ovarian cancer Stages and Treatment

 Multiple sclerosis: treat early to limit the disability of MS

Multiple sclerosis, or MS, is a chronic autoimmune disease that affects the central nervous system that primarily affects young people. The disorders are linked to inflammatory foci that appear in flare-ups in different places of the white matter in the brain and spinal cord.

What is multiple sclerosis? 

Multiple sclerosis (also called by its acronym, “MS”) is a chronic autoimmune disease of the central nervous system. It is characterized by an inflammatory reaction of autoimmune origin in the white matter of the brain and spinal cord. The reaction of the immune defense system is directed against "myelin", a component of the protective sheath of nerve fibers and therefore very important for the transmission of nerve signals in cells of the brain and spinal cord (i.e. - say the central nervous system). 

In most cases, this disease progresses to focused inflammatory flares with the appearance of one or more neurological signs during the flare. This can be a lack of muscle strength in a limb (motor disturbances), tingling or strange sensations in different parts of the body (sensory disturbances), sudden loss of vision (damage to the central vision pathways), a disorder balance ... 

At the beginning of the disease, these disorders have the particularity of regressing, totally or partially, in a few weeks. The occurrence of these outbreaks is unpredictable.

 Recovery, frequency and intensity of relapses vary for each patient. The severity and time to progression of the disease are therefore variable from one patient to another. Multiple sclerosis is secondary to a disorder affecting the body's immune system. 

This will attack and destroy myelin at different times and in different places in the central nervous system. Myelin is a component of the protective sheath of nerve fibers that convey sensory or motor impulses. 

To better understand, you should know that myelin loss is a bit like the deterioration of the insulating sheath of an electric cable, which will then cause disturbances in the electric current. Several million nerve fibers can be affected with each outbreak. This destruction can even extend to the nerve fiber itself, if the immune response is too strong.

The central nervous system can synthesize myelin again, a process called “remyelination”, but in a very limited way. This explains why patients can recover from their first symptoms, during the first outbreaks. 

Over the course of the outbreaks, a phenomenon of cicatrization appears which will disrupt regeneration: the destroyed myelin and axons cannot be repaired and are lost forever. The healing process that is triggered when the inflammatory process stops (evolution by flare-ups) results in a "scar plaque" which will disrupt the normal architecture of neural circuits and interrupt nerve connections: sclerotic scar lesions are also called " plates ”. 

As these scar plaques appear to be distributed randomly, multiple regions of the central nervous system can be affected and this is what makes the initial presentation of the disease diverse and the complexity of early diagnosis.

What is the cause of multiple sclerosis?

 The exact causes of multiple sclerosis remain unknown to this day even though we know that it is an autoimmune disease, that is, one that involves abnormal activity of the immune system, that is directed against normal components of the body. 

Several factors are believed to favor the onset of the disease: 

genetic factors, with a probable family background and environmental, viral or geography-related factors. If the familial "aggregation" of multiple sclerosis is certain (multiple sclerosis occurs more frequently in members of the same family), it is not, however, a hereditary disease: the parents do not transmit MS to their children.

 The hypothesis of the role of environmental factors in the occurrence of multiple sclerosis has been proposed because this disease is more common in countries located far from the equator.

  A link with climate and diet has been researched, but nothing has been shown. Due to differences in geographic distribution, the role of sunshine has long been suspected and studies seek to highlight the role of Vitamin D since the synthesis of this vitamin is itself linked to sunlight.

Another theory which has been much explored is that of the responsibility of a virus (Epstein-Barr virus?) Which could trigger an immune system reaction directed against the "healthy" cells of a person genetically "predisposed" to the disease. . However, no virus in particular could be associated with the development of multiple sclerosis.

What is chronic cerebrospinal venous insufficiency? 

The term chronic cerebrospinal venous insufficiency, or CCSVI, has been proposed by Dr Paolo Zamboni, of the University of Ferrara, Italy. It was a new theory explaining the development of MS due to abnormalities in the vessels of the brain. CCSVI is thought to consist of strictures or blockages in the veins of the head and neck, which are more common in people with MS. These veins would not be able to properly drain the blood contained in the central nervous system which would cause an increase in the pressure in the cerebral veins and back flow of blood to the central nervous system. The reflux of blood and the structural insufficiency of the blood vessels are thought to be responsible for blood leakage and iron deposits in the central nervous system (there is a lot of iron in hemoglobin, the protein transporting oxygen in Red cells). It is this phenomenon which, according to Paolo Zamboni, triggers an immune response in multiple sclerosis. The proposed treatment therefore consisted of dilating the veins with a balloon (angioplasty) and placing a spring (stent) to keep their lumen open. 

To date, the results of numerous studies carried out by teams other than that of Paolo Zamboni have revealed no link between chronic cerebrospinal venous insufficiency and MS and angioplasty of the veins would not bring any benefit on the profile. 

progressive disease. According to the research carried out, the few benefits observed in some studies could be due to the differences in imaging techniques used and the interpretation of their results. In addition, CCSVI angioplasties can lead to complications. Venous angioplasty with or without stenting is therefore not currently recommended by health authorities.

Is Multiple Sclerosis Hereditary? 

MS is not an inherited disease. We do not know the exact cause of the disease, but various scientific works incriminate the interaction of certain contributing factors, such as environmental factors (viral infection, vitamin D deficiency, etc.) and a predisposing genetic background to the origin. vulnerability to this autoimmune disease. Since genetic vulnerability is not based on the defect of one gene, but probably several, the chances of transmission to the child are very low.

What are the neurological damage during multiple sclerosis?

 Multiple sclerosis simultaneously affects areas that are scattered throughout the white matter of the brain and the spinal cord. At the onset of the disease, the signs seen depend on the area of ​​the brain or spinal cord that is affected by the lesions.

 The first signs are therefore often varied (motor skills, sensitivity, vision, balance, mental disorders, etc.) and can be very different from one patient to another. 

The first symptoms are typically sudden onset, then they disappear within a few days or weeks. Visual disturbances are one of the main early manifestations of multiple sclerosis. 

They can result in a sudden blurring of the sight which then progresses to a loss of sight in part of the visual field or to monocular blindness (loss of sight in an entire eye). 

These disorders generally affect only one side each time. Sometimes it could be just a gene on exposure to light ("photophobia") or eye pain with eye movement. We can also observe loss of color vision or a central black hole in the visual field (the "scotoma"). This inflammation of the pathways of vision in the brain is called retrobulbar optic neuritis (NORB) and is indicative of the disease in one third of cases. Recovery of visual function is complete in 80% of cases within 6 months.

 In a third of patients, multiple sclerosis begins with sensitivity disorders. They may initially appear as "weird" sensations in certain areas of the body (paresthesias). Some patients sometimes describe tingling, an electric current that runs through their back or lower limbs. Conversely, sensitivity disorders can start with numbness or a complete absence of sensation (anesthesia = sensory deficit). These symptoms are usually asymmetric on the limbs or trunk.

The frequency of problems associated with impaired muscle control increases as the disease progresses. It may initially be a simple discomfort or a deficit in muscle strength, then with successive outbreaks of the disease, the motor disorders worsen and can completely prevent the realization of a movement: the muscle no longer responds. There are also problems with muscle tone with the appearance of stiffness during movement (hypertonia) or, on the contrary, hypotonia. These disorders become more and more important as the multiple sclerosis progresses.