Contents
What is multiple sclerosis?
Multiple sclerosis is an autoimmune disease that attacks the myelin sheath, a protective layer of neurons, making synapses more difficult and causing several problems for its patients, such as cognitive disorders and problems with balance and motor coordination.
It is a disease that affects the Central Nervous System (CNS) as a whole, affecting both the brain, spinal cord and nerves, and therefore has systemic proportions.
About 2.5 million people around the world suffer from multiple sclerosis. Well-known examples are Brazilian actresses Claudia Rodrigues, from A Diarista , and Ana Beatriz Nogueira, famous for many global soap operas, who suffer from multiple sclerosis.
The disease has no cure yet and is progressive, that is, its symptoms worsen over time. Despite this, numerous researches have been carried out in recent years, which can be a “light at the end of the tunnel” for its carriers.
Treatment, to date, seeks to slow the progression of the disease and recover the patient from the attacks caused by the disease. With this, patients suffering from multiple sclerosis can benefit and lead a better quality of life, with a life expectancy of 5 to 10 years less than the population not affected by the disease.
In the International Classification of Diseases, 10th edition (ICD-10), multiple sclerosis can be found using the code G35.
Learn more about what multiple sclerosis is, its symptoms and how it works in the body in the following text!
What is the myelin sheath?
To explain what myelin sheath is, we first need to talk a little bit about neurons. Simplifying the explanation for didactic purposes a little, we can say that the neuron is composed of 2 essential parts: the cell body, where the nucleus and some receptors are located, and another part more elongated and thin, called the axon.
The axon is like a little leg of the neuron and its function is to conduct the electrical impulses that leave the cell body to another more distant location, such as a muscle or another neuron. We can compare it with a copper wire, which transmits electrical currents.
This structure is quite fragile and does not work at maximum power alone. It is to fulfill these functions that the myelin sheath exists. It makes the axon more protected, in addition to speeding up the speed of nerve impulses. It is as if it were the insulator around the copper wire.
It is a series of spiral folds around the axon. They are an essential fatty tissue for the proper functioning of neurons.
When a person develops multiple sclerosis, the myelin sheath is compromised and the axon is demyelinated. This causes nerve impulses to be compromised, the main cause of disease complications.
What are outbreaks?
Multiple sclerosis outbreaks, that is, when there is a high incidence of demyelination, are identifiable from the moment that a new neurological symptom appears or else the significant worsening of an old symptom, with a minimum duration of 24 hours.
Are observed mainly the loss of strength of one or more limbs, numbness and / or tingling in the feet and hands, also called sensitivity disorders, and changes in the cerebellum, such as vertigo ( dizziness ), which may come associated with nausea, vomiting, tremors, changes in speech, difficulty walking and imbalance.
A large number of patients have optic neuritis, that is, a reduction in vision and eye pain, with worsening eye movement. More rarely, changes in cranial nerves occur, such as paralysis of eye movement (or difficulty moving the eye) or trigeminal neuralgia (severe pain, such as a shock to the face).
Once diagnosed, there is a minimum interval of approximately 30 days between an outbreak and another.
The clinical picture of each outbreak varies from patient to patient, and in many cases there is the presence of more than one associated symptom. Recovery is also individual, with some patients showing complete remission of symptoms and others with sequelae.
Many patients may experience clinical worsening with fever , heat, fatigue , hyperventilation, physical exercise, smoking and emotional stress . The worsening in these situations is usually transient.
However, it must be emphasized that there is always a need to rule out the presence of infections that can worsen the symptomatic picture.
Types
There are essentially 4 different subtypes of multiple sclerosis. There is also a fifth type, which is less common than the others, called clinically isolated syndrome (first attack).
It is very important to identify which subtype of MS the patient is in so that the appropriate therapeutic decisions are made by the medical team.
Check out the difference between these 4 subtypes of MS:
Clinically isolated syndrome (SCI)
The clinically isolated syndrome is the first attack, or relapse, caused by inflammation and demyelination of the central nervous system. This episode, by definition, must last at least 24 hours and has characteristics of MS. However, it alone is not enough to arrive at a conclusive diagnosis of multiple sclerosis.
When SCI is accompanied by lesions in the brain, an MRI scan is done to assess whether they are similar to those caused by MS. If the characteristics are similar, the chances of the patient suffering from multiple sclerosis are greater. If the incident did not cause brain damage, the chances of a person having MS are much less.
Recurrent-remitting multiple sclerosis (EMRR)
The remitting-relapsing subtype, also called relapsing relapsing, can be described as the initial stage of the disease.
It is characterized by episodes of recurring and unpredictable attacks, followed by a period of months or years of tranquility (renunciation) without symptoms or activities of the disease.
The neurological damage that this subtype can cause occurs during episodes of attack and can disappear on its own or leave permanent sequelae.
It is more common for the sequelae to remain with the patient, since the time of resignation, that is, the spacing between the attacks, was very long, making the attack more traumatic for the organism.
About 80% of individuals with MS are first diagnosed with this variation of the disease.
When neurological damage goes away on its own, this subtype can be called Benign Multiple Sclerosis. Despite this, in the long run, the individual suffering from the disease will progress.
Secondary-progressive multiple sclerosis (SPSP)
Secondary-progressive multiple sclerosis can be categorized as the evolution of recurrent-remitting.
In the beginning, the patient has outbreaks and remissions that are very different from each other. However, the disease starts to become more serious and increase in severity, worsening slowly and gradually, without the presence of outbreaks necessarily.
Primary-progressive multiple sclerosis (PPMS)
In this variation, the patient has no outbreaks, but the disease progressively worsens since his diagnosis and the person develops symptoms and even sequels progressively because of the disease.
That is, this multiple sclerosis subtype is characterized by the progressive worsening of neurological functions, without the presence of previous relapses or even remissions.
It can be characterized as active, when occasional relapses occur, not active, or with progression, when there is evidence of worsening of the disease.
Progressive relapsing multiple sclerosis (EMRP)
This is the least common form of the disease. In it, attacks are less common, but they still happen from time to time and the symptoms continue and worsen between relapses.
This type of MS is very rare. Doctors do not know very well about this variation of the disease, and probably only about 5% of people who suffer from MS have this form.
Causes
Unfortunately, to this day, the cause of multiple sclerosis is not known. What is known is how it acts in the body and that it is an autoimmune disease, that is, when the body creates antibodies against itself.
In the case of MS, this failure in the body attacks the myelin sheath, a protector of neurons, which, in other words, is like the insulating material that protects a copper wire, for example.
When the myelin sheath is damaged, the nerve is exposed and the electrical currents released by neurons are compromised, which can cause symptoms such as motor dysfunction, cognitive problems or loss of sensation in some regions.
Risk factors
Multiple sclerosis is probably an autoimmune disease. That is, like lupus or rheumatoid arthritis, the body creates antibodies against itself, damaging the body itself, especially in the myelin sheath, the nerve covering.
There are some risk factors that can increase your chances of developing multiple sclerosis. One of them, for example, is being female, since women are much more likely to develop the disease. Check out:
Age
Multiple sclerosis can affect anyone at any age, however it is more present in people in the age group between 15 and 60 years.
Sex
Women are approximately 2 times more likely to develop multiple sclerosis than men.
Family history
If you have a family member who has developed multiple sclerosis, your chances of developing the disease are greater than that of other people.
Breed
White people, especially Nordic people, have a much higher risk of developing multiple sclerosis. People of Asian, African or Native American descent are less likely.
Climatological
Multiple sclerosis is much more common in temperate countries, such as Canada, the northern United States, New Zealand, southern South America and Europe.
Autoimmune diseases
People who suffer from thyroid problems, type 1 diabetes or inflammatory bowel disease are more likely to develop MS.
Vascular anomalies
In 2008, surgeon Paolo Zamboni raised the hypothesis that MS involves the narrowing of veins that drain the brain, a process also known as chronic cerebrospinal venous insufficiency.
In his study, he found that all of his MS patients had this type of vascular abnormality. The interesting thing is that, after correcting this problem in their patients, approximately 73% of them showed improvement.
This drew a lot of attention from MS patients around the world, but Zamboni remains skeptical, reiterating that no type of controlled or blind test has yet been done, and that taking on similar treatment for MS patients is not yet recommended.
Smoking
Smokers who have experienced a symptomatic event that led to the suspicion of MS are much more likely to develop the disease than non-smokers.
Exposure to certain types of viruses
Some research has shown that people who develop MS have antibodies to the Epstein-Barr virus, which causes mononucleosis, in the body. This means that they have been exposed to this virus. The researchers believe that those who became ill thanks to this virus are more likely to develop multiple sclerosis.
In addition, it is suspected that exposure to varicella-zoster viruses and those present in the hepatitis vaccine may also be related to multiple sclerosis.
However, none of these hypotheses has been confirmed .
Hormonal factors
In recent years, evidence has suggested that hormones, including sex hormones, can affect and be affected by the immune system. Testosterone, estrogen and progesterone , for example, can act by suppressing the immune system.
One of the evidences that led to this hypothesis is the fact that women with MS have less activity of the disease during the periods of pregnancy, when the levels of progesterone and estrogen are high.
Another evidence is the low incidence in men, who have higher levels of testosterone. Despite this, these hormonal factors alone are not sufficient to explain the higher prevalence of the disease in women.
Symptoms
There are some characteristic symptoms that may indicate the presence of multiple sclerosis. Watch out for them if you are in a risk group and do not hesitate to see a doctor whenever you have a suspicion.
Symptoms vary in intensity as the disease progresses and affect different regions of the body. Specialties generally divide them into primary, secondary and tertiary symptoms. Check out:
Primary symptoms
The primary symptoms are the body’s direct reactions to demyelination processes. As stated earlier, these processes make it difficult to transmit nerve signals between the brain and the rest of the body, causing all of these symptoms.
As we will see below, intestinal problems, balance and sensitivity and vary greatly according to the person and the nerve fibers that have been demyelinated.
Basically, if the sensory nerve fibers undergo demyelination, sensory problems occur; on the other hand, if the demyelinated fibers are the ones that transmit signals to the muscles, mobility problems (motors) will appear and so on. Get to know them more closely:
Lhermitte
It is a very peculiar symptom: a sensation of electric shock, which radiates from the back and legs when the neck is flexed. It is a sign of nerve damage that can be seen when the neck is in a flexed position and the corresponding nerves are stretched.
It was named after the French doctor who discovered it, Jean Lhermitte, and is closely associated with MS. However, it is not considered a diagnosis, as it can have several other causes, such as spinal cord compressions, spinal trauma, vitamin B12 deficiency and others.
Ache
Pain is a relatively common symptom in patients with multiple sclerosis. In general, it presents with moderate intensity and is triggered by an irritation of the sensory pathways that take stimuli to the brain.
It can occur as a symptom of optic neuritis (pain when moving the eyes sideways), trigeminal neuralgia (severe pain on one side of the face), or because of general muscle spasms and problems that lead to musculoskeletal pain.
It is classified in two ways:
- Neuropathic pain: when it is due to the nerve itself;
- Nociceptive pain: when it is of musculoskeletal origin.
Regarding duration, it can be classified as acute or chronic. Acute pain is more intense, short-lived or intermittent and can start and end quickly. The chronic one, on the other hand, lasts long periods, sometimes more than 1 month, has a gradual onset, fluctuates in intensity and, many times, does not disappear completely.
Heat intolerance
This is a complaint of virtually all patients with MS. It is so common that, in the past, they used a test called the “hot bath test” to diagnose people with multiple sclerosis.
In these tests, the person dived into a hot tub and tested themselves to see if the neurological symptoms appeared or worsened. This is because the increase in temperature tends to decrease the speed of nerve transmission. As myelin is already damaged, an increase in temperature then tends to worsen symptoms.
These effects can be caused very easily by a change in body temperature of much less than 1 degree difference.
When exposed to heat, the patient with MS may experience blurred vision, fatigue, tremor and cognitive complaints. It is worth remembering that, although the heat increases the symptoms of MS, this worsening is temporary and no tissue damage actually occurs.
Drinking fluids to prevent dehydration, preferably water or diluted fruit juice, is highly recommended. Looking for an air-conditioned room and taking cold baths can also help.
Speech-language disorders
These symptoms usually appear at the onset of the disease, but may extend as the symptoms gradually get worse. They are usually linked to swallowing and speech, such as:
- Slower speech (slower);
- Dragged words;
- Shaky voice;
- Dysarthria (difficulty in the reproduction of phonemes);
- Escandada speech (slow pronunciation);
- Dysphagia (difficulty swallowing liquids, pasty and solid).
Cognitive disorders
Cognitive disorders are also common in patients with MS. Memory problems can appear during any time of the disease, regardless of physical symptoms.
The cognitive functions that are most commonly affected by multiple sclerosis are memory processing and task execution. Those who suffer from these problems usually complain about taking more time to memorize tasks and have difficulties in performing them.
Dizziness
People with MS may experience dizziness, but it usually does not come with vertigo or the feeling that the room is spinning.
Tremors
About half of people with MS suffer from tremors. They have different intensities and can affect daily activities.
Spasticity
Spasticity is characterized as the rigidity of a limb when moving. It mainly affects the lower limbs, causing mobility problems.
Paraesthesia
The paresthesia , numbness in the body that undertakes the tactile sensation, is also one of the symptoms that may arise, bringing the burning sensation or tingling in any part of the body.
Visual Disorders
Degradation of the myelin sheath can affect the senses, such as vision. It may be blurry or lighter. Mostly, people lose the ability to see when they look ahead (central view). Peripheral vision is generally less affected.
In addition, other problems may arise, such as:
- Internuclear ophthalmoplegia: occurs when the fibers that coordinate the horizontal movement (from one side to the other) are injured. One eye, for example, may lose the ability to rotate inward, which causes double vision when looking at the opposite side of the affected eye. The unaffected eye can also begin to move very quickly in an involuntary manner, a problem called nystagmus.
- Optic neuritis (inflammation of the optic nerve): in these cases, partial loss of vision in one eye may occur and cause pain when moving the eye.
Problems with balance and coordination
The disease can cause motor problems, causing symptoms such as:
- Loss of balance;
- Tremors;
- Instability when walking (ataxia);
- Vertigo and nausea;
- Lack of coordination;
- Weakness (can affect legs and walking);
- General weakness.
Fatigue
Do not confuse fatigue with laziness. Fatigue is a debilitating tiredness that prevents a person from carrying out their normal day-to-day tasks. It is a debilitating symptom of unpredictable and disproportionate installation, being one of the most disabling.
It is very common when patients are exposed to heat or when doing very intense physical exercises.
Bladder and bowel changes
Multiple sclerosis can make it difficult to transmit messages between the brain and the bladder or intestine, making problems in these organs more common in people affected by the disease.
An interruption between the brain-bladder / bowel signals can result both in the absence of the need to go to the bathroom, and in feelings of extreme urgency.
Sexuality
In men, multiple sclerosis can cause erectile dysfunction , while in women it decreases vaginal lubrication. It also decreases the sensitivity of the perineum (region of the genitalia), which compromises sexual performance.
Secondary symptoms
Secondary symptoms are those that come with or as a result of primary symptoms. A clear example concerns urinary infections. Because MS patients have a harder time emptying their bladder completely, they are more likely to get urinary tract infections.
Of course doctors treat secondary symptoms, but the goal of MS treatment, in general, is to prevent them from even happening and, for that, it always focuses on treating primary symptoms.
Tertiary symptoms
Tertiary symptoms are social, psychological and work-related symptoms and living with multiple sclerosis. MS can make driving very difficult and laborious, for example, or make it difficult to do your job.
These symptoms are treated with the support of a psychologist or social worker, who will help the patient to live better with the disease and improve their daily lives despite the challenges provided by the condition.
However, because it is a disease that varies greatly according to each patient, the best thing to do is not to compare yourself with other patients also diagnosed with MS. The symptoms are different for each one and, therefore, the treatment is also different. Most people with the disease learn to manage their own symptoms and return to live a normal life.
How is the diagnosis made?
To correctly diagnose multiple sclerosis, first, in cases of suspicion, it is necessary to seek the correct doctor, who, in this case, is the neurologist .
That’s because there is a wide variety of inflammatory and infectious diseases that can have the same symptoms as multiple sclerosis. The most important thing, in these cases, is to take everything into account: from the patient’s medical history, family history and complement it with physical, neurological and laboratory exams.
It is very common for people to underestimate or overestimate the symptoms of the disease, which makes them either worry less or too much. There are cases of false negative and false positive and, therefore, it is always advisable to repeat the tests.
In order to diagnose MS, some criteria have to be established and fulfilled, such as:
- Evidence of multiple lesions in the central nervous system;
- Evidence (clinical or para-clinical) of at least 2 episodes of neurological disorder.
The main tests ordered by doctors to diagnose the disease are:
MRI
Magnetic resonance imaging is an examination that serves to see the interior of the human body through the mapping of water molecules, which exist in different densities and tissues around the body.
The device creates a magnetic field that realigns the nucleus of the hydrogen atoms, causing them to become small magnets that will later be mapped, forming an image that can be observed by doctors.
In the examination, the doctor will analyze the condition of the skull and spine at cervical, thoracic and lumbar levels. This examination can be performed repeatedly for a period of time to monitor the disease.
Lumbar puncture
Lumbar puncture is nothing more than the collection of cerebrospinal fluid (cerebrospinal fluid) in the spinal cord. The doctor places a needle between the vertebrae and collects a sample that will later be analyzed in the laboratory.
As it is an exam that can bring a lot of discomfort and pain to the patient, it is done with the application of local anesthesia.
Evoked potential
It is a painless test that checks the health of the nerve pathways. He will assess the functioning of the spinal cord, peripheral nerves and also the optical and auditory pathways.
It is objective, that is, it does not depend on the patient’s response. Electric, audible or light signals are used to record the organism’s responses and verify the functional integrity of the analyzed structures.
There are, in an applicable manner, 3 types of evoked potential. Check out:
Visual evoked potential (ENP)
In this test, an electrode is placed on the posterior region of the scalp (occipital lobe) and the vision of each eye is stimulated separately through a checkered screen that passes over a computer screen.
The answer obtained with the exam is the visual evoked potential. Its main indication is the detection of asymptomatic lesions of the visual pathway in patients with multiple sclerosis.
Auditory evoked potential (PEA)
As in the ENP, electrodes are placed on the scalp, but this time on the lateral region (temporal lobe) and a series of auditory stimuli, clicks, are emitted by a headset to analyze each ear separately.
The answer obtained with the exam is the auditory evoked potential. The main indication is in the study of lesions of the cochlear nerve with hearing loss, as can occur in Meniere’s syndrome.
Somatosensory evoked potentials (PESS)
They are tested by placing electrodes in the region on the sides of the head, on the scalp (parietal lobe) and stimulating the somatic sensory fibers of the median (arm) and tibial (leg) nerves on each side, separately, through small electric shocks low intensity.
The answer obtained in this exam is the somatosensory evoked potential. Its main indication is in the study of lesions of the posterior cord of the spinal cord that may be present in myelopathies of different etiologies, including multiple sclerosis.
Is there a cure?
Unfortunately, multiple sclerosis has no cure . It is not yet known what causes MS, so finding a cure for the disease becomes even more difficult.
However, in early 2018, researchers at Northwestern University School of Medicine in Chicago identified, through experiments on mice, a molecule whose production is linked to testosterone and which appears to protect the body from multiple sclerosis.
The rodents, genetically modified to have a disease similar to that affecting humans, had a significant improvement in the symptoms of the disease after being treated with the substance described in the study.
Despite the importance of the discovery, the best thing to do is to remain skeptical and keep expectations low, as the experiment was done only with animals and the result may not be the same with humans.
What is the treatment?
As there is no cure for multiple sclerosis and attacks can cause serious problems for the patient, treatment is usually focused on recovering the patient from the damage suffered in the attacks, on slowing the progression of the disease and on maintaining symptoms.
Some people have symptoms so mild that often no treatment is needed.
Therefore, the types of treatment for the disease can be divided by its purpose. Understand:
Treatment for recovery from attacks
Attacks of multiple sclerosis can leave several consequences in those who suffer from the disease. Therefore, this type of treatment is more immediate and seeks to reverse these sequelae.
Corticosteroids
These drugs are used to help reduce inflammation of the nerves.
Plasmaferese
This treatment involves using a machine that filters the blood to remove harmful elements from the blood plasma. It is a procedure very similar to hemodialysis, but the process is different.
While hemodialysis performs renal functions, plasmapheresis serves more as another type of cleaning that, in contrast to filtering nutrients in excess of the blood, seeks to reduce the incidence of pathological agents.
Treatment to slow the progression of the disease
As the name says, this type of treatment aims to slow down and slow the progression of the disease, preventing the onset of severe relapses and, consequently, serious sequelae. Through these treatments, it is possible to decrease the damage on the myelin sheath.
However, they are not suitable for anyone with MS. They are only prescribed for people with relapsing-remitting multiple sclerosis or secondary-progressive multiple sclerosis and who fit some criteria, such as the number of relapses they have had since the disease was diagnosed.
People who do not suffer from MS attacks will rarely benefit from these treatments and may still suffer from side effects, so it is unnecessary and inadvisable to carry out this type of treatment.
Check out the treatment options to slow the progression of MS:
Interferons
Interferons act on the body by controlling the activities of the immune system, in addition to having antiviral function. They work by slowing the process of multiple sclerosis, reducing the number of seizures and complications.
Immunomodulators
It is a type of protein that aims to reduce the number of seizures. It is not yet known exactly how it acts in the body, but it is believed that it is able to inhibit the attack of the immune system against myelin.
Sphingosine-1-phosphate receptor modulators
This class of drugs was recently discovered and works by selectively trapping diseased lymphocytes (white cells) in the lymph nodes to prevent them from attacking the central nervous system myelin.
Treatment for symptoms
Esses tipos de tratamento buscam recuperar o paciente das crises e trazer mais qualidade de vida. Inclui o uso de relaxantes musculares, que ajudam a controlar a dor causada pela rigidez dos músculos e outros medicamentos que melhoram a fadiga muscular.
Além disso, existe a fisioterapia, em que exercícios alongamento e fortalecimento muscular ajudam o paciente a realizar melhor as tarefas do dia a dia. Ela pode ajudar a melhorar a fadiga e outras sequelas causadas pelos ataques.
Medicamentos
Os medicamentos para o tratamento de EM normalmente buscam diminuir as crises, aumentado o tempo entre as ocorrências. Dentre esses medicamentos, temos:
Betainterferona
É administrada de forma subcutânea ou intramuscular diariamente, uma vez por semana ou 3 vezes por semana, dependendo do tipo de medicamento escolhido.
However, this medication can cause a number of unwanted side effects, such as:
- Flu-like symptoms, such as fatigue, chills, fever, muscle aches and sweating during the initial weeks of treatment;
- Reactions at the injection site, such as swelling, redness, discoloration and pain;
- Sadness, anxiety, irritability and feelings of guilt, which makes people with a history of depression need more careful monitoring;
- Difficulty sleeping and eating.
Ocrelizumabe
This is the only type of disease-modifying drug approved by the FDA to treat relapsing-remitting multiple sclerosis. That’s because its discovery is recent and the side effects of this medication are not yet known.
What is known, however, is that it is very effective and can increase the time between episodes by up to 12 weeks.
Glatiramer acetate
It is a protein that seeks to reduce the number of attacks by stopping the immune system from attacking myelin, reducing the autoimmune process of the disease.
It is injected into the skin, subcutaneously, once a day. Some rare side effects of this medication are:
- Pain, redness and swelling at the application site;
- Chest pain or tightness;
- Heart palpitations;
- Anxiety;
- Blush;
- Difficulty breathing.
It is distributed free of charge by the Unified Health System (SUS).
Dimethyl fumarate
Another relatively new treatment, dimethyl fumarate acts on the body through its anti-inflammatory and cytoprotective action. It has been shown to be an excellent treatment for multiple sclerosis in recent years and, it seems, is well tolerated by patients, and its adverse effects are rare and include:
- Blush;
- Gastrointestinal problems.
Fingolimode
It is an immunosuppressant that reduces the number of relapses. It is necessary, in the first 6 hours after the first dose, to monitor the frequency of the heartbeat, as it can slow down the heart.
Other side effects include headache , increased blood pressure and blurred vision.
Teriflunomida
It is not known exactly how this medication works, but it is able to reduce outbreaks caused by MS.
Its side effects include liver problems, hair loss , and it is contraindicated for pregnant women, as it affects the formation of the fetus.
Natalizumabe
This medication apparently blocks the action of white cells that attack the myelin sheath and cause multiple sclerosis. It can be considered the first treatment option for people with severe MS.
However, it increases the risk of viral infection in the brain, also called progressive multifocal leukoencephalopathy.
Alentuzumab
It is an antineoplastic medication, that is, it is used to destroy neoplasms or malignant cells, preventing, among other things, the growth and spread of tumors.
Despite its beneficial effects, it can increase the risk of infections.
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Living together
Living with multiple sclerosis is a challenge, especially because of the complications of the disease. Therefore, we have separated some tips on how to better deal with the disease and its symptoms. Check out:
Focus on being positive
Having resilience and staying positive even in the most difficult situations is an arduous task. Even so, it is important not to let your guard down and try to try not to let the illness bring you down emotionally.
Prevent fatigue
One of the symptoms of multiple sclerosis is fatigue, extreme tiredness. One way to prevent this symptom from happening is to get enough rest, enough to feel energized, and avoid the heat, as it can make this situation worse.
Seek emotional support
As much as we strive, it is often difficult to maintain positivity on your own. Sadness and discouragement hit each other and it is difficult to face situations. It is at these times that you should seek help. And there are many ways to do this!
You can seek help from your relatives and close friends. They can help you live better with the disease and give you the emotional support you need.
And if that is not enough, you can still go to a psychologist, psychiatrist or other health professional. They are professionals who have studied ways to help other people to deal with their own problems better and can be of immense help in times when we can no longer see a solution.
Support groups for people with multiple sclerosis still exist. Going to meetings of these groups can help you to better deal with your condition, because there you will find people who suffer from the same problem as you and will empathize, they will know what you feel and be able to advise you on how to solve the problems that you’ve been facing.
Have discipline
The treatment of multiple sclerosis can be quite annoying. Nobody likes to take medicine every day, but it is extremely important that you maintain your discipline and follow all medical recommendations strictly to prevent the appearance of any further outbreaks.
Ensure accessibility
Multiple sclerosis can often cause mobility problems. So, it is very important that you ensure the accessibility of the places you frequent.
At home, you can make structural changes to make your life easier. At work, you can try to talk so that the environment becomes more comfortable for people who suffer from motor weaknesses. Do not be shy. It is your right to come and go.
Search leisure activities
It’s always good to turn your mind off and focus on something you like. Activities such as reading a book, watching movies, playing video games, going to a museum and stimulating hobbies, such as painting, writing or music; all of these are activities that will help you “turn off”, leave reality a little aside and live, for a few moments, something different.
Performing this type of activity is very good for increasing the quality of life. Not because reality is a terrible thing, but because it is good to put aside problems, even for a few hours.
Take care of your health
People with multiple sclerosis often need to take immunosuppressive drugs. Therefore, it is very important to be in good health, as the risks of contracting a disease are much greater, so it should be in your interest to stay healthy.
Therefore, exercising and maintaining a healthy diet are a good choice. Your health will thank you!
Empathize with your family members
Living with a person who has multiple sclerosis is not easy. But remember that it is not your fault. It’s not anyone’s fault, actually. MS is something that happens and is inevitable. What you can do is learn to live with it in the best possible way. And it can be very difficult, both for you and for the people around you.
As multiple sclerosis affects everyday life, feelings such as hopelessness, anxiety , depression and others are common not only in the patient but also in family members.
There is still a belief that multiple sclerosis is a disease that will cause death and intense suffering in a short period of time, which is not true, since people who suffer from MS tend to live, on average, only 5 to 10 years. 10 years less than the population not affected by the disease.
So try to empathize with the people around you. They also suffer, especially because of the possibility of seeing a loved one suffer or lose. Again, this is not anyone’s fault. It is something that happens. And one way to get around these situations is through conversation and information.
Always talk with your family and close friends. Open your feelings and ask them to do the same. Despite being a difficult task, it will do everyone good.
Prognosis
Despite being a serious disease, the prognosis of people suffering from multiple sclerosis is good. However, there are a number of variables that are associated with a more favorable prognosis of disease progression, such as the patient’s gender, the disease subtype, neurological symptoms and, above all, the onset of the disease.
This is because the disease progresses over several decades, going through periods of improvement and worsening. It is estimated that the life expectancy of people with MS is 5 to 10 years lower than that of normal people, however, about 40% of carriers reach the seventh decade of life.
Even so, although most carriers will lose their ability to move around in the final stages of the disease, 90% are still able to walk 10 years after the onset of symptoms and 75% 15 years later.
Complications
Motor complications
As multiple sclerosis progresses, motor complications begin to happen. The movements can become shaky, irregular and ineffective. In addition, people may be partially or completely paralyzed.
Weak muscles can involuntarily contract (spasticity), often causing painful cramps. Muscle weakness and spasticity can interfere with walking and even make it impossible, even with the aid of a walker or device.
People who cannot walk because of multiple sclerosis are still more likely to develop osteoporosis (decreased bone density).
Cognitive complications
In many people, multiple sclerosis causes memory loss, attention deficit and reduced information processing speed in the brain, which slows down the reasoning.
In more severe cases, MS can even end up leading to dementia. Therefore, the sooner these types of problems are identified the better, as the chances of reversing the condition decrease as time goes by and the number of injuries increases.
Respiratory complications
Respiratory complications can happen because multiple sclerosis is often related to reduced muscle strength. This contributes to the occurrence of pulmonary changes, making these complications frequent causes of death in patients.
However, respiratory functions are rare and only affect the patient in the final stages of the disease. In addition, respiratory muscles play an important role in the development of fatigue in patients with MS.
One of the ways to treat this complication is through expiratory and inspiratory exercises that, over time, will improve or help maintain the condition of the muscles responsible for this function.
How to prevent
Despite the fact that it is a genetic disease and the exact causes of multiple sclerosis are not known, there are some ways to try to prevent the development of multiple sclerosis. Check out:
Vitamin D supplementation
Some recent studies have shown that individuals who are more exposed to the sun early and later in life are less likely to develop multiple sclerosis.
Whether this is because the body synthesizes more vitamin D or because the sun is related to other factors is not yet known, but the levels of vitamin D deficiency or insufficiency in today’s populations is still high, reaching about 70% of the population.
So while it is not exactly a 100% effective and proven method, it is a good thing to keep your vitamin D levels healthy. Not only because of multiple sclerosis, but also for other problems that the deficiency of this vitamin can cause.
Prevent obesity in childhood and adolescence
A modifiable environmental risk factor for the development of multiple sclerosis is childhood and youth obesity (up to 20 years old). Studies have associated childhood obesity with an increased risk of multiple sclerosis in both sexes.
Although there is no clear correlation between the two, it is also good to maintain health and fitness in general.
Smoking
Smoking is another risk factor for the development of multiple sclerosis. In addition, there is evidence that smoking worsens the progression of the disease.
So, if you smoke, stop. Not only because of multiple sclerosis, but also because of all the other problems that smoking can cause, such as cancer and pulmonary emphysema .
Common questions
How many people have MS?
Approximately more than 2.3 million people suffer from multiple sclerosis around the world. More than two-thirds of these people are women and this difference between the sexes has been growing in the last 50 years.
Does MS cause paralysis?
No . Paralysis is different from the symptoms of multiple sclerosis. In paralysis, the person is no longer able to move the muscles voluntarily, while in the case of multiple sclerosis the person feels great difficulty in moving the muscles because of the compromised nervous system.
Another very reassuring fact is that most people who have multiple sclerosis don’t even get serious motor problems. Approximately two-thirds of people with the disease continue to be able to walk after diagnosis, although many need some help, such as crutches, and some will opt for the wheelchair because of fatigue.
Why is it so difficult to diagnose MS?
What happens is that the initial symptoms of multiple sclerosis are quite common in other diseases, making the possibilities of diagnosis very great. The initial symptoms come and go very quickly and they can easily go unnoticed by the medical team.
Is multiple sclerosis a fatal disease?
Sadly yes. Because it is a progressive disease, over the years it gets worse until it reaches a time when it invariably causes death.
However, the life expectancy of people with multiple sclerosis has grown over the years, as treatments progress. Nowadays, a person diagnosed with multiple sclerosis lives, on average, 5 to 10 years less than a person who does not have the disease, which is not such a big difference.
Does MS lead to dementia?
Most symptoms of MS are physical, however, some people also suffer from cognitive problems. So, we can say that yes, in some cases , multiple sclerosis can lead to dementia.
Not so infrequently, multiple sclerosis causes memory loss, attention deficit and reduced information processing speed in the brain, slowing down the reasoning.
When this type of problem is identified at the beginning of the disease, the chances of reversing the condition are greater, however, as time goes by and the number of injuries increases, total recovery becomes gradually more difficult.
Multiple sclerosis is a complicated disease, difficult to treat and that progresses over the years, with life expectancy for its carriers being 5 to 10 years less than for people who do not have the disease.
Despite this, treatments are being studied and it may be that, within the next few years, the treatment will be more efficient and the quality of life of patients with multiple sclerosis will improve.
Is that you? Do you have multiple sclerosis? Do you know or live with someone who has it? How about telling us about your experience? If you want, leave your opinion on problems such as accessibility and prejudice. Oh, and don’t forget to share the text so that people are more aware of the disease!
