging meet these criteria, the patient is diagnosed with multiple sclerosis.

The treatment for MS aims to reduce the number of attacks and the effects of the disease on the individual. During MS attacks, methylprednisolone (a steroid) or commonly known as intravenous cortisone is administered for 3 to 10 days. In selected cases, cortisone treatment is continued orally. During this period, salt and carbohydrates are removed from the diet. To reduce the number of attacks and correct the immune system disorder, different medications tailored to the individual may be prescribed. MS treatment is carried out with appropriate medications depending on the patient's current condition.