Multiple sclerosis (or encephalomyelitis disseminata) is a degenerative disease that affects the myelin sheaths of the nerves (Weinshenker – 1996).
As a rule, it is a juvenile disease, because it mainly affects people between 20 and 40 years of age.
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When to worry? First symptoms of multiple sclerosis
The first symptoms are:
Visual impairment
Optic neuritis, the inflammation of the eye nerves, is a common initial symptom.
At the beginning, patients may have double vision or a clouded vision, usually the problems show up only in one eye.
As the disease progresses, vision continues to decline, but complete blindness is rare.
Numbness and ant tingling
You may notice itchy discomfort, the feeling of burning on the feet and loss of sensitivity.
Symptoms usually begin on the lower legs or arms and run along the limbs.
Lhermitte’s sign is caused by lesions of the cervical spine and refers to the sensation of electrical shocks that run along the back and legs. It arises when preventing the cervical spine.
Muscle weakness and spasms
Patients may experience muscle weakness as well as heavy and tired legs.
Individuals with multiple sclerosis sometimes limp and have difficulty moving their fingers.
The muscle cramps and stiffness are mainly evident in the legs. Patients have difficulty speaking because the tongue muscles are weakened and have reduced coordination.
Problems of balance and coordination
Patients show an unsteady gait with walking difficulties and balance disorders.
Multiple sclerosis sufferers may have trouble grabbing small objects.
These problems can exacerbate other symptoms, such as dizziness and tremor. Ataxia (loss of muscular coordination) and tremor affect more than half of patients.
Bladder and bowel problems
Some patients have difficulty emptying the bladder (urinary retention) and bowel (constipation) or find that they cannot control them.
Patients with severe incontinence need to urinate more often or are unable to reach the toilet quickly enough.
Urinary problems and the use of a urinary catheter for urinary retention can lead to infections (for example, cystitis).
Ache
Many patients experience punctual pain, which can occur constantly or intermittently.
MS symptoms also include trigeminal pain (on the face), spasms and severe cramps, feelings of pressure, itching, burning and shooting pain.
Sexual dysfunction
Erectile dysfunction is a common problem.
Men can have erection problems and women often suffer from vaginal dryness (low lubricants). The sexual dysfunction seems to occur mainly together with urinary dysfunction.
Difficulty speaking and swallowing
More than half of patients have difficulty chewing and swallowing.
Concentration and memory problems
Problems with concentration and thought processes affect about half of patients.
More than 75% of patients have memory problems.
Mood changes
Depression is widespread and sometimes very pronounced.
This can be caused by physical changes in the brain as well as an emotional reaction to living with this disease.
Psychosis (depression and paranoia) is less common.
How does MS manifest itself in children?
- Sudden loss of vision in one eye
- Indistinct vision or seeing of double vision
- Eye pain during eye movements
- Gait uncertainty
- Difficulty controlling balance and coordination (ataxia)
- Spasms and muscle weakness
- Loss of muscle tone and muscle stiffness
- Tremor
- Exhaustion and tiredness
- Urinary incontinence or inability to empty the bladder completely
- Intestinal problems such as constipation and fecal incontinence
- Drowsiness and dizziness
- Pain, especially in the arms and legs
- Attention and concentration disorders
- Amnesia
Course of multiple sclerosis
The course of the disease is highly variable (Goldenberg – 2012). Some people have an initial flare-up and after that the symptoms do not appear for many years, while in other cases there is a constant worsening with periods of remission or short stabilizations.
Factors that trigger a boost
Some patients believe that the recurrence of MS (flare-ups) is triggered by certain factors.
Triggering symptoms include:
Infections
Viral and bacterial infections can provoke MS symptoms.
Heat and cold
Sudden changes in temperature or humidity can trigger the symptoms.
Many patients with MS have an intolerance to heat and find that heat worsens symptoms.
Stress
Many patients say that stress worsens symptoms.
Complications and consequences
People with multiple sclerosis may develop the following complications:
- Muscle stiffness
- Muscle spasms
- Paralysis of the legs
- Sexual problems
- Intestinal problems
- Bladder problems
- Hearing loss (rare)
- Mood swings
- Amnesia
- Depression
- Epilepsy
Effects of pregnancy on MS
Before 1950, all women with MS were advised to avoid pregnancy because it was believed to make MS worse.
Over the next 40 years, many studies were conducted on hundreds of women with MS, and all came to the same conclusion: that pregnancy reduces the likelihood of developing MS, especially in the second and third trimesters.
Bibliography:
- Weinshenker BC. Epidemiology of multiple sclerosis. Neurol Clin.1996;142:1–308.
- Marvin M. Goldenberg, PhD, RPh, MS. Multiple Sclerosis Review. P T. 2012 Mar; 37(3): 175–184.
- Vukusic S, Confavreux C. [Multiple sclerosis and pregnancy]. Rev Neurol (Paris). 2006 Mar;162(3):299-309.
- Laura Airas, MD PhD and Risto Kaaja, MD PhD. Pregnancy and multiple sclerosis. Obstet Med. 2012 Sep; 5(3): 94–97. doi: 10.1258/om.2012.110014
- Multiple sclerosis: forms and causes
- Multiple sclerosis: diagnosis and drugs to treat
- Multiple sclerosis: treatment and life expectancy
