Photo: Canva
Multiple Sclerosis afflicts predominantly young, economically active people, with 32 the average age of diagnosis globally.
Photo: Canva
Pretoria neurologist Dr. Chris Retief said the disease afflicts predominantly young, economically active people, with 32 the average age of diagnosis globally.
“It is the most important cause of neurological disability in people under the age of 60.”
Retief co-authored the South African guidelines for diagnosis and management of Multiple Sclerosis.
The symptoms of Multiple Sclerosis are not always obvious.
Still, the disease can cut short the life ambitions of young, economically active people.
“However, earlier diagnosis and better access to treatment can offer a better quality of life to those affected by a disease for which there is no cure.”
Retief further explains: “Relapses are characteristic of the initial or early phase of the disease. Treatment of a relapse consists of high-dose steroids administered through a drip over a few days. Initially, the relapses actually resolve quite well, perhaps giving one a false sense of security that the disease can easily be kept under control with only steroids.”
However, if the disease is not treated more intensively, the abnormal B-cells can become clustered in the brain, resulting in chronic continuous inflammation. This is called secondary progressive Multiple Sclerosis, which leads to progressive disability.
Hence, it is vitally important to attempt to prevent or at least delay this phase of the disease.
“It is important to appreciate the concept of neurological reserve. Children and young people have enormous neurological reserve, and generally recover very well from a neurological insult such as a head injury or a Multiple Sclerosis relapse. Unfortunately, recurrent relapses and silent ongoing inflammation deplete this neurological reserve and leave the patient disabled in middle age when their professional demands and family responsibilities are greatest.
“In short: untreated Multiple Sclerosis makes a patient’s brain grow old a lot faster,” Retief said.
Multiple Sclerosis must be recognized and treated early, even if the person feels well in the beginning, he advised.
Retief said that 25 years ago, there was no treatment for Multiple Sclerosis, and up to 10 years ago only one tier of treatment was available.
“In 2021, fortunately, we have several treatment modalities,” he said.
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The treatments available range from immunomodulators (which change the immune system but are very safe to use), immunosuppressive medications (suppresses the immune system), lymphocyte sequestrators (prevents the abnormal B-lymphocytes from entering the brain), immune reconstitution therapies (resets the immune system for several years) and bone marrow transplantation (the immune system is eradicated, and replaced).
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