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It is an immune-derived disease of the central nervous system with loss of myelin. Lesions called “demyelinating plaque” accumulate in the brain and spinal cord. In the later years of the disease, it can lead to disorders such as loss of vision, loss of muscle strength, balance disorder and speech disorder. clinical features; It usually starts between the ages of 20-40, but it can also start in children and later ages. It is common in northern European countries and less common in Asian countries. Its incidence in Turkey is considered to be at the transition level between these two regions. The exact causes of the disease are still unknown, it is thought to occur as a result of genetic characteristics and environmental factors. MS risk factors; Interaction with tobacco in adolescents, being deprived of sunlight, low vitamin D during pregnancy, excessive alcohol, night shift, and a history of infectious mononuclease can be counted.
Clinical manifestations can be very different. Sometimes, MS plaques can be found in brain imaging examinations taken for a different reason, such as headache or head trauma, without any symptoms. It usually starts as a relapsing-remitting form (RRMS) with worsening in the form of attacks. Along with active plaques in the brain and medulla pinalis, symptoms such as vision loss, loss of strength in the arms or legs, balance or speech disorders, urination or sexual dysfunctions may occur in accordance with the localization of the plaques. While these symptoms partially improve after attacks, they may remain partially as sequelae. According to clinical features; clinically isolated syndrome is classified as RRMS, primary progressive MS and secondary progressive MS.
The diagnosis of MS is made by a specialist clinician based on the history of the disease, examination findings and features of the MRI lesions, and evaluation of the cerebrospinal fluid (CSF). In the diagnosis of the disease, it is important that the lesions increase over time and their distribution in the brain and spinal cord. MRI appearances of MS lesions are not always specific and can be seen in conditions such as small vessel infarcts, Lyme Disease, Systemic Lupus Erythematosus, and Sjögren's Syndrome. In terms of these diseases, differential diagnosis is made with additional examinations and evaluations. There are two main types of treatment for MS patients: attack treatment and treatments that control the disease process.
