Multiple sclerosis or multiple sclerosis is an autoimmune disease that affects the brain, spinal cord and eyes. It needs immediate treatment, as it can cause a number of problems in the body, putting the sufferer under great physical strain.
“The disease is multidimensional, affecting many scattered areas of the brain and causing a variety of symptoms. In modern times, with the advancement of science in the fields of neurology, immunology and genetics, significant progress has been made in the therapeutic approach to disease”, underlines Konstantinos Voumbourakis, Director – Head of the Department of Multiple Sclerosis of the Metropolitan Hospital, professor emeritus of Neurology, Greek University of Athens, who then explains what it is, what the symptoms are, what the causes are and how it is treated the disease.
What does multiple sclerosis do to the body?
In multiple sclerosis (MS), the patient’s immune system is dysregulated and, through various mechanisms, “attacks” by destroying myelin. This is the fatty substance that protects nerves and allows them to function properly and transmit nerve signals that control movement, speech, and other functions. When myelin is destroyed, scar tissue forms on the nerve cells, so the corresponding function cannot be carried out. That is, nerve signals are not transmitted correctly.
At what age does it appear?
It usually appears during the reproductive age, i.e. between the ages of 20-40, but it can appear earlier or later than specific ages.
Is it a hereditary disease?
The disease is not considered hereditary, but a genetic burden has been found. Specifically, people who have a parent or sibling affected by the disease have a probability of approximately 1-3% of experiencing it, while in twin brothers this percentage rises to approximately 30%, i.e. its pathogenesis is attributed a multifactorial etiological substrate.
It is more common in women (women/men: 3/2)
What are the causes of the disease?
The causes that lead to its appearance remain unknown, but, as already mentioned, it is considered a multifactorial disease. In particular, genetic predisposition contributes to its onset, since there are many genes that appear to be susceptible to its manifestation. Furthermore, exposure to pathogens and the development of pathological immune mechanisms against the central nervous system from unspecified causes influence its appearance and development.
How does it manifest itself?
Multiple sclerosis has the following symptoms:
• Weakness in the arms or legs
• Numbness
• Diplopia
• Loss of vision in one (each) eye, accompanied by pain when moving the eye (optic neuritis)
• Sensation of electricity in the back
• Difficulty walking
• Difficulty speaking
• Dizziness
• Fatigue
• Itching
• Disorders of urination, defecation or sexual function
• Progressive mental decline
In what forms is the disease distinguished?
MS is characterized by the existence of four main clinical forms:
• the relapser
• secondary development
• the primary producer
• the progressive-relapsing form
In recent years, two new “atypical” forms associated with the first onset of the disease have also been identified. The first of these is demyelination syndrome identified radiologically, where through a random brain MRI examination, changes similar to those of the disease are detected, without however presenting clinical symptoms or other indicative signs. The second form concerns the clinically identified syndrome, which initially presents one or more clinical symptoms.
How is the diagnosis made?
The initial clinical examination is essential for every patient. Imaging tests, such as CT and especially MRI, blood tests and ophthalmological examination with evoked potentials and/or visual fields are usually necessary.
In many cases, definitive diagnosis and confirmation of the disease requires a lumbar puncture (LUP), which is performed in the hospital, with the patient staying in hospital for one day. This procedure is performed exclusively by a neurologist and is performed under local anesthesia. The fluid obtained is sent for particular analyses.
How is it treated?
The approach to the disease is individualized with an anthropocentric character, therefore it is targeted and adapted to the needs of each patient, who is called to actively participate in the decision-making process, supported by numerous scientific research.
In the past, treatments focused on immunosuppression. Today, however, most treatments aim to modify the disease, placing less emphasis on immunosuppression and with the aim of minimizing the relapses and impact of the disease on the person’s daily life, preserving quality of life and without negatively affecting the pregnancy. (when the affected person is a woman) and the patient’s fertility.
Therapeutic approaches include:
• Subcutaneous or intramuscular injectable treatments.
• Oral therapies.
• Treatments with monoclonal antibody biologic agents, usually administered via intravenous infusions.
• In many cases they are combined with specialist medical-physical rehabilitation sessions, in order to improve the patients’ conditions and prevent possible complications of the disease.
How good can people’s quality of life be?
Multiple sclerosis?
Quality of life will depend on symptoms and the patient’s response to treatment. This rare but unpredictable disease can change course without warning. Most people with MS do not experience severe disability and continue to live normal lives.
*The Center for Multiple Sclerosis and Special Neurological Diseases operates at the Metropolitan Hospital, a specialized unit that focuses on the treatment of patients suffering from the above diseases. The Center uses the most modern internationally approved treatments, including symptomatic and disease-modifying treatments. The Center’s staff is made up of specialized doctors with many years of experience in caring for MS patients, while they are informed about the latest developments in the field through participation in international and national scientific conferences.