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Multiple Sclerosis

Multiple sclerosis (MS) is a chronic, inflammatory, demyelination and multifocal neurological involvement of the central nervous system. The immune system is considered to play a role in the pathogenesis of the disease. It starts on average at the age of 30 (15-50). It starts at an earlier age and is more common in women than men.

Disorders in MS are progressive and may result in disability. However, the onset, symptoms, duration, severity and progression of the disease are different. It frequently affects the brain and spinal cord, and paraplegia is often seen as the lack of control on the legs. It is less common that the arms and legs are involved together (tetraplegia).

The disease progresses with exacerbation and extinction. There may be double vision. When the patient suddenly bends his / her neck forward, he / she feels pain and electrification extending downwards. Speech and balance may be impaired. The heat resistance is reduced. Patients get tired and wake up in the morning with a feeling of unrested.

Memory impairment is the most important complaint of MS patients. Short memory loss, attention and slowdown in processing information, and blurring of consciousness are common.

Medications and rehabilitation are used in the treatment.

Pharmacological Treatment

Corticosteroids are administered in attacks. Corticosteroids should be carefully monitored for side effects. Chemotherapeutics such as azathioprine, methotrexate, cyclophosphamide and mitoxantrone are used as immunosuppressive. They have serious side effects. Interferon, glatiramer acetate and natalizumab are immunomodulatory drugs.


Strategies are developed to maximize the level of independence through rehabilitation. Excessive fatigue and sweating should be avoided during rehabilitation. Treatment should be adjusted to compensate for motor problems and inactivity complications should be prevented. Occupational skills should be increased, the balance of sitting and standing should be provided, walking should be corrected. Devices can be given according to the patient's condition. Occupational problems are tried to be solved.

Robotic rehabilitation may enhance the walking capacity and duration of the patient with MS.

Ozone can be effective in the recovery of the disease and the continuation of the gains. Promising results give hope for the future with the improvements in stem cell therapy.

To maintain a functional and quality life, regular physical therapy and rehabilitation are required. More than 85% of rehabilitated MS patients reported improved quality of life and skills.