Multiple Sclerosis

Multiple Sclerosis

MS (Multiple Sclerosis) is a chronic disease of the central nervous system. This consists of the brain, cerebellum, brain stem, and spinal cord. In MS there are disseminated abnormalities in the central nervous system. The myelin sheaths (sheaths) of the nerve fibers are damaged at the site of the abnormalities. As a result, the nerves do not function or function less well. Failure symptoms arise in the body, which can be very diverse. This may concern, for example, paralysis and sensory disturbances. Characteristics of the disease is the changing course with exacerbations (exacerbations, relapses, relapses) and improvements (remissions). Especially at the beginning of the disease, the complaints can disappear completely between the attacks. As the disease progresses, more and more symptoms will remain. The complaints generally start between the ages of 20 and 40. MS is more common in women. In the Netherlands, about 17,000 people have MS, and about 350 people are added every year. It is remarkable that the disease mainly occurs in Northern countries. MS is rare in the countries around the equator.

Symptoms of MS (Multiple Sclerosis)

The symptoms of MS depend on the location of the abnormalities in the central nervous system. The first symptoms of MS often disappear (in 90%), this mainly concerns visual disturbances of an eye. Symptoms of double vision, sensory disturbances, loss of strength in arms or legs and dizziness can also be the first manifestations of MS. New symptoms often appear, especially at the beginning of the disease. The place where the abnormality occurs in the central nervous system is completely accidental. Because every place in the nervous system has a specific function, MS can cause many different symptoms (including fatigue, coordination disorders, speech disorders and mental changes).

How does MS (Multiple Sclerosis) arise

MS involves damage to the myelin sheath of nerve fibers in the central nervous system. The cause of this is unknown. A disorder in the immune system probably plays a role. Its own defense produces antibodies against the sheath of the nerve fibers. There may be an overreaction of the immune system to a virus infection experienced years earlier. The geographic distribution is very striking. The frequency of MS is increasing in the Northern countries. There are further indications that there is a connection with the vitamin D level in the blood. There are also studies that show a connection between certain diets and the course of MS. There are no clear indications that heredity plays an important role.

MS (Multiple Sclerosis), is it serious what can you expect?

MS is a chronic condition. The course of the disease can vary greatly. The following forms are distinguished:

1. Benign MS Benign MS, also called mild MS, is characterized by long periods without exacerbations. These periods can be 10 years or longer. About 10% of people with MS have this form.

2. Relapsing – remitting form of MS The course of the disease is characterized by ups and downs (exacerbations and remissions). Recovery from relapse cannot be complete. It is impossible to predict when a relapse will occur. This form occurs in about 80% of people with MS. Medicines are available that reduce the number of exacerbations.

3. Secondary progressive form of MS The relapsing-remitting form of MS can progress to this form. There is a gradual irreversible loss of functions.

4. Primary progressive form of MS This form occurs in about 15% of people with MS. There are no periods of relapse or recovery. There is a steady decline with an increase in complaints. No treatment is available for this form of MS.

The most serious but extremely rare form can lead to death in weeks. This mainly involves damage to the brain or brain stem. Large studies show that about 5% of patients have had no new attacks for up to 15 years after the onset of the disease. But there is also a group of about 5% who die within 5 years after the onset of the disease. About 20% of patients can still work 20 years after the onset of the disease.

The treatment of MS has received a boost in recent years with the development of new drugs. The drugs act on the immune system. These include drugs that affect the severity of the exacerbation (eg corticosteroids) and drugs (immunomodulating drugs) that are designed to limit the irreversible consequences of MS.

It may also be necessary to treat symptomatically. This can be done with medication, but also with physiotherapy and psychological assistance. Good guidance is very important.

When to go to the doctor?

It is advisable to consult your doctor in case of complaints. When the doctor thinks about MS, he will refer you to the neurologist. Based on your complaints, the findings of the physical examination, and any follow-up examinations, the neurologist can make the diagnosis likely. Follow-up examinations that can be done include a CT scan, MRI examination, and examination of the cerebrospinal fluid. In the case of exacerbations, it is advisable to consult your practitioner.

What can you do about it yourself?

There are no known measures that can help prevent MS. A regular lifestyle has a beneficial effect on the course of the disease.

General advice and precautions

In general, it is recommended that you continue to live your normal life as much as possible after a diagnosis of MS. However, it is advisable to avoid excessive exertion. This could increase complaints. During an exacerbation, mental and physical rest is recommended. Some people experience more complaints with warm weather, in which case it is advisable to avoid hot weather and to seek cooling.

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