It is a disease that causes fear at the mere mention of it. This is because at first glance it suggests a life of possible disability and loss of autonomy and independence. However, multiple sclerosis has many different aspects, it can, as well as showing flares, also show remissions, and with modern medical technologies it can be detected in time and treated effectively. Although there is no definitive cure, there are treatment methods that slow down its progression.
But what is multiple sclerosis? It is a chronic demyelinating disease of autoimmune origin that affects the central nervous system. It is in fact the most common neurological condition among young adults, with approximately 2.5 million people worldwide suffering from it. It causes lesions in the brain and spinal cord that, depending on the area where they are located, can affect the patient’s movement, touch or other senses.
Specifically, in multiple sclerosis the myelin that surrounds the neuroaxons of the central nervous system and allows the transmission of electrical impulses between neurons is destroyed and prevents the conduction of nerve impulses, with the communication system of the brain cells being disrupted.
Cause and symptoms
The underlying causes are not known, although there is some genetic background, and environmental factors, possibly certain viruses, vaccines, stress and heredity, have often been held responsible, but their effect on the onset of the disease is not known.
Multiple sclerosis usually occurs in people aged between 20 and 40 years and although its symptoms vary, it has some common symptoms, ranging from impaired vision-diplegia, numbness (tingling) of the upper and lower limbs, muscle weakness, limb paralysis and severe fatigue to balance disorders, dizziness, vertigo, instability, instability, episodes of depression, the need to urinate urgently or urinary disorders, spasticity, and problems with sexual function.
Nine out of ten patients will experience a form of multiple sclerosis with flares and remissions, in which periods of flares will be followed by remissions. And one in ten patients will have what is known as the prodromal form of multiple sclerosis, in which the disease gradually worsens after its onset.
The psychological factor plays a very important role in the progression of the disease. Thus, the patient ‘s aggravated psychology has been linked to incidents of exacerbations, and often patients, in addition to the pathological state in which they find themselves, also experience symptoms of depression and social marginalisation.
Diagnosis and treatment
The main imaging method for early diagnosis of the disease is MRI, and, although there is no definitive cure, treatment with drugs that act on the immune system to modify or suppress it is effective. The aim of the medication is to reduce the frequency of recurrences of the disease, to control them and to maintain the patient’s functional independence.
Also crucial to the lives of multiple sclerosis patients are rehabilitation programmes that focus on each patient’s functional deficits and the degree of independence they can achieve. Through the collaboration of the physical rehabilitation physician with the neurologist, the patient’s treating physician, but also with speech therapists, occupational therapists, physiotherapists, hydrotherapists and psychologists, an individualized rehabilitation program can be developed in order to achieve functional independence for the patient in all activities of daily living. In this rehabilitation, psychological support is of enormous importance, since the patient feels that he/she is losing a part of his/her life and is struggling to regain it, in the face of difficulties and social and psychological pressures.
Patients with multiple sclerosis can live a normal life through early diagnosis and personalised treatment, without being excluded from society and certainly without bearing the heavy stigma of disability. Indeed, internationally, research into the treatment of multiple sclerosis is intensifying and evolving, with dozens of experimental therapies being developed, laying the foundations for future treatment. World Multiple Sclerosis (MS) Day, on the last Wednesday in May (25 May), is an opportunity to raise public and governmental awareness of the huge challenges faced by people with the disease and their families. At the same time, it highlights the need for early diagnosis of this condition and the importance of treating it so that the patient can live a functional and independent life.
Dr. George Strikes, Neurologist, Euromedica-Arogii Rehabilitation Center of Thessaloniki