Multiple Sclerosis
What is the prognosis of multiple sclerosis? Tips to improve quality of life.
Symptoms and Causes
Multiple sclerosis (MS) is a chronic inflammatory disease that affects the central nervous system, especially the myelin, which is the layer that covers nerve fibers. This causes problems in communication between the brain and the rest of the body, and in the long term, it can lead to permanent nervous system damage. The neurological sequelae caused by multiple sclerosis are one of the leading causes of disability among young adults.
The development of this disease can occur progressively or in flare-ups, with total or partial remission. In some cases, the progression is very slow, and patients may remain asymptomatic for years. In other cases, the flare-ups are frequent, and the deterioration is rapid.
Although there is currently no definitive cure, there are various treatments that improve the quality of life of patients and help them recover from multiple sclerosis flare-ups more quickly.
Symptoms
The symptoms of multiple sclerosis vary greatly depending on the characteristics of each individual, the course of the disease, and the nerve fibers affected. The most common symptoms include:
- Numbness and tingling in the limbs.
- Prolonged blurred or double vision that can lead to total vision loss.
- Weakness in muscle groups of the limbs.
- Lack of coordination.
- Dystonia with involuntary muscle contractions that cause unusual postures.
- Fatigue that can limit daily activities.
- Cognitive problems such as difficulties processing information, making calculations, or finding the right word when speaking.
- Hemifacial spasm, which causes uncontrollable movements of muscles on one side of the face.
- Mood disorders such as sadness, anger, or frustration.
Causes
The causes of multiple sclerosis remain unknown, although it is understood to have an immune origin, as the body attacks its own tissues. Studies conducted so far have concluded that the development of the disease is influenced by a combination of genetic and environmental factors.
Risk Factors
Although many aspects of multiple sclerosis are still not fully understood, several factors have been identified that increase the risk of developing the disease:
- Family history.
- Infections caused by certain viruses, such as the mononucleosis virus.
- Low levels of vitamin D.
- Genetic factors, as a gene on chromosome 6p21 has been associated with the onset of the disease.
- Women with childhood and adolescent obesity.
- Immune disorders such as type 1 diabetes, psoriasis, inflammatory bowel disease, or pernicious anemia.
- Smoking.
Complications
Multiple sclerosis flare-ups can leave lasting effects that complicate the patient's condition. Notable complications include seizures, bladder control problems, sexual dysfunction, muscle stiffness, paralysis, and difficulty speaking.
In addition to the effects caused by multiple sclerosis flare-ups, which affect both physical abilities and cognitive skills, one of the main complications of this condition is the deterioration of mental health. Beyond the initial impact of the diagnosis, as patients become aware of the limitations that come with living with MS, depression and anxiety often develop.
Prevention
Due to its nature, it is not possible to prevent or avoid the onset of multiple sclerosis. However, there are some factors that can be considered to minimize symptoms and improve quality of life. These include:
- Engaging in exercise adapted to your physical condition.
- Maintaining a balanced diet.
- Participating in leisure activities to maintain a positive attitude.
- Sharing concerns and aspirations openly with healthcare providers and loved ones, without taboos or fear of judgment.
Which doctor treats multiple sclerosis?
A neurologist diagnoses and treats multiple sclerosis. However, specialists in physical medicine and rehabilitation also play a role in the recommended therapies. To help maintain quality of life, patients can visit a bodily injury assessment unit.
Diagnosis
There is no established protocol for diagnosing multiple sclerosis. Therefore, specialists perform a differential diagnosis, which involves ruling out other diseases that cause similar symptoms.
Initially, the patient's medical history is reviewed, and a physical examination is conducted. Then, various tests are requested to obtain a general overview of the patient's health status. These include:
- Blood tests to reveal signs of infection or disease.
- Magnetic resonance imaging (MRI), which can show lesions caused by MS.
- Lumbar puncture to rule out other infections and detect possible abnormalities in the antibodies associated with multiple sclerosis.
Treatment
As mentioned earlier, there is no cure for multiple sclerosis. Therefore, treatments focus on facilitating quick recovery after flare-ups, reducing the risk of relapses, slowing the progression of the disease, and alleviating the symptoms it causes. Some of the most common treatments include:
- Corticosteroids to reduce nerve inflammation. They are used during flare-ups to shorten their duration and decrease the severity of their effects. They can be administered orally or intravenously.
- Plasmapheresis, which uses the patient's own blood as part of the therapy to alleviate the autoimmune effects that destroy the myelin. It is applied in cases of corticosteroid intolerance or lack of response to corticosteroids.
- Disease-modifying therapies (DMT) that require extensive prior evaluation to assess the risks and benefits. Several DMT drugs are available, chosen based on the patient's characteristics and priorities.
