Multiple sclerosis (MS) is a disease that progresses with structural deterioration in the sheaths of nerve fibers called demyelination in the brain and spinal cord. The disease occurs when the myelin substance in the lipid (fat) structure that forms the sheath of the nerve fibers leaves its place to scars called sclerosis after deterioration. Damaged areas are called plaques. These plaques can form in many parts of the nervous system and cause deterioration in functions related to that center due to the inability of nerve conduction. It is not contagious. Although the exact cause of the disease is not known, there is an abnormal behavior in the immune system in the damage of the myelin sheath, that is, an attack on the myelin sheath like a foreign tissue. However, the reason for this attack is not yet known. It is not hereditary. The cause is not known yet. It is more common between 20-40 years of age. It is two times more common in women than men. It is more common in the temperate climate zone. The region with the highest incidence is Canada and Northern Europe.
Patients often describe fatigue, weakness, weight loss, muscle and joint pain weeks or months before the onset of nervous system symptoms. Symptoms may develop insidiously within hours, days, or weeks, rarely over years.
The disease picture comes in attacks and regresses spontaneously or with treatment, but the clinical picture progresses a little more in each attack. It shows a long course over the years. There are occasional exacerbations. These sometimes cause new findings to be added to existing findings. Their aggravation is usually followed by periods of remission (remissions), in which the patient can return to the pre-relapse state and may leave some disabilities behind. Not every MS is the same. Some people have few or no severe attacks, but there are also patients whose symptoms constantly worsen and disability develops over time.
Regardless of its form, MS can pause at any time during its course
Symptoms vary depending on which part of the brain or spinal cord is affected. Weakness, tingling, numbness, balance disorder, double vision, visual impairment , involuntary eye movements, tremor, weakness in the face, arm or leg (paralysis), speech disorder, memory problems, sexual dysfunctions, problems in urination may be present. One or more of these symptoms can be seen together.
MRI is a very valuable method in the diagnosis of the disease. It is very important to see MS plaques with myelin destruction during attacks. During the remission period, the plaques disappear.
In addition, in the examination of Cerebrospinal Fluid (CSF) taken from the waist; Abnormal values in measurements such as oligoclonal band, myelin-based protein, immune globulin G index indicate that there is a problem with the immune system in the brain. In addition, the diagnosis of the disease is made by applying a test that measures the response of the central nervous system to a stimulus from any part of the body, called Evoked Potentials.
There is no known effective treatment for MS. However, cortisone treatment, which reduces the frequency and severity of attacks, is the most well-known and frequently applied one. However, in recent years, it is possible to slow down the progression of the disease and reduce the rate of disability with some treatment methods.
In addition, the symptoms can be treated (physical therapy in strokes, etc.).
