Multiple sclerosis

Multiple sclerosis is a degenerative disease, chronic inflammatory central nervous system: the substance that surrounds nerve fibers in the brain and spinal cord, called myelin, has deteriorated and has scars (sclerosis). Myelin serves to insulate nerves and allow them to transmit impulses rapidly. The speed and efficiency of impulse conduction allows for smooth movements and fast but always coordinated with little effort. Myelin, as the plastic coating of electrical cables, ensures the correct transmission of the stream, but if information is lost damaged that carries or is incorrect.

The cause that causes this disease. Some studies suggest that genetics may play a role in a person's susceptibility to this disease, but environmental factors can also influence, for example, viruses or other factors. Many characteristics of MS suggest that its origin is autoimmune and is the patient's own immune system destroys myelin.

Symptoms and Diagnosis

The diagnosis is clinical and must perform various medical tests. The incidence of MS is 1 per thousand of the population.
The most common symptoms that can make you suspect that you have multiple sclerosis, are:

• Vision problems
• Numbness of extremities
• Loss of balance
• Motor disturbances
• Cognitive problems
• Overstrain
• Lack of sphincter control, among other.

Depending on how developed in a few years can cause severe disability to the sufferer. The stages of evolution can be distinguished in three main groups:

• Primary progressive (PP)
• Relapsing-remitting (RR)
• Secondary progressive (SP)

Multiple Sclerosis(MS) is an illness that up to now has not a definite cure. Nevertheles we have treatments providing a better quality of life. Present treatments of the remittent recurrent MS are based in the prescription of short cycles of corticoids by parenteral (vein) delivery to alleviate symptoms produced by the sprouts and in the prescription of inmunomodulators to reduce the frequency of sprouts in the patient´s life. Inmunomodulators are are: interferon beta(Avonex, Betaferon, Extavia,Rebif) or acetate of glatarimero(Copaxone).

Patients who keep presenting sprouts in spite of being treated with inmunomodilators or have sprouts too frequents and severe from the beginning are advised to use the monoclonal antibody natalizumab(Tysabri) or fingolimod(Gilenya). The mentoned drugs are useful for the patients who have sprouts but not for those patients who progress without sprouts. Therefore,patients with secondary progresive manifestations without sprouts or fundamentally progressive will not be candidates to use these products. For these two last groups there is no treatment to modify the evolution of the illness. The treatment of Multiple Sclerosis has other aspects to be considered like the relief of permanent symptoms or outcomes. The Neurologist tries also to treat pain and fatigue and this increases the number of specialists around him to treat and accompany the patient with Multiple Sclerosis.

For instance the Ophtamologist to make adequate visual and ocular adjustments, the Urologist to alleviate frequent problems to empty the bladder, the Neuropsicologist for the study and treatment of attention/memory problems, the Psychiatrist and Psychologist to treat emotional problems as a result of the diagnosis of the illness or its treatments, the Rehabilitation specialist to help the patient to return to daily life and adapt to his new life conditions and the Social Worker for aids to dependence.

BIBLIOGRAPHY Official Guide for the Diagnosis and Treatment of Multiple Sclerosis. Spanish Society of Neurology. November 2007.http://www.sen.es/

Information reviewed and validated by:
Dra Eva Martínez Cáceres, MD, PhD. Colegiado nº: 26066
Responsable Sección Inmunopatología.
Laboratorio de Inmunobiología para la Investigación y las Aplicaciones Diagnósticas (LIRAD)-BST
Hospital Germans Trias i Pujol - Badalona, Barcelona

Cristina Ramo Tello. Colegiado nº : 38141
Adjunto de Neurología. Responsable Unidad Esclerosis Múltiple
Hospital Universitario Germans Trias i Pujol. Badalona, Barcelona

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