Multiple sclerosis: types, symptoms, and possible causes

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

For all this the neurons that are part of the nervous system are connected 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 environmental stimuli. Achieving such speed is possible thanks to a substance called myelin, a substance that allows the acceleration of the nervous impulse.

This transmission of information also allows us. However, there are some problems and diseases that cause myelin to not work properly or to be destroyed, causing a slowdown in the transmission of impulses, which can cause serious problems in the vital functioning of the person. 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 a progressive demyelination of the nervous system. This demyelination is caused due to the action of the immune system, which attacks the myelin present in neurons and causes its destruction.

Small scars are also generated in the form of a hardened plaque that makes it difficult for the nervous stimulus to pass. The loss of myelin, together with the presence of these scar plaques, causes that at the neuronal level the information transported by nerve fibers takes longer to reach its destination, causing great difficulties for those who suffer it.

Symptoms of the disease

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

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 an intellectual affectation also occurs, being frequent that there is a deterioration of the frontal area and therefore of the executive functions and cognitive.

Multiple sclerosis is a disorder that occurs in the form of flare-ups, generally occurring partial recoveries 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 it, the body sends stem cells to damaged areas, which 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, leading to degeneration in the long run progressive.

Causes

As we have said before, 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 poor transmission of the nerve impulse. Thus, the mechanisms through which it acts are already in our body. However, the causes of this attack remain unknown to this day, and there is no clear reason to explain this affectation.

Some of the most accepted theories indicate that those who suffer from multiple sclerosis have a genetic vulnerability than before the arrival of some type of stimulus from the environment such as an infection causes the immune system to react on the wall of the blood vessels that supply 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 flare-ups. 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 type of multiple sclerosis, unexpected and unforeseeable symptomatological outbreaks arise that with the passage of time end up disappearing, having both remission and recovery symptomatological. This recovery between outbreaks can be partial or even complete. Symptoms do not get worse during the periods in between.

2. Primary progressive multiple sclerosis

One of the less frequent types, specific outbreaks cannot be identified in this subtype of sclerosis, but progressively symptoms are seen that gradually worsen. In this case there are no periods of remission or recovery (or at least not of great importance). However, on some occasions it can be parked.

3. Secondary progressive multiple sclerosis

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

4. Recurrent or relapsing 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 specific outbreaks are recognizable.

5. Benign multiple sclerosis

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

In search of a treatment

Although there is currently no cure for multiple sclerosis, there are a large number of pharmacological treatments that can be used to alleviate and delay the progression of the disease. In addition, symptoms can be controlled, their severity reduced, and the patient can be helped to maintain their quality of life.

Some of the medications used include corticosteroids to reduce the severity of flare-ups, 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 continues in the search for a cure for multiple sclerosis. Some of the latest research has gone into testing and conducting trials with a drug called Ocrelizumab, which has been shown to delay the progression of symptoms in the early stages of disorder.

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

Therefore, it can also be useful to work from a psychological perspective, increasing the level of emotional expression of the patient regarding his situation and working on it, as well as in that he sees the situation in a realistic way and there are no behavioral avoidance, isolation or self-destructive behaviors.

Occupational therapy

Specifically, the use of occupational therapy has been shown to be useful in increasing autonomy and the level of activity of the patient and participation in support groups as a method to express and share feelings and views of the disease, its consequences, and ways of coping with other people with sclerosis multiple. 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 allows to cope with the day to day and makes the subject see that he is not alone or helpless. Also the use of devices such as wheelchairs and bars can help the patient to maintain a some autonomy for a longer time, in addition to helping the level of disability produced by the disease to be less.

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): pp. 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.