Multiple sclerosis: types, symptoms and possible causes

Our nervous system transmits large amounts of information throughout the body, Enabling them to think and have physical, cognitive and emotional skills and abilities. It also directs and maintains in operation the various organs and systems of our body.

For all this, the neurons that are part of the nervous system connect with each other to form structures, pathways and nerves, which are projected to the rest of the body. But the information they convey must reach their goal as quickly as possible, given the need to coordinate actions or react in time to environmental stimuli. Achieving such a speed is possible thanks to a substance called myelin, a substance that allows the acceleration of nerve impulses.

This transmission of information also allows us. However, there are certain problems and diseases that prevent myelin from working properly or from destroying it, causing the transmission of impulses to slow down and can lead to serious problems in a person’s vital functioning. One of the most common disorders of this type is multiple sclerosis.

What is multiple sclerosis?

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

Small scars are also generated in the form of a hardened plaque which makes it difficult for the nerve stimulus to pass. The loss of myelin, associated with the presence of these scars, means that at the neuronal level, the information conveyed by the nerve fibers takes longer to reach its destination, which causes great difficulty for those who suffer from it.

Symptoms of the disease

Symptoms of this disorder will depend on the demyelinated areas, but generally speaking, it is common for those who suffer from it to experience fatigue, muscle weakness, incoordination, vision problems, pain and / or muscle tension.

Although it was initially thought to be an illness that only caused physical symptoms, it was detected that during the illness there was also intellectual disability, and it is common that ‘there is deterioration of the area. Frontal and therefore executive and cognitive functions.

Multiple sclerosis is a disorder that manifests itself in the form of epidemicsUsually, partial recoveries occur once the outbreak subsides. This is because although myelin is destroyed by the immune system and the oligodendrocytes that produce it are unable to regenerate, the body sends stem cells to damaged areas which over time transform into new oligodendrocytes and generate blood. new myelin.

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

the causes

As we said before, multiple sclerosis is an autoimmune disease, Which, by attacking and removing myelin from neuronal axons, causes a number of effects resulting from poor transmission of nerve impulses. Thus, the mechanisms by which it acts are already in our body. However, the causes of this attack are still unknown today, with no clear reason to explain this impact.

Some of the more widely accepted theories indicate that people with multiple sclerosis have a genetic vulnerability which, when a type of environmental stimulus such as infection arrives, causes the immune system to respond to the lining of the blood vessels that supply blood. the brain. , crossing the blood-brain barrier and attacking the myelin of neurons.

Types of multiple sclerosis

As stated, multiple sclerosis is a disease that presents itself in the form of epidemics. But these outbreaks do not always occur in the same way or with the same intensity, and there can be different courses of the disorder. Depending on the course you are taking, the existence of different subtypes of this disease can be considered.

1. Recurrent transmitting multiple sclerosis

The most common subtype and courseIn this type of multiple sclerosis, unexpected and unpredictable symptomatic outbreaks occur which, over time, eventually go away, with both symptomatic remission and healing. This recovery between epidemics can be partial or even complete. Symptoms do not worsen during the intervening periods.

2. Primary progressive multiple sclerosis

One of the less common types, in this subtype of sclerosis, no specific outbreak can be identified, But gradually showing symptoms which gradually worsen. In this case, there are no periods of remission or recovery (or at least not of great importance). However, sometimes you can park.

3. Secondary progressive multiple sclerosis

As in the emitting-relapsing form, in this type of multiple sclerosis, various unexpected flare-ups are observed. and unpredictable. However, in the periods when the epidemic has ceased, the degree of disability of the patient does not improve but in fact an aggravation can be observed, being this progressive.

4. Recurrent or relapsing progressive multiple sclerosis

As with the primary progressive form, in this uncommon subtype there is progressive worsening. and without periods of remission, with the difference that in this case specific epidemics are recognizable.

5. Mild multiple sclerosis

Sometimes identified with recurrent transmitting sclerosis, this type of multiple sclerosis gets its name because, despite the presence of epidemics, the patient is fully recovering, Having milder symptoms that apparently do not get worse over time. The handicap it causes is very low.

In search of treatment

While multiple sclerosis is currently untreated, there are a large number of pharmacological treatments that can be used to reduce and delay the progression of the disease.. They can also control symptoms, reduce the severity of symptoms, and help the patient maintain their quality of life.

Some of the drugs used include corticosteroids to reduce the severity of what is breaking out, pain relievers or immunosuppressants to alter the course of the disease and reduce the level of deterioration.

drugs

But if these treatments do not cure the disease, research and progress in finding a cure for multiple sclerosis continues. Some of the latest research has gone as far as testing and conducting trials with a drug called Ocrelizumab, which has been shown to be able to delay the progression of symptoms in the early stages of the disease.

While the problem itself is neurological and therefore treated by medicine, the difficulties produced by multiple sclerosis often lead to difficulties and problems that affect the psyches of those who suffer from it. It is common for patients to experience grief for the detection of the disease in the face of progressive loss of faculties, and even for depressive episodes.

That is why it can be useful to also work from a psychological point of view, increasing the level of emotional expression of the patient in relation to his situation and working on it, as well as for him to see the situation realistically. and without behavioral avoidance. , isolation or self-destructive behavior occurs.

occupational therapy

Specifically, the use of occupational therapy to increase independence has been found to be of some benefit. and the patient’s activity level and participating in support groups as a way to express and share feelings and opinions about the disease, its consequences, and how to cope with others with multiple sclerosis. It is one of the most effective therapies for alleviating the psychological impact of symptoms.

Family and social support is essential in cases of multiple sclerosis, because it allows you to cope with everyday life and shows the subject that it is not. alone or helpless. In addition, the use of devices such as wheelchairs and bars can help to allow the patient to maintain some independence for longer, in addition to helping to reduce the level of disability caused by the disease.

Bibliographical references:

  • Bermejo, PE; Blasco, MR; Sánchez, AJ and García, A. (2011). Clinical manifestations, natural history, prognosis and complications of multiple sclerosis. Drug; 10 (75): 5079-86

  • Compston, A .; Coles, A. (2008). Multiple sclerosis. The Lancet, 372 (9648): p. 1502-1517

  • World Health Organization (2006) Neurological Disorders. Public health challenges. WHO. 45-188.

  • Rubin, SM (2013). Management of Multiple Sclerosis: An Overview. Monday; 59 (7): 253-260

  • Widener, GL (2013). Multiple sclerosis. A: Umphred DA, Burton GU, Lazarus RT, Roller ML, eds. Umphred’s neurological rehabilitation. 6th ed. Philadelphia, PA: Elsevier Mosby: Chapter 19.

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