The second cause of disability in young adults after trauma is multiple sclerosis, which affects 2,8 million people worldwide, according to data published by the Multiple Sclerosis Association of the Cyprus Neurological Society and the Cyprus Medical Association, which in informing and guiding the public, explaining the course of the disease.
In a statement today, the Multiple Sclerosis Association reports that multiple sclerosis (MS) is the most common inflammatory, demyelinating and neurodegenerative disease of the central nervous system (CNS) and is the second leading cause of disability in young adults after trauma, affecting 2,8, XNUMX million people worldwide.
As he notes, it mainly affects people aged 20-40 and is 2-3 times more common in women than in men, adding that the disease is observed to a greater extent in people of the white race and less often in people of African or Asian origin.
According to the Multiple Sclerosis Association, the pathogenesis of the disease remains generally unknown but it is thought that there is an interaction of environmental and genetic factors that increase the risk of developing abnormal immune mechanisms resulting in the onset of the disease.
Risk factors include latitude (more common in latitudes further north and farther from the equator), low levels of vitamin D, smoking, childhood obesity, Epstein-Barr virus infection, and genetic characteristics.
In addition, the Multiple Sclerosis Association reports that in MS the patient's immune system turns against the myelin that is the protective covering of neurons in the CNS and which ensures the smooth transmission of stimuli to the periphery. Multiple areas of demyelination (plaques) are created accompanied by varying degrees of inflammation, gliosis and neurodegeneration.
Lesions are usually scattered (dispersed in space) but have a preference for the optic nerves, periventricular white matter, spinal cord, stem, cerebellum and cortex. They appear at different times (dispersion in time) and naturally the clinical picture and course of the disease shows great heterogeneity in proportion to the location and severity of the damage.
Symptoms
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The most common symptoms are muscle weakness in the extremities, sensory disturbances, blurred vision, diplopia, ataxia, vertigo, bladder dysfunction and fatigue.
The diagnosis is made by the history and the clinical picture, the magnetic resonance imaging in which the foci of demyelination are depicted, the evoked potentials in which it is possible to record a delay in the transmission of the stimuli, and the lumbar puncture where specific antibodies (oligoclonal) are detected. It is important to rule out conditions that may have a similar clinical or radiological picture.
The most common form of the disease is relapsing or intermittent MS-Relapsing Remitting Multiple Sclerosis (RRMS) (85%) in which episodes or attacks of neurological symptoms occur with symptoms that develop within a few days and then gradually subside over a few weeks. Between episodes the patient's clinical picture is stable. The average age of onset is 30 years.
A percentage of these patients will progress to the secondary progressive form-Secondary Progressive Multiple Sclerosis (SPMS) after years or even decades and usually presents with increasing difficulty walking.
Other forms of the disease are Primary Progressive Multiple Sclerosis (PPMS (10%), with gradual deterioration from the beginning and an average age of onset of 39 years) and Progressive relapsing Multiple Sclerosis.
Patients with an onset of optic neuritis or sensory disturbances, fewer than two relapses in the first year, and minimal symptomatology in the first five years have a more favorable prognosis. Patients with physical ataxia, tremors, or a progressive course are more likely to be disabled.
The treatment of multiple sclerosis consists of treating the acute phase (episode-thrust) by administering intravenous cortisone for 3-5 days, treating symptoms that the patient may experience during his life such as spasticity, pain, urinary disorders and prevention of new relapses and the appearance of new foci of demyelination as well as delay in the progression of the disease.
Treatments
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Over the past two decades, the Association reports, many immunomodulatory therapies have been developed that mainly target the relapsing form of the disease, but in recent years one drug has been approved for the primary disease and one for the secondary disease.
The choice of treatment is individualized and should be made in close cooperation with the patient himself after receiving the correct information.
There is currently no cure for the condition, but existing treatments provide a large percentage of patients with a very good quality of life.
The fact that MS is a chronic but also unpredictable disease that appears mainly at a young age creates, at least in the initial stages, some difficulties in the acceptance of the diagnosis by the patient and his family.
Finally, the Multiple Sclerosis Association states that appropriate information and guidance from the treating neurologist and the development of a proper therapeutic relationship both with the medical staff and with other professionals such as the psychologist and physical therapist are important factors in enabling the patient to walk with the disease and not to discount his dreams.
Source: KYPE