It is one of the diseases for which it was considered necessary to establish a World Day of Remembrance, Awareness and Coordinated Actions, in order to favor and promote developments in their treatment.
“World Multiple Sclerosis Day is celebrated every year on the last Wednesday of May. On the occasion of this day, let us see what are the forms of the disease, what are the symptoms that should put us in the process of being controlled and what treatment options exist today “, says Mr. Konstantinos Voumbourakis, Professor of Neurology-Neuroimmunology at EKPA, Director of the 2nd Neurological Clinic-Head of the Multiple Sclerosis Unit of the Metropolitan Hospital.
The most common acquired neurological disease
Multiple sclerosis is the most common acquired neurological disease in adults, between the ages of 20 and 40, without excluding its occurrence sooner or later than certain ages. It is an autoimmune disease that affects the brain, spinal cord and eyes. Specifically, the individual’s own immune system “attacks” and destroys myelin, the fatty substance that protects the nerves and allows them to function and send signals that control movement, speech and a number of other functions.
In the place of the damaged myelin, scar tissue is created, so the nerve signals are not transmitted properly. The cause of this attack is unknown, but it is considered that the provocation involved:
Genetic predisposition: there are too many disease susceptibility genes along with too few protective genes
• Exposure to one or more pathogens of the environment
• The development of pathological immune mechanisms against the central nervous system.
The numbers “say” that: in terms of gender the disease is more common in women and in terms of race it is more common in white, while the probability of infection in the general population is about 1: 1000. Heredity also seems to play a role in its occurrence: people whose sister or brother or parent is sick have a 1-3% chance of getting sick themselves. The corresponding rate for twin brothers is about 30%.
The diagnosis of the disease is clinical and is assisted by laboratory support for magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) testing.
Forms of the disease
The disease is divided into 4 “typical” and 2 “atypical forms”, depending on its clinical features.
Specifically, the “typical forms” are: the recurrent, the secondary progressive, the primary progressive and the progressive-recurrent form.
At the same time, in recent years, we distinguish two other “atypical” forms of initial manifestation of the disease, namely: 1) radiologically localized demyelination syndrome, in which, in a randomized MRI scan of the brain, findings are found that resemble those of the disease, but without the person having shown clinical symptoms or other signs of the disease and 2) the clinically localized syndrome, which initially appears with one or more clinical symptoms.
Treatment
About 85% of all forms of the disease are manageable, as today there are 14-16 specialized therapeutic approaches for its typical forms, while, for 10-15% of the most difficult forms, therapeutic efforts are aimed at slowing down the progression of this peculiar condition.
A prerequisite for the appropriate and effective therapeutic approach of the typical and atypical forms of the disease is their timely diagnosis and treatment.
Symptoms that should make us suspicious
“The disease in its initial appearance can potentially manifest itself with some symptoms that, even if they do not make us suspect the specific disease, they should definitely send us for control. “These are: weakness of the limbs, numbness, loss of balance, vision problems (‘blur’, inability to distinguish colors), speech problems, memory problems, confusion and inability to concentrate as well as urinary incontinence,” the doctor points out.
What are the goals of the treatment of the disease
The treatment of the disease is “anthropocentric”. This means that any treatment applied should have the following objectives:
• Maximum reduction in disease activity
• Minimal impact on the patient’s daily life
• Maintaining the patient’s independence
• Maintaining the patient’s ability to work
• Maintaining the patient’s quality of life
No worries about pregnancy or fertility
• Ease of use
• Maximum tolerance
• Maximum security
• Reliable long-term effectiveness.
Therapies that serve these purposes may be injectable subcutaneously or intramuscularly, oral therapies as well as intravenous injections. In many cases, it is important that therapeutic drug approaches are combined with specialized physical rehabilitation sessions, in order to help the sufferers “live with the disease” and to prevent any complications of the disease.
This means that people with multiple sclerosis should be involved in making decisions about their condition, something that has been pointed out by many clinical studies.
An additional problem that any treatment has to deal with is the fact that due to the chronicity of the disease patients often get tired and abandon treatment or turn to alternative therapies. In fact, this fatigue often affects caregivers. Treatment should prevent these turning points of the holistic treatment of the disease and support both the patient and the caregiver, through information, support and discharge programs.
Multiple Sclerosis Department of Metropolitan Hospital
“Multiple Sclerosis is a multidimensional disease and its treatment requires a specialized and multi-faceted team, which in the case of the Multiple Sclerosis Unit of Metropolitan Hospital consists of: a Director Neurologist, three Curators Neurologists with expertise in the field. , while it is secretarially supported by a specialized secretary with a 5-year term in a Multiple Sclerosis Unit of the University Neurological Clinic. This team is in constant and open collaboration with Physiatrist, Orthopedist, Urologist, Ophthalmologist, Pathologist and Psychiatrist, is supported by a Radiology, Hematology and Neurophysiology laboratory and is supported by Physiotherapists, Psychologists and Nurses. of chronic bipolar problems that afflict sufferers of the disease and its complications.
In the Unit the monitoring of the patients is done with regular examinations, every 3 or 6 months, while in the intervals, and always in collaboration with the respective treating doctor (private doctor, fund doctor, regular doctor of other private or public health structure), are offered the necessary medical services for a complete and as effective approach as possible of the disease and its complications “, concludes Mr. Voumbourakis.
Writes:
Mr. Konstantinos Voumvourakis, Professor of Neurology-Neuroimmunology at EKPA,
Director of the 2nd Neurological Clinic-Head of the Multiple Sclerosis Unit of the Metropolitan Hospital
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