23 Mar Multiple Sclerosis
Multiple Sclerosis (MS) or plaque sclerosis is a chronic neurological disease of an inflammatory and autoimmune nature that is characterized by the development of demyelinating lesions and exonal damage in the central nervous system.
To date, the causes that produce this disease are unknown, but what we do know is that its development is associated with a combination of genetic factors that predispose us to suffer from the disease, these factors are the following
- Environmental (Vit D deficiency, environmental toxins, diet or harmful habits), and
- Infectious (viral or parasitic) make it favor the appearance of Multiple Sclerosis.
It is one of the main causes of neurological disability of non-traumatic origin in young adults, mainly women.
Today Multiple Sclerosis affects between 2 and 3 million people worldwide and is after epilepsy the most common neurological disease in young adults and the most common paralysis in Western countries.
In its development or aggravation, the existence of increased intestinal permeability is implicated, which allows the uncontrolled passage of substances into the blood (viruses, toxins, bacteria…) causing an abnormal response from the immune system.
The inflammation of Multiple Sclerosis is characterized by lymphocytic infiltration that produces damage to myelin and axons.
At first, the inflammation is transient, so the onset of the disease is usually characterized by periods of neurological dysfunction followed by complete recovery. The worst thing about this is that as we advance in time, these predominant pathological changes become more chronic, creating a progressive disability in the patient.
Several phenotypes are distinguished within Multiple Sclerosis:
- Recurring outbreaks and little disability.
- Progressive with cumulative disability.
Multiple Sclerosis is characterized by two phenomena.
- Appearance of foci of demyelination in the brain and bone marrow.
- Damage caused to axons and neurons.
Subtype classification:
- Isolated Clinical Syndrome: First time you have objective symptoms that reflect a demyelinating inflammatory neurological disorder, which lasts a minimum of 24 hours and occurs without fever or infection, these symptoms are usually monofocal and evolve acutely over days or weeks , being able to have a complete recovery or not, mainly affects the optic nerve, the spinal cord, the brainstem or the brain.
- Relapsing-remitting (RRMS): It is the most common with almost 85% of cases and is characterized by unpredictable periodic exacerbations of neurological dysfunction (flare-ups) that last between weeks or months alternated by some periods of complete or partial remission of these symptoms.
- Secondary progressive (SPMS): It occurs after 10 or 20 years of suffering from RRMS since it is considered that between 30-50% of these cases end up suffering from it and consists of a progressive and gradual worsening with acute exacerbations.
- Primary progressive (PPMS): There are only between 10-15% of patients who present this subtype, which does not generate outbreaks but begins silently and deceptively and gradually worsens from the beginning, unfortunately it is the fastest in progression.
- Progressive-recurrent (PMRP) or Progressive-remaining or Progressive-recurrent: It is the most aggressive mode of this disease and affects 3-5% of cases, presenting periodic acute severe exacerbations.
When talking about the activity of the disease, the following parameters are considered:
- Number of outbreaks in a period of time “X”.
- Grade of DISCAPACITY.
- Brain lesions visible on an MRI.
-The disease is considered NOT ACTIVE when these parameters have not progressed.
Logically, as time goes by, patients lose their motor system, making it very difficult to do day-to-day activities, so it is very important to seek help to try to maintain as high an independence as possible and thus gain self-esteem.
It tends to be diagnosed when compatible symptoms and signs are found in a patient’s neurological evolution and with the results of magnetic resonance imaging (MRI) that shows demyelinating lesions in the central nervous system.
There is a great variety of treatments but all these drugs consist of delaying the accumulation of lesions (disease-modifying treatment), treatment for relapses (flare-ups), symptomatic treatment and rehabilitation.
It affects approximately 1 in 1,000 people, especially women.
