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Wat is MS? | MS Center
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class="field-item even" property="content:encoded"><h3>Epidemiologie</h3> <p>Multiple sclerose (MS) is chronische neurologische aandoening waaraan momenteel in België ongeveer 12,000 mensen lijden. Deze ziekte komt niet overal ter wereld in gelijke mate voor. Globaal genomen worden de hoogste prevalenties vooral gezien in streken die verder van de evenaar liggen. De eerste symptomen verschijnen meestal tussen het twintigste en veertigste levensjaar. De diagnose kan echter ook bij (oudere) kinderen en ouderen worden gesteld. Vrouwen worden twee tot drie keer vaker getroffen dan mannen.</p> <h3>Vormen</h3> <p>MS is een zeer heterogene aandoening waarbij verschillende klinische beloopsvormen van elkaar kunnen worden onderscheiden. De meeste patiënten (85%) starten met een relapsing-remitting patroon. Relapses of opflakkeringen van neurologische uitval (met meestal evolutie over een aantal dagen) worden in dat geval afgewisseld met periodes van herstel en relatieve stabiliteit. Een deel van hen gaat na verloop van tijd over naar een secundair progressieve fase. Er treedt dan een meer geleidelijke neurologische achteruitgang op, zonder of met minder opflakkeringen. Een minderheid (15%) van de patiënten heeft van bij aanvang een primair progressief ziektebeeld. Soms is er sprake van gemengde ziektevormen.</p> <h3>Ontstaansmechanisme</h3> <p>MS is een aandoening van het centraal zenuwstelsel (CZS); dit wil zeggen van onze hersenen, ruggenmerg en/of oogzenuwen. Op dit moment is de exacte oorzaak nog steeds niet gekend. Er wordt aangenomen dat een interactie tussen verschillende genetische risicofactoren en elementen uit de omgeving leidt tot een opeenvolging van gebeurtenissen waarbij het immuun- of afweerstelsel nauw betrokken is. Neurodegeneratieve verschijnselen treden eveneens op. Het aandeel van beide verschilt van persoon tot persoon en verandert ook volgens de leeftijd.</p> <p>Het individueel risico op MS neemt toe met een factor 12 wanneer een eerstegraadsfamilielid deze ziekte ook heeft. Het Epstein-Barr virus (i.e., het virus dat de infectieziekte klierkoorts veroorzaakt), lage bloedwaarden vitamine D, roken en obesitas op kinderleeftijd worden in verband gebracht met een verhoogd risico op MS. Recente literatuur suggeert dat contact met het Epstein-Barr virus zelfs een noodzakelijke voorwaarde is voor het ontstaan van de ziekte.</p> <p>"Multiple Sclerose" verwijst naar de aanwezigheid van meerdere (multipele) sclerotische haarden bestaande uit littekenweefsel (plaques) ter hoogte van de myeline. De myeline vormt een isolatielaag rond de zenuwvezels en is belangrijk voor de functie en overleving van zenuwcellen. MS is deels een autoimmune ontstekingsziekte en deels een neuro<span class="qtip-link">Degeneratieve aandoening</span><span class="qtip-tooltip" data-qtip-title="" data-qtip-instance="tooltips">Langzaam achteruitgaande aandoening.</span>. Lokale ontsteking gaat gepaard gaan met afbraak van myeline, waardoor de zenuwgeleiding in het gedrang komt en soms kunnen de onderliggende zenuwvezels zelf ook beschadigd raken. Het optreden van nieuwe ontstekingsletsels kan zich uiten als een klinische opflakkering. Een tragere meer diffuse schade aan de zenuwvezels – in het kader van neurodegeneratie – wordt vooral, en in toenemende mate, vastgesteld tijdens de progressieve ziektefase. Het exacte mechanisme daarachter is vooralsnog onduidelijk.</p> <h3>Symptomen en prognose</h3> <p>Er is bij MS een brede waaier aan mogelijke symptomen. Bij veel patiënten begint de ziekte met een oogzenuwontsteking. Andere vaak voorkomende manifestaties zijn gevoelsvermindering en/of krachtverlies in de ledematen, pijn, coördinatieproblemen en moeilijkheden met het aansturen van de oogspieren. Verder kunnen er ook meer verdoken klachten aanwezig zijn zoals blaas- of darmproblemen, vermoeidheid, depressie en cognitieve dysfuncties. Externe factoren zoals warmte, koorts en infecties kunnen oude symptomen tijdelijk terug erger maken.</p> <p>Het natuurlijk verloop van MS verschilt van persoon tot persoon en is niet makkelijk voorspelbaar. Volgende factoren worden geassocieerd met minder gunstige vooruitzichten: mannelijk geslacht, aanvang op latere leeftijd, meerdere opflakkeringen tijdens de eerste 2 jaar, uitgebreide neurologische uitval bij de eerste opflakkering, belangrijke toename van invaliditeit tijdens de eerste 5 jaar en een primair/secundair progressief ziekteverloop. Ten opzichte van enkele decennia geleden lijkt de evolutie – gemiddeld gezien – iets minder snel progressief te zijn.</p> <p>Het is belangrijk op te merken dat MS geen aandoening is waaraan men vlugger sterft. Globaal is de levensverwachting iets verminderd, vooral als gevolg van het voortijdig overlijden van de meest ernstig aangetaste patiënten, vaak door verwikkelingen van bedlegerigheid (slikpneumonie, blaasinfectie, diep veneuze trombose en doorligwonden).</p> <p>Auteur: Dienst Neurologie - Neurologen en verpleegkundig experts<br />Laatste aanpassing: 22-6-2022</p> </div></div></div></div> </div> </div> <!-- Needed to activate display suite support on forms --> </div> </div> <!-- End block container --> </div> </div> </section> <!-- Sidebar Right section --> <!-- End Sidebar Right section --> </section> <!-- End Content section --> <!-- Content Bottom section --> <!-- End Content Bottom section --> </section> <footer id="footer-section" class="footer-section"> <div class="container-fluid"> <div class="row"> <div class="region region-footer-top"> <section id="block-menu-block-12" class="block block-menu-block clearfix"> <h2 class="block-title">Patiënten</h2> <div 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