Of all chronic neurological diseases, multiple sclerosis It is the one that affects the greatest number of young people.
It is estimated that around 2.5 million people worldwide suffer from it, with an average of around 30 years and with a peak incidence between 21 and 25.
The disease is characterized by the appearance of inflammatory lesions in the nerve fibers and in their protective layer, the myelin sheath, which is attacked by the immune system itself. These lesions are located in multiple areas of the brain and the spinal cord, which implies a direct involvement of the central nervous system.
The symptoms are very broad and may differ from one patient to anotherand even change over time. Among the most common are altered visual acuity (including double vision), sensory and motor disorders, lack of coordinationalteration of the sphincters, weakness – usually in both legs or in the leg and arm on one side of the body -, involvement of several neurological functional systems and fatigue.
All of these symptoms can significantly affect patients’ quality of life. Photo: PexelsAll of these symptoms can significantly affect the quality of life of patients, especially considering that they are, for the most part, young people.
Although the exact causes of multiple sclerosis are not yet known, advances in research have made it possible to significantly improve their treatment to increase the quality of life of patients.
Furthermore, given that symptoms vary significantly between patients, it is essential to «seek the most appropriate treatment on an individual basis,» emphasizes the Dr. Albert Saiz, neurologist at Hospital Clínic Barcelona. Currently, although the disease has no cure, there are treatments to slow its progression and control the symptoms.
Available treatments
First, there are pharmacological treatments to control outbreaks or acute episodes. They are usually based on the administration of corticosteroids, to reduce inflammation, or on plasma exchange procedures, which allow the antibodies involved in the autoimmune response to be eliminated from the blood plasma.
There are also treatments that modify the course of the disease, whose objective “is not relieve any symptoms«but to prevent the appearance of new episodes,» explains Dr. Ana Hernando, nurse at Hospital Clínic Barcelona.
These treatments are classified based on their route of administration. On the one hand, there are self-injectable drugs, such as interferon beta and glatiramer acetatewhich reduce the number of outbreaks. On the other hand, there are oral treatments, including teriflunomide, dimethyl fumarate and fingolimod.
There are also intravenous treatments, which are administered in the hospital and which, in some cases, are based on monoclonal antibodies. These options already available new drugs added in development phase with promising short-term results, such as daclizumab and ocrelizumab.
Along with treatments that modify the course of the disease, there is also symptomatic treatment, whose objective is to alleviate the clinical manifestations. Some symptoms can be controlled with specific medication, while others require a broader approach, which may include physical rehabilitation, psychological support or social intervention.
Some symptoms can be controlled with specific medication. Photo: Unsplash
Recommendations for patients
Beyond medical treatments, health professionals insist on the importance of follow a series of recommendations to improve quality of life. “After the impact of a diagnosis of multiple sclerosis, the person has to continue with life as normally as possible,” emphasizes nurse Hernando.
Among the most common recommendations are maintaining a balanced diet—rich in vitamin D—, avoid toxic habits such as tobacco and alcohol, continue with work activity whenever possible and practice physical exercise.
“Good physical shape will allow us to counteract some symptoms that can appear in the future as fatigue, spasticity or rigidity,” adds Hernando.
Treatments for multiple sclerosis. Photo: PexelsMultiple sclerosis is an unpredictable and heterogeneous disease, making it difficult to anticipate how it will evolve in each case. Some people have a “benign” formwithout developing significant disability, while others experience a more aggressive course, with significant sequelae.
However, therapeutic advances have significantly changed the prognosis, since the number of people who develop the disease after a first episode or isolated clinical syndrome have been reduced by half.
Furthermore, life expectancy and average survival have improved substantially: today they are almost 2.5 times higher than 50 years ago. To increase the chances of a favorable prognosisexperts agree that it is key to start treatment in the earliest stages of the disease.
Nora Rosell
