Multiple sclerosis is a disease that causes the protective sheath of the nerves to deteriorate. Multiple sclerosis can cause numbness, weakness, difficulty walking, vision changes, and other symptoms beyond the attacks. These can disrupt patients' quality of life. Therefore, effective management of these frequently reported symptoms improves their daily comfort. Dr. Özden Yener Çakmak, a specialist in the Neurology Department at Memorial Antalya Hospital, explained what you need to know about conditions that occur in MS beyond the attacks.
Complaints Seen in MS Can Be Managed
MS symptoms depend on the individual, the location of the damage in the nervous system, and the severity of the damage to the nerve fibers. Some people lose the ability to walk or move independently. Others may experience long periods between attacks without new symptoms, called remissions. The course of the disease varies depending on the type of MS. Treatment for MS aims to accelerate recovery from attacks, modify the course of the disease, and manage symptoms.
MS can cause the following disorders other than attacks:
1-Fatigue
Patients report a loss of physical or mental energy that prevents them from carrying out activities throughout the day. They often report feeling tired even upon waking in the morning. Fatigue becomes more pronounced midday and worsens with increased stress and increased temperature.
While fatigue is common in MS patients, caution should be exercised regarding other possible differential diagnoses. For example, other conditions that can cause fatigue, such as infection, medication side effects (interferons, benzodiazepines, some antidepressants), anemia, hypothyroidism, and depression, should be considered and investigated.
Treatment primarily focuses on improving daily lifestyle. Healthy eating habits should be followed and attention should be paid to getting 7-8 hours of sleep per day. Furthermore, habits that increase fatigue, such as alcohol and smoking, should be abandoned. Physical therapy is very beneficial in improving muscle strength and reducing fatigue. Medical treatment options include modafinil, amantadine, methylphenidate, and some antidepressants.
2-Depression
The most common neuropsychiatric symptom in MS patients is depression. Anxiety, panic disorder, bipolar disorder, and psychosis can also occur, although less frequently. Cognitive dysfunctions affecting attention, concentration, memory, and learning are also common.
Early diagnosis and treatment of comorbid psychiatric symptoms are crucial for both quality of life and adherence to treatment. A thorough psychiatric assessment can effectively utilize psychotherapy and behavioral therapies, in addition to pharmacological treatments.
3-Sleep problems
Sleep problems are common and significantly impact the quality of life of MS patients. Poor sleep quality can negatively impact quality of life and patient health. Fatigue and cognitive impairment, which are common symptoms throughout the course of the disease, are also frequently associated with sleep disorders. MS patients with good sleep quality are known to have higher physical activity levels and walking capacity.
If it takes longer to fall asleep, if sleep is frequently interrupted, if you experience daytime sleepiness despite sleeping for 6-8 hours, and if you experience increased fatigue, you should definitely consult a doctor.
Therefore, sleep hygiene education, treatment of additional symptoms such as nocturia that disrupts sleep patterns, or appropriate pharmacological treatments may change the course of the disease.
4-Urinary problems
Urinary problems are common in MS patients. Urgent urination, urinary incontinence, incomplete bladder emptying, and frequent urination are among the most common symptoms.
Unless treated, urinary problems can disrupt the patient's daily life quality and activities.
Therefore, patients need to undergo urological evaluation, monitor their kidney functions, and provide suggestions for the problem after the evaluation.
5-Migraine
It is known that the frequency of headaches increases in MS patients. Migraine and tension-type headaches, in particular, are more common in MS patients. While the exact cause of the coexistence of migraine and MS has not been fully elucidated, similar demographic characteristics (gender, age group, hormonal status, psychological characteristics) are observed in the two disease groups. Furthermore, some medications used in the treatment of MS patients are known to increase the frequency of headaches.
Therefore, in cases of increasing or newly occurring headaches, close monitoring and check-ups can be carried out and attack or preventive treatments can be applied.