Today, Monday, May 30, different cities in Spain are preparing to give visibility to a disease that advances stealthily and already affects more than 55,000 people in our country: multiple sclerosis (MS). Every year 2,000 new cases are diagnosed and 70% of these affect people between 20 and 40 years of age. Dr. Antonio Candeliere, a specialist in Neurology at the Rafael Méndez Hospital (Lorca), explains that multiple sclerosis “is a demyelinating, inflammatory and neurodegenerative disease of the central nervous system” which manifests itself when “the demyelinated neurons are unable to transmit nerve stimuli adequately and progressively degenerate and die due to a loss of myelin”.
The disease has multiple symptoms, including fatigue, tingling, imbalance, visual and memory disturbances and impaired concentration. However, Dr. Miguel Láinez, President of the Spanish Society of Neurology (SEN) and founding member of the Board of Directors of the Tinnitus Research Initiative, explains that sometimes “lesions are asymptomatic as a result of various factors, including localization in areas of low clinical expressivity, compensation capacity and brain and cognitive reserve”.
A diagnosis of multiple sclerosis occurs every 5 minutes.
Among the different types of multiple sclerosis, relapsing-remitting MS is the most common form and is characterized by flare-ups followed by periods of disease inactivity. Over the years, exacerbations become gradually less frequent, but a slow and progressive increase in disability begins, giving rise to secondary progressive MS. Primary progressive MS is the least frequent form and is characterized by progressive neurological deterioration from the onset of the disease.
One of the main problems of this disease is that in three quarters of the countries there is no early diagnosis, and a large volume of patients also have problems in accessing treatment.
Vitamin D deficiency and the Epstein-Barr virus
The causes of the disease are unknown and no explanation as to why it manifests in some people and not in others has been established at this time. “It is a disease of multifactorial origin in which both genetic and environmental factors play a role,” explains Dr. Láinez.
Vitamin D deficiency as well as Epstein-Barr virus infection are the two best known environmental factors that could be involved in the development of multiple sclerosis.
Other factors associated with the disease are:
- Age.
- Sex.
- Family history.
- Having suffered from certain autoimmune diseases.
- Smoking.
It should be noted that although these factors are related to the disease, it does not mean that the disease will appear. Environmental factors are not the cause of the disease by themselves. “A person with low vitamin D levels will not develop the disease unless he or she has a certain genetic predisposition and is exposed to other environmental factors,” Dr. Candeliere.
Individualization of treatment, a key factor in the course of the disease
The treatment of multiple sclerosis has evolved significantly over the last 20 years and there are several promising drugs in development. Recently, news of the development of an experimental vaccine against the Epstein-Barr virus was announced, an advance that the studies carried out to date qualify as “promising and oriented towards a hopeful future,” explains Dr. Láinez.
For the moment, despite the lack of a cure, “in most cases it is possible to individualize the treatment of each patient and manage to control the disease”, explains Dr. Candeliere, a position also shared by the President of the Spanish Society of Neurology: “it has been observed that adequate and individualized treatment for each patient in the early years of the disease is crucial for adequate long-term control”.
In addition, specialists advise to follow some recommendations to help a favorable evolution of the disease, such as:
- Healthy diet.
- Regular physical exercise.
- Maintain good levels of vitamin D.