MULTIPLE SCLEROSIS

What is multiple sclerosis?

Multiple sclerosis (MS) is an immunological inflammatory disease  that affects  the  myelinated neuraxons of the central nervous system, damaging variedly the myelin and the neuraxons resulting in causing serious disability in a period  ranging from 20-25 years old in more than 30% of the patients. The MS characteristic is recurrent  symptomatic episodes (impulses) that take place periodically (usually months or years intervene between the episodes). These impulses often cause disability, which is gradually receding but often not fully.

 Is there a therapy for multiple sclerosis?

MS therapeutic approach has two sides: the immune reformative therapy, which aims at the subjective immunologic disorder and at the therapy for improving the symptoms. The immune reformative therapy aims at reducing the frequency of pushes and delaying the course of the disease.

 Which are the first symptoms of multiple sclerosis?

The most common symptoms which appear at first to the sufferers are the following:

• Sensory disorders (numbness, paresthesias): usually early symptom
• Spinal cord symptoms (related to mobility ): muscle cramps secondarily by spasticity
• Spinal cord symptoms (autonomous nervous system): bladder dysfunction, intestine dysfunction and sexual dysfunction
• Cerebellar symptoms: dysarthria, ataxia and tremor
• Optic Neuritis
• Trigeminal neuralgia
• Face myokymias (irregular muscle contractions of the face)
• Eye symptoms: double vision  ( 33% of the patients)
• Heat intolerance
• Fatigue (70% of the patients) and dizziness
• Pain: Appears in 30-50% of the patients during the course of the disease
• Subjective cognitive difficulties: Regarding the range of focus, concentration, memory and judgment
• Depression
• Euphoria: Less common than depression
• The transverse myelitis symptoms

How does the diagnosis takes place?

The MS diagnosis is based on the patient’s medical history, on the clinical signs and symptoms and on the findings of the supplementary clinical investigation. Nowadays, the brain’s depiction with an MRI has a key role in the diagnosis, while testing the cerebrospinal fluid through lumbar puncture has a supporting role. Clinically the episodes should be compatible with the model of the neurological deficits that appear in the MRI, while the duration of the episode should last some days to some weeks.

 Physical Medicine and rehabilitation

The patients of Multiple Sclerosis can truly benefit from an intensive rehabilitation program based on physiotherapy, occupational therapy, speech therapy and hydrotherapy. The Physicist’s role in the patients’ rehabilitation is pivotal and it lies on the evaluation of the broad kinetic dexterities of the patient (i.e. walking) and in the evaluation and establishment of a full recovery program with the proper supporting devices. The Physicist will assess and train the patient in proper exercise programs in order to reduce spasticity, to maintain the mobility range of the limbs, to deal with rectovesic disorders as well as to strengthen the muscles and improve coordination and speech disorders. The rehabilitation program aims at improving walking, balance and flexibility, at increasing aerobic skill and finally the patient’s functional independence.