Multiple sclerosis

Student: Can you tell me a bit about MS?

Supervisor: MS involves an abnormal response of the body’s immune system which attacks the fatty substance around the nerve fibers, as well as the nerve fibers themselves, and the cells that make the myelin in the central nervous system (CNS). When myelin is damaged through inflammation, messages within the CNS are altered or stopped. The damaged areas develop scar tissue, which we call MS, and produce many neurological symptoms that will vary among people in type and severity.

Student: And what are the factors that cause MS?

Supervisor: We don’t know for sure. But it involves genetics, epidemiology or environmental issues like the geographical factor, age, sex and ethnic background, immunology and infections agents.

Student: Ok, but then is there any treatment to it?

Supervisor: Since MS is an incurable disease, it requires an approach from many different healthcare professionals, all contributing to manage the symptoms in order to curb the “attacks” or exacerbations, improve motor and mental function and safety.

Student: Who are the healthcare providers that might care for MS patients?

Supervisor: The primary care doctor, who proceeds to age-appropriate screening tests. The dentist who prevents complications from dental infec - tions. MRI must also be done regularly to detect the lesions so as the neurologist would prescribe medications that would reduce the severity of relapses and the accumulation of lesions in the brain and spinal cord and help improve the quality of life.

Student: You said “inflammation” of the CNS. How does this mechanism manifest?

Supervisor: The inflammation of the CNS causes damage to the myelin that slows or blocks the transmission of nerve impulses for about at least 24 hours, separated by at least 30 days, with most exacerbations lasting from a few days to several weeks or even months. Attacks can be mild or severe enough to interfere with a person’s ability in daily activities, which are commonly treated with highdose corticosteroids and hormone therapy to reduce the inflammation, and help in associated symptoms like bladder and bowel dysfunction and overall pain, but also sexual problems, spasticity, and tremors.

Student: And are non-pharmaceutical approaches taken into account then?

Supervisor: Sure. Rehabilitation, in the sense of emotional, mental, mood and cognitive strategies are considered to help maintain the patients’ ability to perform safely at home and work. Also, healthcare professionals address issues like accessibility, mobility, speech, swallowing, memory and other motor, cognitive and neurological functions, including care for depression, anxiety, fatigue and vision disorders.

Student: Therefore, the healthcare and rehabilitation teams would also include physical, occupational and speech/language therapists.

Supervisor: Exactly. And this is also where alternative medicines might be of help, like diet therapy, vitamin supplements, meditation, exercise…