What is Multiple Sclerosis?
Multiple sclerosis (MS) is a chronic disease of the central nervous system affecting mostly young people and that may generate neurological disability that impairs quality of life.
HOW IS THE COURSE OF THE DISEASE?
Multiple Sclerosis disease onset usually occurs in young adults (between 30-40 years old) in its relapsing form (RRMS). A relapse may cause paralysis of an arm or leg, loss of sensitivity, blurred or double vision or difficulties with coordination and balance during several weeks with a partial or full recovery after this period. After several years, permanent neurological impairment progress in spite of presence or absence of relapses.
WHAT IS HAPPENING?
In Multiple sclerosis, an autoimmune attack against antigens of the central nervous system occurs mediated by macrophages and lymphocytes that cross blood brain barrier due to unknown causes. Even the acute inflammation resolves, some degree of diffuse neuroinflammation remains. Both acute and diffuse inflammation are responsible of neuroaxonal injury.
HOW IS THE DISEASE TREATED?
There are several available treatments that help to reduce frequency of relapses and lesions. These treatments modulate the defenses and prevent inflammation. Some of the treatments can have side effects that require supervision. Most of these treatments are useful for the relapsing form of the disease. In the following months, we expect to have the first drug approved for patients with primary progressive MS. More importantly, there is an important ongoing research activity working to develop new therapies to control disease progression and sequelae recovery for both phenotypes (relapsing and progressive MS).
HOW IS IT DIAGNOSED?
Typical clinical phenotype of MS and magnetic resonance imaging drives the diagnosis of MS. Other tools that may be useful to confirm MS diagnostic are:
- A blood analysis, which allows discard other immune-mediated disorders as well as some infectious diseases
- Optical coherence tomography in the case of acute optic neuritis (AON) presentation in order to diagnosis AON and discriminate other conditions such as Neuromyelitis optica spectrum disorders (NMOSD).
- Visual evoked potentials in the case of AON.
- Spinal fluid evaluation in order to describe the presence of Oligoclonal bands.
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