World Multiple Sclerosis Day

Dr. Fernando Pérez Parra: “We should feel fortunate to live in a country where we have state-of-the-art care for Multiple Sclerosis”.

(Madrid, Lucila Rodríguez)

Every year, some 1,800 new cases of multiple sclerosis are diagnosed in Spain, a demyelinating autoimmune disease of the central nervous system that already affects 55,000 people, which usually begins between the ages of 20 and 40 and is up to three times more common in women than in men.

In addition, it can also begin in childhood, although more and more people are being diagnosed with the first symptoms at an older age. This is explained by the neurologist and assistant physician of the Clinical Neurology Unit of the Ruber Internacional Hospital, Fernando Pérez Parra, on the occasion of the celebration of World Multiple Sclerosis Day, which is held on May 30 with the aim of increasing awareness of this disease.

“Most diagnoses occur between the ages of 20 and 40. They are young people who are in the midst of their personal development in the work or academic world, as well as in the social and family world,” reports the doctor, who warns that the rest consists of adequately treating the disease to help patients continue to carry out all their projects.

Multiple sclerosis is more common in geographical areas farther away from the equator, such as the Nordic countries, although in recent decades its frequency has increased notably in Mediterranean countries such as Italy and Spain. However, Dr. Pérez Parra assures that in Spain we should be proud of the fact that, both in public and private healthcare, there is “cutting-edge” attention to this pathology.

“In Spain we have reference units all over the country. The scientific level and quality of our centers is extremely high, and the research underway in this disease and in demyelinating pathologies is enormous,” says the neurologist. Precisely, the Neurorehabilitation service at Ruber Internacional has physiotherapists, speech therapists, occupational therapists, neuropsychologists and psychologists who provide multidisciplinary care to patients with multiple sclerosis.

Each person affected by this disease has special needs, depending on the progression of the disease or the outbreaks they have or are suffering. “If we have problems of spasticity or gait disturbance, a program with physiotherapists is essential; but if there is an affectation in manipulative tasks, an occupational therapist could help the most. In addition, when cognitive problems appear, the neuropsychologist can establish treatment and stimulation programs after a diagnostic evaluation,” argues Pérez Parra.

Early diagnosis

It is essential that patients are diagnosed early in order to start immunomodulatory treatment as soon as possible, as this therapy is able to modify the history of the disease, reducing inflammation and even slowing down or preventing degeneration. However, new drugs appear on the market every year, so it is essential that patients are treated by multiple sclerosis specialists who are up to date and trained in the disease and everything that surrounds it, such as spasticity, fatigue, neurogenic bladder or gait disturbance.

In addition to treating these symptoms, it is important to prevent them. “If we establish a healthy lifestyle from the start, we will help improve the prognosis of multiple sclerosis. Current studies recommend aerobic physical activity programs along with resistance exercises. Physical activity helps the remyelination of lesional areas and the generation of new connections and alternative networks to the damaged ones. In this case, the physiotherapy team can help us establish this physical activity program,” reports the neurologist at the Ruber Internacional Hospital.

Fortunately, the risk of ending up in a wheelchair has decreased with today’s drugs. “Current therapies are probably going to radically change the statistical data we have today on the progression of disability. Unfortunately, all of us specialists have patients in the office with a high degree of disability and in wheelchairs, but we also have many people who reach an advanced age with very mild disability,” the doctor emphasizes.

Care from the earliest stages

The service’s consultations are attended by patients in both early and late stages of the disease. Specifically, some patients come after suffering a first outbreak and with symptoms related to motor, visual or balance deficits. They are diagnosed, the outbreak is treated and the approach, treatment and follow-up after the disease is planned.

“A second group are people recently diagnosed who are looking for the most appropriate choice of immunomodulator treatment and want to resolve doubts about the disease, the prognosis, what lifestyle and what kind of self-care measures they need to take, plan projects such as having children, know the benefits and risks of the different therapeutic options, among many other questions and doubts. The third group of patients are people with a longer evolution and more advanced forms who need a multidisciplinary approach to the symptoms with physiotherapy, speech therapy, occupational therapy or neuropsychology,” Dr. Perez Parra concludes.