Neurológia pre prax 5/2012

Importance of early diagnosis and treatment in the life perspective of patients with multiple sclerosis

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease with a varying degree of neurodegeneration of the central nervous system (CNS). The clinical presentation is determined by dissemination of inflammatory lesions in the CNS and the degree of brain atrophy. An isolated and abrupt development of focal neurological signs consistent with a possible development of MS is referred to as clinically isolated syndrome (CIS). Since early stages of the disease, processes take place that result in permanent axonal loss correlating with the severity of clinical disease. Important facts supporting early treatment particularly include the fact that patients with CIS exhibit a high risk of conversion to CDMS; moreover, histopathological data show that brain damage is already present prior to manifestation of the initial clinical signs in the patient. Treatments to suppress the pathogenetic processes by affecting the immune system (immunomodulation and immunosuppressive therapy) and treatments to suppress the symptoms (symptomatic therapy) are distinguished in treating MS. Although there is still no therapy that would completely cure MS, it is possible to say that current therapeutic options can, when used appropriately and early, significantly contribute to improving the quality of life of patients with this difficult condition.

Keywords: multiple sclerosis, clinically isolated syndrome, interferon beta, glatiramer acetate, natalizumab, fingolimod.