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Multiple Sclerosis (Ms)

It is a chronic progressive disease characterized by demyelination of the white matter of the central nervous system, in which balance and coordination problems are intense. It is a disease that causes myelin damage.

It is a disease characterized by demyelination areas (demyelinizing plaque) in the central nervous system.
MS is an inflammatory disease of the central nervous system, namely the brain and spinal cord. In particular, the white matter structures in the central nervous system become ill. White matter consists of nerve fibers that enable communication within the central nervous system itself and between this part and other parts of the body.

The average age of onset is 15-50. Both genetic factors come to the fore in MS. It was determined that 15% of MS patients had MS in one person in the family.

MS is more common in women. Multiple sclerosis is a disease with attacks. Although the attacks vary according to the patient and the type of disease, it is absolutely unpredictable when and how often the attacks will occur.

What Are The Causes of Multiple Sclerosis?

The causes of multiple sclerosis are still debated today. Although many different theories on the subject have been emphasized, a full consensus has not been reached since the disease occurs in many people for different reasons.

It has been suggested by some scientists that the disease occurs due to various previous viral infections, various substances that a person can take into his body by eating or breathing, harmful eating habits, geographical factors or the destruction of the immune system. However, none of these theories has been fully proven.

According to an opinion put forward by some respected researchers; Multiple sclerosis occurs when a person is infected with a specific virus. According to this theory, the person is infected with a virus that will lead to multiple sclerosis in adolescence or childhood. The virus in question does not cause any negative symptoms and complaints in the person for about 10-15 years. Then, it occurs as a result of some severe diseases that the person may experience in the future (high fever, viral infection, bacterial infection, severe respiratory diseases, etc.).

In addition to the above factors, the following factors are also considered among the causes of MS disease:

Serious allergic reactions

Nutritional disorders, mineral and vitamin deficiency
Various biochemical cases that may occur in the baby's body in the womb
Being infected with viruses such as "herpes" or "varicella zoster" in the past
In addition, it can be said that the ethnicity of the person has a share in the emergence of this disease. Because when the data collected over the years are examined, it has been reported that the disease is seen at a higher rate in Northern Europe, North America and Canada (mainly the regions where the white race lives). However, people belonging to the yellow and black races have higher protection against the disease.

What Are The Initial Symptoms?

Although the symptoms vary according to the places it affects the brain, cerebellum, brain stem and spinal cord, in general;
Numbness in the body,
Myasthenia/muscle weakness
Coordination disorder,
Blurred-double vision,
The most important clues that can suggest MS are as follows;
Beginning of complaints at a young age (20-40 years)
Symptoms of involvement of different parts of the central nervous system
Symptoms are repetitive
Improvement and re-emergence of symptoms
Common symptoms of attacks
Loss of vision; inflammatory optic neuritis
Unilateral numbness paresthesia of the face or extremity; often spreads to the same or opposite extremity or trunk
Inability to use the extremity
Weakness in one or more extremities
Gait or trunk ataxia
Nausea and vomiting

What Are The Stages of The Disease?

Stage 1 (Early Period = When minimal disability is present)
In these patients who can walk independently but whose walking distance has been shortened;
Improving postural control
Facilitation of normal movement components and patterns
Improvement of muscle strength
Improving normal posture balance, walking and coordination
Informing about the disease and teaching the principles that should be considered in daily life (such as protection from heat and infections)
Placing the habit of regular exercise with the home program
Stage 2 (mid-term = moderate disability)
In these patients who can walk very short distances even with unilateral or bilateral support.
To keep the patient's lung capacities in the best possible condition using chest physiotherapy methods
Trying to maintain and increase muscle strength as much as possible
Maintaining the NEH
Trying to keep the proximal muscle groups functional
Inhibiting spasticity
Stage 3 (advanced stage = severe disability)
For these wheelchair and bed dependent patients;
Appropriate wheelchair design and teaching the exercises to be performed in the chair
Suitable bed selection
Prevention of bed complications (lung infections, decubitus ulcers, joint contractures, etc.) Teaching appropriate transfer methods
Domestic arrangements

What Are Multiple Sclerosis Treatment Methods?

Medical Therapy
Principles to be considered in treatment:
Physical therapy should not be applied during attack periods and the patient should definitely be rested. While the patient is taking medication during attacks, physical therapy should be minimized and more in-bed exercises should be preferred. The exercise program should be planned in a way that does not tire the patient and should include long rest periods.

Since the muscles created by electrical stimulation to strengthen the muscle can cause fatigue, the patient should be observed well.

Hot applications should definitely be avoided, the treatment environment should be cool and morning treatments should be preferred.

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