Living with Multiple Sclerosis
What should MS patients pay attention to?
Multiple Sclerosis, or shortly MS, is a chronic disease, when nerve cells in the brain or spinal cord or, rarely, nerve cells in the brain are damaged. MS can flare up in the form of sudden so-called “acute attacks”. Neurologists point out that high temperatures, heat, intensive physical activity should be avoided during the treatment of MS. It is also a fact that MS is more common in young people, especially, women, though the disease might be presented in more severe form in men than in women.
Uskudar University, NPİSTANBUL Brain Hospital Neurology Specialist Dr. Celal Salcini shared important information about the symptoms and treatment methods of multiple sclerosis.
As it has been mentioned above, Multiple Sclerosis is a disease that occurs, when nerve cells in the brain or spinal cord or rarely nerve cells in the brain are damaged. There is a layer called myelin, a lipid-rich substance, which surrounds nerve cells axons as a layer in the brain and acts as insulation. Myelin is a layer that enhances transmition of electrical impulses. Basically, MS is caused by the damage to that myelin layer. Most of the time, its debut is presented in the form of sudden flares, so-called “acute attacks”. Sometimes health condition of the patient can even improve spontaneously, even without treatment. While many patients still have a single attack followed by partial imrpovement. Nevertheless, those attacks might rarely worsen or present progressive disease.
Drawing attention to the fact that MS can exhibit many different symptoms, Dr. Celal Salcini, states that MS can cause all kinds of neurological disorders. It means that it affects optic nerve, facial nerve, peripheral nerves in feet or arms, and even in any region of the brain. MS usually starts with the involvement of the optic nerve and, as a result, it causes blurried vision in the patient. Later, when the disease progresses and involves some areas in spinal cord or brain, it leads to neurological dysfunction in the related parts of the body. The following symptoms are quite common: numbness, weakness in extremities, high-pitched ringing and buzzing in the ears and facial numbness and palsy.
High risk groups and diagnostics
MS is more common in women than men, though the disease is presented in more severe form in men. It is true that genetic predisposition and environmental factors are important, however, they do not play a leading role in the debut of the disease. At the same time, MS is not of a rheumatological origin. Neurologists recommend a thorough diagnostics and detailed examination to diagnose and confirm the diagnosis. Further, cranial MRI is performed to evaluate the condition of the brain and the spinal cord in general. During diagnostic process, doctors try to differentiate and detect the plaques formed due to MS condition, they check for active plaques, their size and numer, and localisation. We usually perform MRI with a contrasting agent. In some cases, it might be necessary to examine the optic nerve or to take lumbar biopsy of cerebrospinal fluid.
Two types of treatment
To sum it up, treatment of MS can rely on two approaches: the first one is the treatment of acute attacks. Followed by the first patient’s complaints on a single attack, intravenous cortisone infusion is usually given to slow down the attack and protect the tissues from possible damage. If the diagnosis of MS is confirmed, after a while, the patient starts his/her first and later second-line treatments. Not so long ago, treatment of MS could be administrated only via intramuscular or subcuteneous injections. Nowadays, our patients can receive their treatment orally in the form of pills or tablets.
Extreme heat and physical activity
Neurology Specialist Dr. Celal Salcini of NPİSTANBUL Brain Hospital states that during the treatment, patients, who struggle from MS, are strongly recommended to avoid going outside, when it is hot, being under the sun for an excessive amount of time, doing extreme physical activity, and taking hot baths or staying in saunas.