Neurologist Prof. Dr. Rana Karabudak said that although the symptoms occur in the central nervous system, MS is actually a communication error of our immune system. Emphasizing that MS is a problem that concerns 2.5 million people, most of whom are young and at a productive age, Neurology Specialist Prof. Dr. Rana Karabudak stated that Turkey, like other Mediterranean countries, is in the middle risk region in this genetically effective disease.
“Viral load gains importance in those with high genetic predisposition”
Providing information about the views on the emergence of MS, Yeditepe University Koşuyolu Hospital Neurology specialist Prof. Dr. Rana Karabudak said, “The region where childhood and adolescence is spent in genetically susceptible people for the risk of contracting the disease and the "viral load" encountered at that time are emphasized. "When we say viral load, it is thought that encountering chickenpox, rubella, EBV-infectious mononucleosis agent Epstein-Barr virus and herpes-type viral infectious diseases that cause herpes, especially in childhood, may facilitate the emergence of the disease in susceptible individuals," he said.
Karabudak continued:
“According to the opinion that gained the most weight in scientific circles; In this period when the immune system is also developing; The coexistence of a virus that has not yet been identified or one or more of various childhood viral diseases can push the system into vulnerability in individuals who are prone to the disease. The consequences of this situation are that it may occur in the central nervous system over the years.”
Beware of persistent and unreasonable fatigue
Pointing out that MS is very personal in terms of prognosis, Prof. Dr. Karabudak pointed out that the frequency and severity of symptoms differ from person to person. Underlining that although not the most serious, the most common symptom is fatigue. Dr. Karabudak said that particular attention should be paid to resistant fatigue of unknown cause.
Stating that while fatigue is one of the first 75 symptoms most frequently complained about in 3 percent of the patients, Prof. Dr. Karabudak conveyed the following information:
“The cause of MS-related fatigue is attributed to so many factors. The first is the so-called central fatigue, the cause of which is not fully understood, and probably due to myelin damage, in which the adaptation mechanisms are affected. At this point, the person complains of early fatigue regardless of what he does. These patients, who are particularly sensitive to heat, describe the situation they experience as a feeling of decreased energy. Another cause of fatigue can be depression. Depression is a condition that reduces motivation. It can also cause rapid fatigue by disrupting the sleep-wake balance.
What is the difference between the fatigue experienced by healthy individuals?
Underlining that the cause of MS-related fatigue is different, such as changes in the immune system, functional consequences of changes in the nervous system, and neuroendocrine changes, Prof. Dr. Karabudak compared the fatigue experienced by healthy people with the fatigue experienced by people with MS as follows:
“Although there are some similarities between the fatigue described by both groups, there are differences. In both types of fatigue, the need for rest, decrease in motivation and impatience are defined. Fatigue increases with exercise, stress, depression, prolonged physical activity and decreases significantly with rest and quality sleep. However, the effect of fatigue defined by MS patients on daily activities is much more severe than the effects of fatigue observed in healthy individuals. Family life, social and professional activities of MS patients are severely affected by this fatigue. Again, fatigue defined by patients affects physical activities much more than mental activities. In particular, an increase in fatigue with an increase in temperature was found to be typical for MS fatigue.
Avoid activities that increase body temperature
Stating that one-third of patients in MS experience a condition defined as heat sensitivity, such as fever, increased fatigue caused by being in hot environments or strenuous exercise, or worsening of some symptoms, Prof. Dr. Karabudak said, “These patients are more susceptible to central fatigue. For this reason, heavy work and exercises that increase body temperature should be avoided. When there is a fever, reducing measures should be taken immediately and cool environments should be preferred.” said.
prof. Dr. Karabudak said, “Therefore, in an MS patient with fatigue; It should be investigated whether there is a new attack, the presence of infection, whether there is a change in pain, sleep pattern and mood, the drugs used, and immune system-related diseases that may cause fatigue. As fatigue is a subjective symptom, it is difficult to assess. Many different scales and tests can be used for evaluation purposes. made the statement.
How to deal with fatigue?
Underlining that fatigue in MS patients affects both the person and his/her environment, Yeditepe University Hospitals Neurology specialist Prof. Dr. Rana Karabudak gave the following information about the precautions to be taken:
“First of all, if there is loss of strength, the treatment is planned, it is important to rest during the attack period. In terms of long-term strength losses, personalized physiotherapy programs should be prepared and maintained regularly. If the patient has accompanying depression, medical treatment options and psychotherapy should be planned according to the individual. In addition, it is beneficial to stay away from foods such as high-carbohydrate white flour and sugar, and to eat in accordance with healthy nutrition criteria.”
“The patient's homework should be exercise”
"Apart from all these, if there is an unreasonable central fatigue, a realistic and practical activity program should be planned throughout the day," said Prof. Dr. Rana Karabudak, “Resting and working in short intervals, relaxation techniques, planning the day are important. He should avoid strenuous activities during the hot noon hours of the day. Fatigue does not require staying away from regular exercise. Remember that unused muscle, joint and bone structures are increasingly limited. Apart from the additional problems associated with inactivity, a non-working and non-training movement system has to spend more energy each time. The important thing is that each patient should be provided with a reasonable, realistic and regular action plan or exercise assignment appropriate for his/her own situation.