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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 and severe balance and coordination problems.


It is a disease that causes myelin damage. It is a disease characterized by areas of demyelination (demyelinating plaque) in the central nervous system. MS disease is an inflammatory disease of the central nervous system, that is, the brain and spinal cord. Especially the white matter structures in the central nervous system become diseased. White matter consists of nerve fibers that provide communication within the central nervous system and between this part and other parts of the body. The average age of onset is between 15-50. Both genetic factors come to the fore in MS. It has been determined that 15% of MS patients have a family member with MS. MS is more common in women. Multiple sclerosis is a disease that progresses with attacks. Although attacks vary depending on the patient and the type of disease, when and how often attacks will occur cannot be predicted in advance.


What are the Causes of Multiple Sclerosis?


The causes of multiple sclerosis are still a matter of debate today. Although many different theories have been discussed on the subject, a full consensus has not been reached because the disease occurs in many people for different reasons. Some scientists have suggested that the disease occurs due to reasons such as various previous viral infections, various substances that a person can ingest by eating or breathing, harmful eating habits, geographical factors or damage to the immune system. However, none of these theories have been fully proven. According to an opinion put forward by some respected researchers; Multiple sclerosis disease occurs as a result of a person being infected with a special virus.


According to this theory; The person is infected with a virus during adolescence or childhood that will lead to multiple sclerosis in the future. The virus in question does not cause any negative symptoms or complaints in the person for approximately 10-15 years. Later, it occurs as a result of some serious 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 taken into consideration among the causes of MS disease: Serious allergic reactions Nutrition disorders, mineral and vitamin deficiencies. Various biochemical conditions that may occur in the baby's body in the womb. Being infected with viruses such as "herpes" or "varicella zoster" in the past. It can also be said that the ethnic origin of the person also contributes to the emergence of this disease. When the data collected over the years was examined, it was reported that the disease was seen at a higher rate in Northern Europe, North America and Canada (regions where the white race lives). However, people of yellow and black races have higher protection against the disease.


What are the initial symptoms?


Although symptoms vary depending on where it affects the brain, cerebellum, brainstem and spinal cord, in general; Numbness in the body, muscle weakness, fatigue, lack of coordination, blurred-double vision, dizziness. The most important clues that may suggest MS are as follows; Complaints start at a young age (20-40 years old) Symptoms indicating involvement of different parts of the central nervous system Repetitive nature of symptoms Improvement and reappearance of symptoms Common symptoms in attacks Vision loss; inflammatory optic neuritis Unilateral numbness paresthesia of the face or extremities; often spreads to the same or opposite extremity or to the 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 there is minimal disability) In these patients who can walk independently but whose walking distance is shortened; Development of postural control Facilitation of normal movement components and patterns Development of muscle strength Development of normal posture balance, walking and coordination ▪ Informing about the disease and teaching the principles to be considered in daily life (such as protection from heat and infections) ▪ Establishing regular exercise habits with a home program 2nd Phase ( medium term = moderate disability) In these patients who can walk a very short distance even with unilateral or bilateral support, keeping the patient's lung capacity in the best possible condition by using chest physiotherapy methods, trying to maintain muscle strength and increase it as much as possible, ensuring the continuation of N.E.H. keeping proximal muscle groups functional. Trying to hold the bed Inhibiting spasticity Stage 3 (advanced stage = severe disability exists) In these wheelchair and bed-bound patients Appropriate wheelchair design and teaching exercises to do in the chair Choosing the appropriate bed Preventing bed complications (lung infections, decubitus ulcers, joint contractures, etc.). ) Teaching appropriate transfer methods. In-home arrangements 


What are the Multiple Sclerosis Treatment Methods?


Medical Therapy Physical Therapy Psychotherapy Principles to be considered in treatment: Physical therapy should not be applied during attack periods, the patient should definitely rest.

While the patient receives medication during attack periods, physical therapy should be minimized and 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. When using electrical stimulation to strengthen the muscles, the patient should be closely observed as the muscles created may cause fatigue. Hot applications should be strictly avoided, the treatment environment should be cool and morning treatments should be preferred.

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