Multiple sclerosis or MS is the nervous system disorder most common in adolescents. It is a progressive disease of the nerves in the brain and spinal cord that causes muscle weakness and difficulty with the senses. In the Netherlands, more than sixteen thousand people have MS and approximately three hundred and fifty more people are diagnosed every year. What are the causes and symptoms of MS, what treatment options are available and what is the prognosis?
- Multiple sclerosis or MS
- Two forms of MS
- Causes of MS
- Symptoms MS
- Diagnosis MS
- Treatment MS
- Prognosis MS
- Revolutionary treatment in Sweden (April 2016)
Multiple sclerosis or MS
Multiple sclerosis (also called multiple sclerosis) or MS usually develops between the ages of twenty and forty (but also occurs in children) and is more common in women than in men. As for heredity, MS is more common in certain families. In MS, the nerves of the brain and spinal cord become increasingly damaged, which can lead to numerous symptoms. It concerns the senses, movement, balance and functions of the body.
Two forms of MS
- There are two forms of MS, the relapsing-remitting type is the most common. The symptoms may last days or weeks and then be absent for a very long time (months, years). Some of the symptoms may also persist between attacks.
- The second type is slowly progressive . About thirty percent of people with MS have this type. The condition gets worse slowly, without good times (also called remissions). The relapsing-remitting type can progress into the second type.
Causes of MS
MS is an autoimmune disease, in which the immune system attacks the tissue of the nervous system. Many nerve fibers in the brain and spinal cord are covered with a sheath of myelin. This has an insulating and protective effect. In MS, inflammation causes damage to the myelin sheath. A difficult word for this is demyelination. As a result, the stimuli are not sent properly through the nerve fibers. Perhaps there is a certain predisposition to MS in which the disease can be triggered by external factors. For example, a viral infection in childhood. Children of someone with multiple sclerosis probably have a slightly increased risk.
In the beginning the symptoms may appear separately, later also together.
- Blurred vision;
- Blindness may suddenly occur in one eye;
- Muscle weakness and muscle cramps may occur;
- A feeling of heaviness in arms or legs;
- Numbness may occur in one part of the body;
- Tingling may occur in any part of the body;
- A tired feeling and this can be permanent;
- Speech may be unclear (severing speech);
- Difficulties with coordination and balance (walking may appear uncertain);
- The symptoms can be worsened by tension and heat;
- Concentrating can be difficult;
- Gaps in the memory;
- Sad feelings may occur, especially if someone has had the disease for a longer period of time;
- Nerve damage can lead to urinary incontinence and impotence;
- Partial paralysis may eventually occur
There are no special tests for MS and because the symptoms can vary greatly, the diagnosis can only be made by excluding other options. The diagnosis can only be made certain if there is more than one lesion in more than one location, occurring with an interval of at least one month. A lesion is any abnormal tissue in an organism. If the GP suspects that someone has MS, they will be referred to a neurologist. For eye complaints, you can be referred to an ophthalmologist. The neurologist may order an MRI to see if there are demyelinated areas. MRI stands for: magnetic resonance imaging, it is a radiation-free, computer-controlled imaging technique that uses a strong magnetic field and radio waves. An epidural puncture can also be performed to collect spinal fluid.
There is no treatment for MS yet. Interferon beta can prolong the periods of temporary relief of symptoms and shorten the duration of attacks in the type of MS with flare-ups. Interferon beta belongs to the group of medicines also called interferons. These are naturally occurring proteins that play a role in the immune system. The doctor can also administer corticosteroids through an IV to shorten the duration of the relapses. There is currently no specific treatment available for chronic progressive MS. However, many symptoms that occur with both types of MS can be alleviated. For muscle cramps, remedies can be used that relax the muscles, incontinence can often also be treated with medication, this also applies to erection problems. Physiotherapy can help if there are problems with movement, and occupational therapy can help with daily activities. Reducing stress is very important, talk therapy may be useful (also for family members) to reconcile with the disease.
The extent to which the MS worsens can vary greatly, but so can the speed at which it does so. About seventy percent of people with MS lead energetic lives and have long periods of improvement between attacks. But there are also people who become increasingly disabled. Half of people with MS still lead a life with many activities ten years after diagnosis. However, fatigue can occur more quickly. On average, someone lives another twenty-five to thirty years after being diagnosed.
Expanded Disability Status Scale (EDSS) is a table to measure the progress of MS and can provide some insight into the prognosis of the disease course. The score runs from zero to ten with increments of half. Zero represents total absence of any neurological complaints or abnormalities and with increasing disability the score can increase to ten. In the EDSS, a lot of weight is given to the walking function.
Revolutionary treatment in Sweden (April 2016)
Boaz Spermon from Den Bosch has undergone treatment in Sweden, allowing him to walk again. The doctors in Sweden have disabled the immune system through chemotherapy. Then Boaz received a transplant with his own stem cells.