Table of Contents
30 May. It is celebrated the World Multiple Sclerosis Day. And it is the last day of the “Welcome back Gardensia” initiative, the event of AISM (Italian Multiple Sclerosis Association) to raise funds for research and to continue to guarantee responses to care, assistance and support for people with pathology in the area, now more fundamental than ever. What is certain is that research and science are making important progress in the treatment of this pathology, which in recent years has seen the emergence of various therapies capable of helping the sick.
What happens when you are sick
Multiple sclerosis is one neurological disease which affects the central nervous system and tends to worsen over time. Currently the causes of the disease are not known, although a combination of factors that interact in determining it is hypothesized. It often shows the first signs of its presence already at a young age, between 20 and 30 years, and generally appears in people aged between 15 and 45-50 years. Women are twice as affected as men.
It was once called multiple sclerosis because of the characteristic arrangement of the lesions in the central nervous system. In practice, multiple sclerosis is linked to the appearance of myelin lesions, the substance that surrounds the nerves and has the task of ensuring the right speed for the passage of the nerve signal.
The lesions damage myelin, and antibodies directed against myelin can be detected in patients. The result is that the nerve signals do not flow as they should and therefore there is a limitation in the movements that affect the areas of the body normally controlled by the area of the brain where the plaques have appeared. The typical alteration of multiple sclerosis is therefore called demyelination. This phenomenon consists in the disappearance of myelin, the fundamental substance of the sheath that covers the axons of the nerve fibers. Myelin is produced by particular cells (oligodendrocytes) and is “made” by thin layers of lipids that form sleeves interrupted by knots, the Ranvier knots.
It is essential in the transmission of nerve impulses because it makes the conduction of the stimulus along the nerve fiber faster and more effective than non-myelinated fibers. The progressive degradation of myelin in different points of the central nervous system leads to clinical manifestations of extreme variability since the destruction of the myelin sheaths slows or blocks the transmission of nerve impulses along the fibers of the brain and spinal cord.
The areas of the white matter affected by the process of removing the myelinated lining of the nerve fibers are called demyelination “plaques”. Demyelination “plaques” tend to be distributed in the white matter located around the lateral ventricles, in the brainstem, cerebellum and spinal cord and can also extend to the gray matter.
The many faces of the pathology
Classically multiple sclerosis manifests itself with repeated attacks, which are activated by the action of plaques that damage myelin. Unfortunately, over time these lesions can become “irreparable” and therefore the results of the neurological damage can be permanent.
The disturbances are variable and depend on the affected area. Limb movements, sight, speech and other nerve functions may be affected. But it must be said that the clinical course of multiple sclerosis varies from patient to patient and can also change over the course of the same patient’s life.
In some cases it manifests itself a severe disability already after the first attack, in other cases after the first “remission” decades can pass without symptoms appearing. It is therefore necessary to recognize different forms of the disease: the most widespread is the relapsing-remitting. In this case the signs and symptoms tend to appear and disappear, especially in the initial phase of the disease, that is, in the first years. When they recur we speak of relapse, which can manifest itself with a new symptomatology or with the aggravation of pre-existing symptoms.
The complete or incomplete disappearance of symptoms is instead indicated with the term of remission. After a few years from its onset, and without being able to predict the times and ways in which the disease reappears, this form can evolve into a secondary progressive form. This occurs with or without relapses, which however often leave a non-total recovery, with possible phases of relative remission and stabilization.
There is also a progressive-primary form, with the disease that can evolve from the onset with a progressive course characterized by possible phases of relative improvement and stabilization, and a progressive-relapsing form characterized, instead, by a progressive course from the onset , with relapses followed or not by recovery. Finally, you can have a less severe multiple sclerosis characterized, instead, by a complete recovery after one or two relapses and does not cause permanent deficits.
In all cases, the important thing is that the affected person discovers the pathology as soon as possible, thanks to early diagnosis, and then entrusts himself to the specialist and be able to take advantage of the treatments available today. It is not just about drugs, but also about physical supports and possibilities that can really improve patients’ lives.
Read also
