Physiopathology of symptoms and signs in multiple sclerosis

Abstract

The physiopathology of symptoms and signs in multiple sclerosis (MS) is a less divulged topic albeit its importance in the patients' management. OBJECTIVE: It was to summarize the main biophysical and biochemical mechanisms which produce the clinical manifestations in MS. RESULTS: The mechanisms underpinning neurological deficits are described in the relapsing and in the progressive phases, stressing inflammatory and neurodegenerative components, especially demyelination, axonal damage and conduction impairment. Transient worsening based in Uhthoff's phenomenon, mechanisms producing positive symptoms, as paraesthesias and Lhermitte sign due to axonal hiperexcitability and ephaptic interactions, and development of cortical symptoms will also be addressed. The variety of processes leading to neural repair and functional recovery in the remitting phase is focused, as remyelination and adaptive changes due to neural plasticity. CONCLUSION: The awareness of mechanisms producing symptoms in MS emphasises the role of symptomatic and rehabilitation therapies in the improvement of patients' well-being.

Multipl sklerozda ağrı ve klinik özelliklerle ilişkisi

“…This pain is caused by ectopic intraaxial high-frequency stimuli. Spontaneous discharge of demyelinating axolemma causes this (15,16). Especially the demyelination of non-nociceptive Aβ-fiber axons and the involvement of neighboring nociceptive bundles are held responsible.…”

Neuroimaging Biomarkers of Neurodegenerative Diseases and Dementia

“…Multiple sclerosis (MS) is a neurodegenerative condition featuring degeneration of the myelin sheaths that surround neuronal axons, which results in significant impairment in neuronal transmission. 23,24 Although the exact cause of MS is unknown, it is thought to be the result of either an autoimmune syndrome in which inflammatory cells attack the myelin or a dysfunction of the myelin-producing cells. 25 Multiple sclerosis typically presents either as discrete attacks (relapsing-remitting) or progressive over time (progressive MS).…”

Impacto orçamentário de natalizumabe para o tratamento em primeira linha da esclerose múltipla remitente-recorrente altamente ativa sob a perspectiva do sistema de saúde privado brasileiro

“…Os pacientes com EM podem apresentar diversos sinais e sintomas, que variam de acordo com a localização das lesões no SNC (Compston & Coles, 2002;Sá, 2012). Entre os principais sintomas, estão fraqueza muscular, fadiga, dificuldade e perda de deambulação, disfunções urinárias, neurite óptica, diplopia e distúrbios cognitivos (Markowitz, 2013).…”