Multiple Sclerosis: Complications

The following are the major diseases or complications that may be contributed to by multiple sclerosis (MS):

Respiratory system (J00-J99)

  • Pneumonia (pneumonia)

Eyes and eye appendages (H00-H59).

  • Visual impairment

Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93).

  • Constipation (constipation) – due to degenerative processes of the enteric nervous system (ENS; “abdominal brain”):
    • The myenteric plexus (Auerbach’s plexus) between the annular and longitudinal muscle layers.
    • The submucosal plexus (Meissner’s plexus) in the submucosa (tissue layer between the mucosa and the muscle layer)

    This, in addition to intestinal motility (“ability of the intestine to move), regulates baseline gastrointestinal tone, secretion and absorption, which can lead to constipation refractory to therapy (“unresponsive to therapy”).

Musculoskeletal system and connective tissue (M00-M99).

  • Osteoporosis (bone loss)

Psyche – nervous system (F00-F99; G00-G99)

  • Anxiety disorders
  • Depression
  • Fatigue (tiredness)
  • Insomnia (sleep disorders)
  • Cognitive disorders (prevalence (disease frequency): 40-50%).
    • Word-finding disorders
    • In MS patients who smoked cannabis (hashish and marijuana) for good antispastic and muscle relaxant effects, this led to significantly more severe cognitive deficits than in those taking antispastic drugs.
  • Sexual dysfunction
    • Females: decreased lubrication (moistening of tissues with secretions), reduced vaginal excitability, and anorgasmia.
    • Men: decreased libido, erectile and ejaculatory dysfunction.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Chronic pain/pain syndromes
  • Dysarthria (speech disorders)
  • Dysgeusia (synonyms: taste disorder / taste disorder).
  • Dysphagia (swallowing disorder)
  • Fatigue (tiredness)
  • Gait disorders
  • Urinary incontinence (bladder weakness)
  • Nocturia (nocturnal urination; 77% of patients had overactive bladder and 91.5% had nocturnal urinary incontinence)
  • Paresthesias (synonym: numbness).
  • Speech disorders (here: word finding disorders).
  • Fecal incontinence (inability to retain stool).
  • Falling tendency (3 times higher risk).
  • Suicidality (suicide risk)
  • Vertigo (dizziness)

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

Prognostic factors

  • Obesity: obese children were more likely to have further disease relapses during first-line therapy with interferon beta or glatiramer acetate (relapse rate was 1.29 per year vs 0.72 per year in normal-weight children), according to a cohort study. Furthermore, the proportion of patients requiring second-line therapy was increased, 56.8% versus 38.7% in normal-weight children.
  • Depression: MS patients with depression are at increased risk for disability progression. The cause could be depression-induced neuroinflammation (inflammation of nerve tissue).