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Multiple sclerosis: types, symptoms and possible causes

Multiple sclerosis: types, symptoms and possible causes

October 5, 2022

Our nervous system transmits large amounts of information throughout the body , allowing us to think and have physical, cognitive and emotional skills and abilities. It also directs and keeps functioning the different organs and systems of our body.

For all this, the neurons that are part of the nervous system connect to each other forming structures, tracts and nerves, which are projected to the rest of the body. But the information they carry needs to reach its goal as quickly as possible, given the need to coordinate actions or react in time to the stimuli of the environment. Achieving such speed is possible thanks to a substance called myelin, a substance that allows the acceleration of the nerve impulse.


This transmission of information also allows us. However, there are some problems and diseases that cause the myelin does not act properly or that it is destroyed, causing a slowing down of the transmission of impulses can lead to serious problems in the vital functioning of the person. One of the most frequent disorders of this type is multiple sclerosis .

What is multiple sclerosis?

Multiple sclerosis is a chronic, progressive and currently incurable disease in which a progressive demyelination of the nervous system occurs. This demyelination is caused due to the performance of the immune system, which attacks the myelin present in the neurons and causes their destruction.


Small scars are also generated in the form of hardened plaque that makes the passage of the nervous stimulus difficult. The loss of myelin, together with the presence of said scarring plates, causes the information transported by the nerve fibers to take a longer time to arrive at their destination at a neuronal level, causing great difficulties for those who suffer from it.

The symptoms of the disease

The symptoms of this disorder will depend on the areas that are demyelinated, but in general it is common for those who suffer to suffer fatigue, muscle weakness, incoordination, vision problems, pain and / or muscle tension.

Although initially it was believed that it was a disease that only caused physical symptoms, it has been detected that throughout the course of the disease there is also an intellectual impairment, with frequent deterioration of the frontal area and therefore of the executive functions and cognitive.


Multiple sclerosis is a disorder that occurs in the form of outbreaks , usually occurring partial recoveries once the outbreak subsides. This is due to the fact that although myelin is destroyed by the immune system and the oligodendrocytes that produce it are unable to regenerate it, the organism sends damaged cells stem cells that over time become new oligodendrocytes and generate new myelin.

This new myelin is not as effective or resistant as the original due to the presence of damage to the axon, so that subsequent attacks of the immune system will weaken the connections and subsequent recovery will be less, resulting in a long-term progressive degeneration.

Causes

As we said earlier, multiple sclerosis is an autoimmune disease , that through the attack and elimination of the myelin of the neuronal axons causes a whole series of effects derived from the bad transmission of the nervous impulse. So, the mechanisms through which it acts are already in our body. However, the causes of this attack remain unknown today, there being no clear reason to explain this affectation.

Some of the most accepted theories indicate that those who suffer multiple sclerosis have a genetic vulnerability that before the arrival of some type of stimulus of the environment as an infection causes the immune system to react in the wall of the blood vessels that irrigate the brain, crossing the blood-brain barrier and attacking the myelin of the neurons.

Types of multiple sclerosis

As indicated, multiple sclerosis is a disease that occurs in the form of outbreaks. But these outbreaks do not always occur in the same way or with the same intensity, and there may be different courses of the disorder. Based on the course you take, the existence of different subtypes of this disease can be considered .

1. Recurrent-remitting multiple sclerosis

The most frequent subtype and course , in this multiple sclerosis modality unexpected and unforeseeable symptomatological outbreaks arise that with the passage of time end up disappearing, having both remission and symptomatic recovery. This recovery between outbreaks can be partial or even complete. Symptoms do not get worse during the interim periods.

2. Primary progressive multiple sclerosis

One of the least frequent types, in this subtype of sclerosis can not identify specific outbreaks , but progressively you will see symptoms that get worse little by little. In this case there are no periods of remission or recovery (or at least not of great importance). However, on some occasions it can get to park.

3. Secondary progressive multiple sclerosis

As in the relapsing-remitting form, in this type of multiple sclerosis there are different unexpected outbreaks and unpredictable. However, in the periods when the outbreak has ceased the degree of disability of the patient does not improve but in fact a worsening can be observed, being this progressive.

4. Recurrent or recurrent progressive multiple sclerosis

As with the primary progressive form, in this rare subtype there is a progressive worsening and without periods of remission, with the difference that in this case concrete outbreaks are recognizable.

5. Benign multiple sclerosis

Sometimes identified with relapsing-remitting sclerosis, this type of multiple sclerosis gets its name because, despite the presence of outbreaks, the patient's recovery from them is given completely , having milder symptoms and that apparently does not get worse over time. The disability it causes is very small.

In search of a treatment

Although at present, multiple sclerosis has no cure, there is a large number of pharmacological treatments that can serve to alleviate and delay the progression of the disease . Also, symptoms can be controlled, reduce the severity of these and help the patient to maintain their quality of life.

Some of the medications used include corticosteroids when it comes to reducing the severity of outbreaks, analgesics in cases of pain or immunosuppressants to alter the course of the disease and reduce the level of deterioration.

Drugs

But while these treatments do not cure the disease, research and progress is still being made in the search for a cure for multiple sclerosis. Some of the latest research has come to test and perform trials with a drug called Ocrelizumab, which has been shown to delay the progression of symptoms in the early stages of the disorder.

While the problem itself is neurological and therefore is treated from medicine, the difficulties caused by multiple sclerosis often cause difficulties and problems that affect the psyche of those who suffer. It is frequent that before the detection of the disease the patients suffer mourning processes before the progressive loss of faculties, and even that they suffer depressive episodes.

Therefore it can be useful to work also from a psychological perspective, increasing the level of emotional expression of the patient with respect to their situation and working on it, as well as in that it sees the situation in a realistic way and behavioral avoidance does not occur, isolation or self-destructive behaviors.

Occupational therapy

Specifically, it has been shown to be useful to use occupational therapy when increasing autonomy and the level of activity of the patient and participation in support groups as a method to express and share feelings and points of view regarding the disease, its consequences and the ways of facing life with other people with multiple sclerosis. It is one of the most effective therapies when it comes to mitigating the psychological impact of symptoms.

Family and social support is essential in cases of multiple sclerosis, since it makes it possible to face the day to day and makes the subject see that he is not alone or helpless. The use of devices such as wheelchairs and bars can also help the patient to maintain a certain autonomy for a longer time, in addition to helping to reduce the level of disability caused by the disease.

Bibliographic references:

  • Bermejo, P.E .; Blasco, M.R .; Sánchez, A.J. and García, A. (2011). Clinical manifestations, natural history, prognosis and complications of multiple sclerosis. Medicine; 10 (75): 5079-86
  • Compston, A .; Coles, A. (2008). Multiple sclerosis The Lancet, 372 (9648): p. 1502-1517
  • World Health Organization (2006) Neurological disorders. Challenges for public health. WHO. 45-188.
  • Rubin, S.M. (2013). Management of multiple sclerosis: an overview. Dis Mon.; 59 (7): 253-260
  • Widener, G.L. (2013). Multiple sclerosis In: Umphred DA, Burton GU, Lazaro RT, Roller ML, eds. Umphred's Neurological Rehabilitation. 6th ed. Philadelphia, PA: Elsevier Mosby: chap 19.

Update on Multiple Sclerosis | UCLA Neurology (October 2022).


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