It needs immediate treatment, as it can cause many problems in the body, leading the sufferer to physical disability, in the most productive age of his life. “In the past, the disease, due to the fact that the examination for its identification concerns the brain, was not investigated in depth. But, in modern times, with the development of science, not only in neurology but also in sciences surrounding it and medicine in general, such as immunology, genetics, magnetic resonance imaging, we have made important steps in its therapeutic approach” says K. Konstantinos Voumbourakis Director of the Multiple Sclerosis Department at Metropolitan Hospital and Professor of Neurology Neuroimmunology at EKPA.

What exactly does it cause in the body?

The patient’s immune system “attacks” and destroys myelin, the fatty substance that protects nerves and allows them to function and send the signals that control movement, speech and a host of other functions. In place of damaged myelin, scar tissue forms, so nerve signals are not transmitted properly.

At what ages does it appear?

Multiple sclerosis is most common between the ages of 20 and 40, but it can occur earlier or later than those ages. It is characterized as the most common neurological disease of a person’s young and productive age, affecting their quality of life, as it makes mobility difficult, affects the bladder and, over time, can create other problems.

In addition, it occurs more often in women and in terms of race, more so in white, while the probability of being affected in the general population is about 1:1,000. Heredity also seems to play a role in its appearance. People who have a parent or a sister or a brother with the disease have a 1-3% chance of developing the disease themselves. The corresponding percentage for twin brothers is around 30%.

What are the causes?

The causes of multiple sclerosis are unknown. It has been shown, however, that factors involved in its etiology are: genetic predisposition, -as there are many susceptibility genes to the disease, alongside very few protective genes-, exposure to one or more environmental pathogens and the development of pathological immune systems mechanisms against the central nervous system, from unspecified causes.

How is the diagnosis made?

The diagnosis of the disease is clinical and is assisted by the laboratory support of magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) control. Magnetic resonance imaging has helped immensely in the diagnosis of the disease, in order to subsequently provide the necessary therapeutic approaches. “The main problem we face in diagnosing it is many times, diseases of the intestine, heart and other organs, which can have an impact on the brain and cause changes that resemble multiple sclerosis, but in the end it is not “, explains the expert.

What are the forms of the disease?

“The disease is divided into four ‘typical’ and two ‘atypical’ forms, depending on its clinical characteristics. Its typical forms include relapsing, secondary progressive, primary progressive and progressive-relapsing. While, in the last years, we distinguish two other “atypical” forms of initial manifestation of the disease.

The first concerns the radiologically localized demyelination syndrome, in which, in a random brain MRI scan, findings resembling those of the disease are found, but without the individual having presented clinical symptoms or other signs of the condition. The second concerns the clinically identified syndrome, which initially appears with one or more clinical symptoms,” he adds.

What difficulties are there in dealing with it?

There is great difficulty in recognizing the condition, as it is quite insidious and gives multiple symptoms from the entire nervous system. “It is likely to start with symptoms that, even if they are mild, should make us suspicious to be clinically evaluated by a specialist and scheduled for further laboratory testing. Among the most common symptoms are easy fatigue, weakness of the limbs, numbness in the fingertips, vision problems. The most serious symptoms, which are also the most difficult, include memory problems, confusion and inability to concentrate, urinary incontinence, difficulty with speech and balance or various other motor disorders,” he emphasizes.

What is the treatment?

The treatment of the disease is human-centered and individualized for each patient. This means that sufferers should take part in decision-making, which is highlighted by many clinical studies. The treatment to be applied should aim at the maximum reduction of relapses and disease activity, the minimum impact on the patient’s daily life, so as to maintain his quality of life and also not to cause a problem in the patients’ pregnancy and fertility. In the past, the treatments used were aimed at immunosuppression. Today, however, most treatments aim more at immunomodulation and less at immunosuppression.

The form of treatments are: 1) injectable subcutaneous or intramuscular, 2) oral treatments, 3) treatments with biological agents of monoclonal antibodies, mainly given by intravenous infusions. In many cases, they are combined with specialized physical medicine rehabilitation sessions to help sufferers and prevent any complications of the disease.

Is the approach to treatment completely individualized?

“The approach is completely individualized, as the treatment for each person, as well as for each type of disease, is different. In particular, it is different for the recurrent form, another for the recurrent form that gradually evolves and passes into an older form and finally different from the progressive form, which by definition is difficult from its establishment”, the professor points out.

Is it a disease treated exclusively by the specialty of neurologists?

In most cases, the treatment of the disease requires a team of specialized doctors and other health professionals, because it is a multidimensional disease that affects various functions of the brain. As already mentioned, it can affect sensation, mobility, the bladder and even based on newer studies, cause significant cognitive disorders.

Can people with multiple sclerosis have a good quality of life?

“Today, with the development of science, there is a 60-70% possibility for a better quality of life for patients,” concludes Mr. Voumbourakis.

*Since January 2022, the Multiple Sclerosis & Special Neurological Treatment Center has been operating at the Metropolitan Hospital, mainly targeting the group of patients with Multiple Sclerosis. In the center, the disease is recognized and all the latest internationally recognized treatments are applied. At the same time, specialized treatments are administered, such as special immunotherapies, plasmapheresis and immunosuppression treatments. It is staffed by specialized doctors and other health professionals with many years of experience, who provide the best and most targeted medical services.