Multiple Sclerosis, also known by many people as disseminated sclerosis or encephalomyelitis disseminata, is a chronic neurological disorder that affects the central nervous system, especially the brain, spinal cord and optic nerves.
Multiple sclerosis can cause difficulty in strength and muscle control, vision, balance, sensation and disorders of mental function. Brain, spinal cord and optic nerves are connected by nerves and nerve fibers. A protein called myelin surrounds and protects nerve fibers. When myelin becomes inflamed or is destroyed (a process called demyelination) the result is disruption of normal flow of nerve impulses to the central nervous system.
Demyelination process and its result leads to stopping the flow of nerve impulses and in that way occurs a disease known as Multiple Sclerosis. In many cases, the cells (oligodendrocytes) that synthesize myelin are destroyed, as nerve fibers (axons). In this case, the body is unable to restore myelin or nerve fibers, which will contribute more to the development of disability.
It is considered that Multiple Sclerosis is an autoimmune disease in which the patient's immune system affects myelin and myelin-forming cells (oligodendrocyte). Until now, doctors and researchers from different countries have proposed several etiologic factors in Multiple Sclerosis:
-viruses - damages the glial cells through a direct mechanism;
-bacteria - which may contain antigens similar to those of the central nervous system and may lead to cross reactions (immune system forms antibodies against bacteria but attacks the central nervous system elements that are structurally similar to bacterial antigen);
-defective function of oligodendrocytes;
-diet - which can affect membrane composition and functions of macrophages and oligodendrocytes;
-genetic factor - predisposition to brain antigens response and lower control immune response;
-other factors - toxins, stress, trauma, climate, diet.
What cause Multiple Sclerosis remains unknown. It could be a genetic factor involved, because the risk of Multiple Sclerosis in a person is slightly increased if one parent has Multiple Sclerosis. The bond, not always obvious, from where (geographically) the affected person spend his childhood and the risk of developing Multiple Sclerosis later in life, suggests that some environmental factors could be involved in developing Multiple Sclerosis. However, until now there has clearly demonstrated that some specific infection would cause Multiple Sclerosis.
There are other factors suspected to be triggers for Multiple Sclerosis, but so far has not been shown that any of them would be involved for sure. Research studies in progress suggest that a problem in the body's natural defense system (immune system) appears in childhood or early after infection may trigger the onset of Multiple Sclerosis. Can trigger an autoimmune reaction in which the immune system attacks myelin.
Symptoms of Multiple Sclerosis vary from person to person, depending on what part of the brain or spinal cord is affected. Loss of myelin and scarring caused by Multiple Sclerosis can affect any region of the central nervous system. Symptoms may come and go or become more or less severe from day to day or, more rarely, from one hour to another. Symptoms may become more severe with increasing (or less frequently, lower) body temperature or after a viral infection. Some symptoms of MS, such as spastic tremor, pain and difficulty in thinking clearly, are similar to those occurring in other diseases and does not necessarily mean that it's Multiple Sclerosis.
In general, Multiple Sclerosis may develop in one of the four ways below:
1. Relapse-remission: evolution consists of alternating periods of active disease when symptoms flare, with periods when symptoms improve, this cycle can last for many years, in periods of remission, the disease is not progressing;
2. Secondary Progressive: Active symptoms of Multiple Sclerosis are constantly progressive, with further damage to central nervous system symptoms usually worsen as the disease progresses
3. Primary progressive: the disease is progressive from the beginning, although the rate of degradation of the central nervous system varies from person to person and differs from the same person, this mode of evolution of Multiple Sclerosis is not very common, but can be devastating;
4. Progressive relapse: evolution is a rare form of Multiple Sclerosis, which causes a steady degradation of the nerves, which begins with the onset of symptoms and continue to affect the central nervous system even when the symptoms are not present.
Many people with Multiple Sclerosis do not have to follow the exact evolution of these models. Evolution is often difficult to predict. Not only that it differ from one person to another, but the development could change in the same individual over time. Multiple Sclerosis tends to be more severe in men than in women, particularly in middle-aged men who develop the disease.
Typically, Multiple Sclerosis evolves with more episodes of relapse occurring over several years. In many people, the first episode of Multiple Sclerosis has only a single symptom. It may take several weeks, months or years until a relapse. As time passes, the symptoms may persist after each relapse, so they lose the ability to complete recovery after the relapsing episode. When new symptoms occurs, they often will affect other areas of the brain or spinal cord.
Complications that can result from multiple sclerosis are:
1. Urinary tract infections (UTIs): people with Multiple Sclerosis often have trouble urinating and inability to control or eliminate urine; these difficulties increase the risk of UTIs;
2. Constipation: slow intestinal motility and intestinal spasms, and decreased physical activity are common in people with Multiple Sclerosis and can cause constipation;
3. Painful pressure points: they occur when a person is forced to stay in bed for long periods of time, especially if it is unable to change position;
4. Decreased ability to move or walk, which involves using a wheelchair all the time or from time to time.
Multiple sclerosis should not interfere with most health care procedures applied routinely, such as dental anesthesia, general anesthesia (unless the person has breathing problems) or immunizations, such as flu.
In severe forms, Multiple Sclerosis can affect movement and travel, limit daily activity, especially as you age.
Many people with Multiple Sclerosis have different degrees of disability, but it is not always severe or constant. In a recent study on aging people who have Multiple Sclerosis, a third of them retained their work and two-thirds were to go to 25 years after onset.
If someone has Multiple Sclerosis, it is indicated to go to the closest doctor for a long discussion about how this disease can affect everyday life. More complete knowledge of the ways of evolution and possible complications will be useful in developing future plans.
The risk of multiple sclerosis increases according to:
-Geographic location or place where the person grew (up to 15): those who lived in the first 15 years of life in regions with cold climates, those that are farther from the equator tend to have more likely to make Multiple Sclerosis than people who lived in regions closer to the equator during these years.
-If there were cases of Multiple Sclerosis in the family: people who have a parent or relative rank first (including a monozygotic twin) with Multiple Sclerosis have a slightly increased risk of making the condition
- Race: people living in Western Europe for generations, have a higher probability of developing Multiple Sclerosis, is uncommon in Native Americans (American Indians), Eskimos and Africans
- Sex: Multiple Sclerosis is approximately three times more common in women than in men.
It is well indicated to see a doctor if for a longer period of time is present at least one of the following symptoms:
1 Blurred vision, dark spots, eye pain, vision loss or double vision;
2 Feeling of weakness or heaviness, involuntary leg dragging, stiffness, difficulty walking and awkwardness / clumsiness;
3 Tingling or stinging needle, numbness, banda gather around the body, arms or legs;
4 Sensations like electric shocks moving along the back, to arms or down to the feet;
5 Inability to urinate or empty your bladder completely;
6 dizziness;
7 Instability, insecurity feet;
8 Memory problems, decreased attention span, difficulty finding appropriate words or difficulty to solve daily problems.
