Multiple sclerosis, the disease of a thousand faces

Vision and mobility problems, pain, fatigue, vertigo and muscle spasms are some of the visible and invisible symptoms of multiple sclerosis (MS), a neurodegenerative disease that affects 2.3 million people in the world the most common cause of non-traumatic disability in young adults.

It is known as the "disease of a thousand faces" because it manifests itself in many ways and affects each person in a different way. MS is more common (more than double) in women than in men.

Until now, its cause and its treatment are not known. For this reason, many MS patients feel misunderstood, especially because many of the symptoms are invisible and very difficult to recognize and understand by family members, friends or colleagues. It is more common among people aged 20 to 45 years.

Today we celebrate World Multiple Sclerosis Day. This year, the "My Invisible EM" campaign highlights symptoms that are not visible to the naked eye, with the motto "You do not need to see my multiple sclerosis symptoms believe -the. "

At the Latin American level, there are more and more cases of multiple sclerosis in the region, "most are in Mexico, Argentina, Chile and Uruguay," said a statement from pharmaceutical company Roche.

Although in Bolivia there are no statistics on people with MS, according to the Bolivian Association Against Multiple Sclerosis (Asbocem), about 80 people with MS are treated in public and private hospitals. In Cochabamba, there are about 35 patients registered with this disease, in La Paz around 25 and in Santa Cruz 21.

Neurosurgeon Sandra Campero Rivero explains some data to understand this disease.

1. What is multiple sclerosis?
MS is a progressive, chronic, and autoimmune disease that affects the brain and spinal cord, that is, the central nervous system. It causes multiple damage to the myelin sheath, the protective layer that surrounds the neurons. When it is covered with nerves, the nerve impulse decreases or stops and its function will be affected.

2. Causes
"The cause of this damage is still unknown, it is an autoimmune and inflammatory process," says Campero. Explains that multiple sclerosis is an autoimmune disease because the immune system (the defenses that protect us from infections and foreign elements) is altered and confuses the tissue itself as alien, the attacker. "That is, the same defense system is starting to attack the myelin layer."
These attacks damage the myelin that can be repaired later unevenly, forming "plaques" of scar tissue, called "sclerosis" and "multiple" lesions as it affects more of a part of the central nervous system.
The expert points out that we do not know exactly what causes MS. There are many suspicions, such as different types of viruses, genetic causes, or both. Environmental factors can also play an important role.

3. symptoms
The symptoms are different, multiple and vary depending on the affected area, they can appear in many parts of the body. In addition, the scale of each attack may be different. Episodes can last for days, weeks or months. The attacks are followed by referrals.
Thus, MS can cause a wide variety of symptoms. At the muscular level, there may be loss of balance, muscle spasms, numbness, difficulty moving arms and legs, difficulty walking, lack of coordination and small movements, tremors and weakness in one or both two arms or legs.
Some of the symptoms of the bladder and bowel include constipation and stool leakage, difficulty starting to urinate, urge to urinate, and urinary incontinence.
Also, double vision, eye discomfort, uncontrollable eye movements and loss of vision (usually affects one eye at a time); are some of the ocular symptoms of MS.
There may also be numbness, painful muscle spasms and itching, tingling or burning in the arms and legs.
In the same way, brain and neurological symptoms may be present, such as: decreased attention, discernment and loss of memory; difficulty in reasoning and solving problems; depression or sadness dizziness or loss of balance, poorly articulated or difficult to understand language, fatigue, chewing and swallowing problems.

4. Diagnosis Tests and exams
Campero says that the diagnosis of this disease is difficult and expensive. "Normally, the patient diagnosed with MS has already gone through several doctors and specialists without being able to find the wrong one," he said.
He explains that imaging studies, neurological, nuclear magnetic resonance – brain and spinal cord – are necessary to be able to determine that it is about SP. In addition, the lumbar puncture allows to examine the cerebrospinal fluid and to search for certain substances that give the characteristics of this disease.

5. treatment
Campero points out that there is still no cure for MS. However, some pharmacological treatments may delay the disease. There are those who help stop their progression, control the symptoms and help the person maintain a better quality of life.
He explains that the patient should be treated by a group of specialists such as a neurologist, a physiotherapist, a psychologist, a psychiatrist; according to the badignment. In addition, he considers it necessary to support the patient and the family or relatives.

challenges

exams The diagnosis requires a neurological examination and nuclear magnetic resonance, which can cost about $ 400, says a statement from Roche, a pharmaceutical company.

Lumbar puncture Lumbar puncture to extract fluid from the spinal cord is another of the required diagnostic tests. These punctures are not practiced in Bolivia and patients must perform them in Chile, Brazil, Argentina or the United States, at an economical cost for the patient.