Multiple Sclerosis (MS)

Multiple Sclerosis is a chronic, debilitating neurologicaldisease that is characterized by the disruption of signals between the brain and the body. Understanding the multiple sclerosis symptoms, diagnostic criteria, and treatment options enables patients and caregivers to manage the condition and make informed decisions.

The World Health Organization (WHO) estimates that over 1.8 million people are suffering from MS globally. It is a progressive disease that causes significant morbidity, though MS progression and symptoms vary widely among people.

What is Multiple Sclerosis (MS)?

Multiple sclerosis is a chronic, progressive, autoimmune disease of the central nervous system. The body’s immune system mistakenly labels myelin sheaths around nerve cells as foreign and attacks them. This leads to a disruption of signals between the brain and body.

According to a 2024 study measuring the prevalence/incidence of MS in Turkey by using official health records, the national prevalence of MS in Turkey was measured at 96.4 per 100,000 individuals, with a female-to-male ratio of 2.1:1.

Recognizing the Symptoms of Multiple Sclerosis (MS)

Symptoms of Multiple Sclerosis vary among individuals. Their severity depends on the location of the brain lesions and the extent of nerve damage. 

Early Symptoms of MS

Early symptoms suggestive of MS in Turkey that warrant a clinical evaluation include:

• Vision problems
• Paresthesia
• Muscle weakness
• Fatigue
• Loss of balance

Common MS Symptoms

• Muscle spasms/stiffness
• Memory/concentration problems
• Depression, anxiety, mood changes
• Neuropathic pain
• Bladder and bowel problems
• Electric shock-like sensation (Lhermitte Sign)

When to Seek Medical Attention

People with vague signs of Multiple Sclerosis, like pain, overheating, and bladder/bowel/sexual dysfunction, can opt for an expert MS evaluation at the Medical Park International. Relapsing and remitting symptoms warrant an immediate check-up.

Diagnosing Multiple Sclerosis (MS)

There are no specific examinations for MS. Multiple Sclerosis diagnosis is made through history, examination, MRI, and Lumbar puncture results. The presence of MS requires substantial screening and varies significantly by region; therefore, establishing a proper diagnosis is essential.

Neurological Examination

A neurological exam for MS includes the following:

• Cranial Nerves (Ocular function, Facial sensitivity)
• Motor Function (Muscle spasticity/strength)
• Sensory Exam (Paresthesia)
• Coordination/Gait
• Cognitive Exam
• Bladder/Bowel Function

MRI Scans for MS Diagnosis

Demyelinating lesions of the brain and spinal cord on MRI, when correlated with clinical findings, point to an MS diagnosis. MRI scans are also an effective way to track the progression of an MS attack, its relapses, and response to treatment. Patients from all over the world seek MS treatment in Turkey due to its multidisciplinary services and advanced diagnostic facilities.

Other Diagnostic Tests

Other supportive tests for a Diagnosis of Multiple Sclerosis include a spinal tap, Optical Coherence Tomography, Evoked Potential Test, etc.

Types of Multiple Sclerosis (MS)

The exact cause of Multiple Sclerosis is not known. It is classified into various types based on symptomatic progression and the number of relapses. As per global statistics, the male-to-female ratio of MS in Turkey is 2:1 as well.

Relapsing-Remitting MS (RRMS)

The Relapsing-Remitting Multiple Sclerosis (RRMS) is the most common among various types of Multiple Sclerosis. RRMS patients suffer from frequent relapses, which subside and recur, with quiet periods that may last months.

Secondary Progressive MS (SPMS)

20% - 40% of Relapsing-Remitting MS cases may develop Secondary Progressive Multiple Sclerosis (SPMS). There is a consistent progression of symptoms with mobility issues and worsening gait. 

Primary Progressive MS (PPMS)

In Primary Progressive Multiple Sclerosis (PPMS), the symptoms have a gradual onset and progress without periods of remission.

Progressive-Relapsing MS (PRMS)

Progressive-Relapsing Multiple Sclerosis (PRMS) is a rare type of MS. Patients with PRMS often show progressive worsening of symptoms from the onset, with occasional flare-ups.

The initial episode of neurological signs, such as vision loss, balance problems, weakness, and paresthesia, is known as CIS - Clinically Isolated Syndrome. If associated with suggestive MRI findings, a CIS is considered a precursor to MS.

Treatment Options for Multiple Sclerosis (MS)

Multiple Sclerosis causes a wide range of physical and cognitive symptoms. MS treatment options in Turkey often include the following:

Disease-Modifying Therapies (DMTs)

DMTs reduce the frequency of relapses, limit disease progression, and formation of new lesions on MRI. They include:

• Oral Meds (Fingolimod)
• Injectable (Interferon-beta)
• Infusions (Natalizumab)

Managing MS Symptoms

Living with Multiple Sclerosis requires managing its symptoms. This is done by a combination of rest, light exercise, physical therapy (muscle spasms), corticosteroids (vision problems), dietary adjustment, and cognitive rehabilitation.

Rehabilitation and Therapy

For MS patients in Turkey, physical therapy improves function and quality of life. This includes speech therapy, physiotherapy, occupational therapy, and neuropsychological support for Multiple Sclerosis.

Emerging Therapies

Emerging therapies that are under research for MS in Turkey and other parts of the world include:

• BTK Inhibitors
• Remyelination Agents
• Biologics
• Stem Cell Therapy
• Neuroprotective Medications

While MS is often managed with DMTs and physical therapy, the Neurology department at Medical Park Hospitals also specializes in advanced movement disorder treatments like deep brain stimulation.

Living Well with Multiple Sclerosis (MS)

An uneventful MS journey requires multidisciplinary support and treatment modalities, such as:

Lifestyle Adjustments

Alongside prescribed treatments, patients are encouraged to maintain an active lifestyle, follow a nutritious diet, and ensure good, consistent sleep. 

Stress management plays a crucial role in reducing flare-ups, while a supportive network of family and friends provides emotional strength and encouragement. These multidisciplinary strategies together help improve quality of life and promote long-term well-being for individuals living with MS.

Diet and Exercise

A balanced and nutritious diet and regular low-impact workouts help in reducing inflammation and improving immunity and health status.

Emotional Support

Support from family, friends, and other patients is invaluable in working through a chronic illness like Multiple Sclerosis.

Understanding the Causes and Risk Factors of Multiple Sclerosis (MS)

The fact that the exact cause for MS is not known makes its available treatment options even more important. International patients can access the latest in MS care at the Medical Park Hospitals with ease and affordability. Medical Park boasts an impressive portfolio of 2500 multidisciplinary staff and a plethora of advanced equipment and facilities. With quality certifications like JCI and over 210 fully equipped sterile operating rooms, Medical Park Hospitals offer expert care for chronic diseases like MS.

Genetic Factors

Genetic factors influence susceptibility to MS. These include:

• Positive family history
• Presence of the HLA-DRB1 gene

Environmental Factors

Several environmental factors are known to influence the risk and progression of multiple sclerosis (MS). Infections, particularly certain viral infections, have been linked to triggering immune system responses that may contribute to the disease. 

Smoking is another significant risk factor, as it can worsen symptoms and accelerate disease progression. Additionally, Vitamin D deficiency has been associated with a higher likelihood of developing MS, highlighting the importance of adequate sun exposure and nutritional supplementation when needed.