ALL ABOUT MS (Part 2)

Types and course of the disease

The course of the disease is different and difficult to predict in each person, but over time, as the MS shows certain regularities when the disease is monitored over a longer period of time, most patients can be classified into one of four MS forms. When determining MS forms, knowledge of the previous course of the disease is used to try to predict a further course of the disease. MS forms are: relapse-remitent, secondary progressive, primarily progressive and progressive-relapse form.

Relapse-remitent form

In 85% to 90% of diseased illnesses begin as a relapse-remitent form. In these patients, unpredictable seizures (so called relapse, exacerbations, mosses, and swabs) are observed, followed by periods when the disease recedes (remission) and in which the patient's condition returns to what was before the attack, and may also be left behind damage. When the patient's condition always returns to what was before the attack, it is usually said that it is a benign form of MS.

Relapses occur within a few days or one to two weeks, and last for one to three months. The frequency and severity of the attack is different and variable in each patient, but can be reduced by treatment. Remissions can last only a few months, but usually last from one to two years. Attacks are more frequent in the first years of the disease with the tendency to extend their duration over time. The number of attacks does not affect definite disability. In about half of patients with this type of disease, a progressively progressive form develops over time.

Secondary progressive form

In this form of disease, there is no complete recovery after the worsening phase, but in time, disability accumulates and the disease is slightly worse, that is, there is a continuous progression of the disease with periods of improvement. This is the most common form of multiple sclerosis.

Primary progressive form

This type of disease affects about 15% of people. These are mostly people in whom the disease started later. There is no remission after the first appearance of the symptoms, but the ongoing progression of damage with the loss of certain functions and abilities starts without a clear-cut attack.

Progressive-relapse form

In this form of illness, progressive deterioration of the disease progresses from the very beginning, but there are also attacks after which the patient's condition can return to the one before the attack or remain slightly worse. The disease progresses continuously between these attacks. This is the most common form of multiple sclerosis.

Other effects on the occurrence and the course of the disease

There are some studies that show that smoking can exacerbate the symptoms of multiple sclerosis. Smoking can cause a sense of lack of air, improper heartbeat, increased preference for airway infections, and this can aggravate health.

Taking alcohol causes bad coordination, disturbance of balance, and interrupted speech, and changes the thinking process and behavior. Although there is no evidence that alcohol consumption worsens MS, the fact is that its symptoms tend to be associated with the action of alcohol.

The ability to conduct electrical impulses with nerve fibers, among other things, depends on body temperature. The rise in temperature causes deterioration, and the reduction in the improvement of symptoms. The heat does not worsen the symptoms permanently. Many patients noted that they were hot and damp weather, hot bath or fever temporarily aggravate symptoms. Therefore, avoiding strong heat and bathing in lukewarm water is recommended. Many have noticed that cooling with ice, ice drinks or cold cloths alleviates symptoms. Air conditioners can be an important part of the equipment that will make it easier for patients with MS to live everyday life.

The risks of general anesthesia that apply to all other patients also apply to patients with MS, with the exception of patients with MS who have breathing problems at the same time; they require cautious application of general anesthesia. Avoiding local anesthesia, such as the frequently used novocaine, is not necessary, except in case of allergy to it. Most people with MS also well tolerate epidural anesthesia. Maternal multiple sclerosis, who received epidural anesthesia during labor, have no more relapse due to this procedure. However, some neurologists, due to potential complications, do not recommend spinal anesthesia.