Multiple sclerosis – MS

Multiple sclerosis, MS, is a disease of the central nervous system, that is, the brain and spinal cord. If you have MS, inflammation, and scars occur on the nerve fibers and this means that impulses do not appear as they should. There is no treatment to cure the disease, but drugs can slow the course of the disease and relieve the problems.

Inflammation and scars can be found in various parts of the central nervous system, which is why you can get discomfort from different parts of the body.

Symptoms of Multiple Sclerosis

You usually get several of these symptoms of Multiple sclerosis:

  • emotion and shaking
  • difficulty walking and keeping balance
  • trouble with vision
  • impaired control of the bladder
  • stiffness of the muscles
  • tiredness
  • mood swings with depression
  • disorders of memory and thought activity
  • pain.

Various forms of MS

The course of the disease varies greatly between different people. MS is usually divided into four different forms, or phases:

Forest-shaped MS

Most people get forest-shaped MS. In this form of the disease, you have periods of trouble, so-called forests, which can last from a few days to months. The symptoms you experience during the forest can go back in whole or in part. The condition is stable between the forests. It can vary greatly between different people how often the forest comes. For some people, it can be several years between the forests, while others have several forests the first year. In rare cases, it can take more than ten years between the periods of trouble.

Secondary progressive MS

Over the years, you tend to find it harder to safely delimit the forest. Many people with MS experience after a certain time, often after about 10-15 years with the disease, that they slowly become worse even among the forests. Then a secondary progressive phase of MS has begun. This form of MS comes after the forest-shaped period of MS and involves a gradual increase in the problems, such as increasing difficulties. In this phase of the disease, you can still get a go.

Primary progressive MS

The form called primary progressive MS is an uncommon form of the disease where you have no foreskin at all. Instead, you have a slow increase in inconvenience right from the start. Almost every fifth person with MS has this form.

Benign MS

About one in five people have so-called benign MS. This includes those who, despite many years of illness, do not get troublesome symptoms of their disease. The diagnosis of benign MS can only be made after many years have passed and it is possible to look back on the course of the disease.

When should I seek care?

If you have symptoms that you believe are due to MS, contact a health care center. If the inconvenience is severe or suddenly comes, you should seek treatment immediately.

You can seek care at any healthcare center you want throughout the country. You also have the opportunity to have a regular doctor’s contact at the health center.

Investigations

The diagnosis of MS is usually made by a specialist in disorders of the nervous system, a neurologist. When examined, reflexes, sensation, balance, and other neurological functions that may reveal if the central nervous system is affected.

To see if you have diffuse MS changes in the central nervous system, you will be examined with a magnetic camera. Such a study can also rule out other causes of the problem, such as tumors.

Spinal fluid tests, called lumbar puncture, are done to see if there are any signs of inflammation in the central nervous system. Such a sample is taken through a thin needle inserted between the vertebrae.

Neither an examination with a magnetic camera of the brain and spinal cord nor a spinal fluid test provides enough information to diagnose MS. The results must first be weighed together with the neurological examination and your medical history. Sometimes the course of the disease may need to be monitored for some time and sometimes a new magnetic camera examination is done before you get a safe diagnosis.

Often you yourself think you have MS

Not having been given any explanation for their problems can feel hopeless. Getting the diagnosis means that it is possible to explain invisible problems such as fatigue, numbness and pain to close relatives and workmates. The symptoms of multiple sclerosis are so well known that you yourself often have the idea that you have the disease.

Although it may feel like a relief to get an explanation for their troubles, the message can also be overwhelming. It is common for you to feel anxious about the future and how life will be affected by the disease. But there is a good treatment for multiple sclerosis and many can live more or less as usual. It is important that you get correct information about the disease in order to become less worried and to clear up any misconceptions. A secure diagnosis also makes it possible to move on in life and to decide on different treatments.

Treatment for Multiple Sclerosis

There is no treatment for multiple sclerosis that cures the disease MS, but there are drugs that slow down the course of the disease and that can relieve the problems. 

  • interferon-beta – Betaferon, Extavia, Rebif, Avonex, and Plegridy
  • glatiramer acetate – Copaxone
  • natalizumab – Tysabri
  • fingolimod – Gilenya
  • teriflunomide – Aubagio
  • dimethyl fumarate – Tecfidera
  • alemtuzumab – Lemtrada.

All types of drugs affect the immune system and suppress inflammation of the central nervous system. You receive the medicines as syringes, drips or tablets and the treatment lasts for several years. The medication reduces the number of forests and attenuates the spread of changes in the nervous system in the form of forest-shaped MS. Treatment of MS with these drugs is prescribed by neurologists.

Other treatment

The following treatments for MS also occur:

Treatment for acute deterioration

If the disease is severely worsened, usually in a forest, you may receive high dose cortisone for a few days. You often get cortisone as a drop or tablet.

Symptomatic treatment

If you experience symptoms such as difficulty controlling the bladder, muscle cramps or fatigue, you may receive treatment that relieves those symptoms. The treatment of multiple sclerosis is adapted to each individual person and the symptoms you have.

You should go to annual examinations at doctors with experience of MS. You also need access to a multidisciplinary team. It should consist of a doctor, nurse, physiotherapist, occupational therapist, curator, and psychologist. Then you should also have access to a speech therapist, dietitian and ur therapist.

Since you have been living with MS for many years, it is also important to have ongoing contact with your doctor for other help, for example in the case of infections.

Rehabilitation

In accordance with the guidelines of the National Board of Health and Welfare, continuous team rehabilitation should be offered to people with MS with impaired functional ability. 

Try to avoid infections

If you have MS, you should try to avoid getting infections, as they can trigger an infection and worsen the disease. If you still get an infection, it is good if you get treatment for it as soon as possible. Vaccination against influenza can prevent forests associated with the flu. The vaccine itself does not aggravate MS disease.

Fatigue can make it hard to work

Fatigue is common in MS and can make you hard to work. If fatigue is due to MS, it is good if you try to adapt, plan and prioritize your daily activities so that you utilize your energy in the best way. There may also be other causes of fatigue, such as depression. Then it is important that you get treatment for it.

Diet and alternative treatment

You should eat at all times, but there is no special diet recommended if you have MS. 

What happens in the body?

Multiple sclerosis, MS, is a neurological disease that attacks the central nervous system, that is, the brain and spinal cord. MS is characterized by the fact that different areas of the central nervous system are affected during the course of the disease, and that you, therefore, have several different symptoms.

The nerve fibers are isolated

In the brain and spinal cord are nerve threads that transmit nerve impulses between the brain and the various parts of the body. The nerve wires can be likened to electrical wires because a nerve signal is an electrical impulse. Just like other electrical wires, and insulation is needed around the nerve wire for the impulse to progress. Nervous cord insulation in the central nervous system is a fat substance called myelin.

Inflammation of the nerves

If you have MS, the white blood cells of the immune system enter the central nervous system and attack the myelin. An inflammation occurs, and sometimes the nerve fibers themselves are damaged. Then the nerve impulses cannot be properly guided. Which symptoms you get depends on which nerve fibers become inflamed. If, for example, nerve fibers to muscles in a bone are inflamed, you become weak in the bone, and if there are nerve fibers from the sensory organs in the bone you get numbness.

It is still unknown why the white blood cells attack the myelin when you have MS.

Scars are formed by the inflammation

Inflammation of the nerve cord can heal after a few weeks and then the symptoms often disappear. Such a period of trouble is usually called a forest. If the inflammation does not heal properly, a scar may form where the inflammation has been. It is these scars that have given the disease its name, multiple sclerosis, which means “many cures”.

Good with a long time between the trouble periods

When you have had your first stroke, that is, a period when you are suffering from the disease, it is impossible to predict when the next period will come. It will usually be good for the continued course of the disease if it takes a long time between the first and second forests, and if you have few forests during the first years of the disease. 

What does MS depend on?

The cause of MS is not known, but about every fifth person with MS has a close relative who also has the disease. Combinations of certain inheritance systems increase the risk of MS, but there is no single inheritance system that gives you MS. The disease is therefore not considered hereditary.

MS is a disease that you live with for many decades. The average life expectancy for people with MS is almost as long as for the rest of the population. MS does not infect and there is no known environmental factor or other external cause of the disease. Smoking is considered to have an adverse effect even in MS.

MS and pregnancy

There are many women with MS who have undergone pregnancies and deliveries over the years. MS does not pose any obstacle to pregnancy and childbirth. In connection with childbirth, you can get pain relief in the usual way. MS is no obstacle if you want to breastfeed your baby. The disease usually has a calmer course with fewer forests during pregnancy but after the birth the risk of forests increases. All in all, the disease activity during pregnancy and the following months is much like a year when you are not pregnant.

If you have MS and are planning to get pregnant, it is important to discuss this with your doctor. This is especially true if you are being treated with any disease-modifying medicine, called brake medication since the effects of these drugs on pregnancy and the fetus are still not fully investigated. As a general rule, brake medication should not be taken during pregnancy or while breastfeeding, as some medications pass into breast milk. Therefore, you need to balance the desire to breastfeed your child and the worry of getting a disease.

Influence and participate in your care

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should receive information about treatment options and how long you may have to wait for care and treatment.

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