The multiple sclerosis (EM) It is a neurological disease that attacks the central nervous system and interferes with communication between the brain and the rest of the body. Every May 30 takes place the World Multiple Sclerosis Day which this year has as its motto ‘A life in community. A life with more opportunities’ to raise awareness about the impact that this pathology has on patients and their families and their right to receive quality care.
Multiple sclerosis cases are increasing worldwide and according to data from the International Multiple Sclerosis Federation they have gone from 2.3 million affected in 2013 to 2.8 million in 2020 and 2.9 million in 2023. In Spain, estimates that around 55,000 people suffer from this condition, and that each year 2,500 people are diagnosed, according to the Spanish Society of Neurology (SEN). The disease usually manifests itself between the ages of 20 and 40, which is why it is considered the second most frequent cause of disability in Spanish young adults and, after epilepsy, it is the second most frequent neurological disease among Spanish young people.
“Multiple sclerosis is a chronic, autoimmune, inflammatory, demyelinating and degenerative disease of the central nervous system. It occurs when the immune system mistakenly attacks myelin, a protective layer of neurons that, when affected, causes nerve impulses to slow down or stop, causing different symptoms of the disease,” explains the Dr. Ana Belén CamineroCoordinator of the Study Group of Demyelinating Diseases of the Spanish Society of Neurology.
“About 75% of people with multiple sclerosis in Spain will experience some kind of disability at some point during the disease”
“According to the latest records, in the last five years the number of patients with multiple sclerosis has increased by nearly 20%. It is true that behind this increase are implicated both the improvement in diagnostic techniques and the increase in treatment options, but also, for reasons that are still unknown, because we are witnessing an ever increasing number of new cases in women and in the child population”, highlighted Dr. Caminero.
“Depending on the areas of the central nervous system that have been affected, the symptoms vary greatly from person to person. So almost any neurological symptom or sign can be part of the multiple sclerosis symptomatology. However, mobility, vision, balance and coordination problems, as well as fatigue, pain and sensitivity disorders are usually the most common”, adds the expert.
A disease that affects mainly women
This disease is between two and three times more common in women than in men, and its progression and severity also vary greatly between patients, although in 85% of them it appears in the form of outbreaks or episodes of neurological deficit that constitute a manifestation of the lesions that are taking place in the central nervous system. .
Although it is autoimmune, its exact causes are unknown, but it is believed to affect people with a genetic predisposition when exposed to certain environmental factors such as infections, vitamin D deficiency or smokingand probably to certain hormonal factors that make women twice as likely to develop this disease.
The early diagnosis of multiple sclerosis is essential to minimize its negative consequences on the quality of life of patients and to better control the symptoms. Treatment should also be based on a comprehensive and multidisciplinary approachwhich includes medicines, lifestyle changes, complementary therapies and psychological and social support.
Physiotherapy: key to curbing disability
“In recent years there has been a true revolution in the management of multiple sclerosis and we currently have numerous treatments that can modify the course of the disease, with immunomodulatory or immunosuppressive drugs, and symptomatic therapies that address the specific symptoms of the disease. Therefore, there are already many affected people who enjoy a good quality of life”, highlights Dr. Ana Belén Caminero.
“Even so, multiple sclerosis is a disease that can have a significant impact on the quality of life of those affected, especially in terms of disability. At the SEN we estimate that around 75% of people with multiple sclerosis in Spain will experience some type of disability at some point during the disease”.
The disability associated with multiple sclerosis can manifest itself in different ways depending on the symptoms and the severity that each person presents. The most common disabling factors are mobility problems, muscle weakness, fatigue, pain, sphincter disorders, difficulties speaking or swallowing, vision and balance disturbances, and cognitive problems such as difficulties concentrating. and memory problems. Disability may also vary over time and may even be progressive in some patients as the disease progresses.
“In recent years, the treatment of multiple sclerosis has evolved a lot, but not only pharmacologically, but also from a rehabilitation point of view,” says Berta de Andrés, Coordinator of the Neurophysiotherapy Study Section of the Spanish Society of Neurology. “There are already enough studies that confirm that the different therapeutic modalities used in Physiotherapy help improve physical aspects such as mobility or muscle strength, which has a positive impact on quality of life and decreases the feeling of fatigue perceived by the patient. For this reason, we stress the importance of patients with multiple sclerosis being able to receive adequate neurorehabilitation, within their multidisciplinary treatment, which seeks to delay the onset of disability and maximize personal autonomy of the people affected.
Anxiety and depression as a consequence of multiple sclerosis
The SEN experts have also wanted to emphasize the anxiety and depression disorders suffered by many patients with multiple sclerosis due to the uncertainty they feel about the disease and its symptoms, and the consequences they have in all areas of their lives: social, family and work. From this society they indicate that the prevalence of depression associated with multiple sclerosis it is between 37%-54% and that of anxiety oscillates between 12%-40%.
“Since 2009, World Multiple Sclerosis Day has been commemorated, with the aim of raising awareness about this disease and improving the quality of life of people who suffer from it. We trust that dates like today will help raise awareness about the challenges and difficulties faced by people with multiple sclerosis and encourage greater inclusion and support for them”, says Dr. Ana Belén Caminero.
“On the other hand, we must not forget that, despite the progress of recent years, we are facing a disease that still presents several important challenges. Among them is improve disease detection timesin order to start treatment as soon as possible and prevent the progression of disability, as well as to improve research and development of new treatments, since there is still no cure for multiple sclerosis and not all treatments are equally effective for everyone the patients,” he concludes.
Fuente: Spanish Society of Neurology (SEN)