Our nervous system transmits throughout the body large amounts of information , allowing us to think and have physical, cognitive and emotional abilities and capacities. It also directs and keeps the different organs and systems of our body functioning.

For all this, the neurons that are part of the nervous system connect with each other forming structures, tracts and nerves, which are projected to the rest of the body. But the information they carry needs to reach its target as quickly as possible, given the need to coordinate actions or react in time to environmental stimuli. Achieving such speed is possible thanks to a substance called myelin, a substance that allows the acceleration of the nerve impulse.

This transmission of information also allows us to However, there are some problems and diseases that cause the myelin not to act correctly or to be destroyed, causing a slowing down of the transmission of impulses and can cause serious problems in the vital functioning of the person. One of the most frequent disorders of this type is multiple sclerosis .

What is multiple sclerosis?

Multiple sclerosis is a chronic, progressive and currently incurable disease in which there is a progressive demyelination of the nervous system. This demyelination is caused by the action of the immune system, which attacks the myelin present in the neurons and causes their destruction.

Small scars are also generated in the form of hardened plaque that makes it difficult for the nerve stimulus to pass through. The loss of myelin, together with the presence of these scar plates, causes the information transported by the nerve fibres to take longer to reach its destination at a neuronal level, producing great difficulties for those who suffer from it.

The symptoms of the disease

The symptoms of this disorder will depend on the areas that are demyelinated, but roughly speaking it is common for those who suffer from it to suffer from fatigue, muscle weakness, lack of coordination, vision problems, pain and/or muscle tension.

Although initially it was believed that it was a disease that only caused physical symptoms, it has been detected that throughout the course of the disease there is also an intellectual affectation, being frequent that there is a deterioration of the frontal area and therefore of the executive and cognitive functions.

Multiple sclerosis is a disorder that occurs in the form of flare-ups , usually with partial recovery once the flare-up subsides. This is because although myelin is destroyed by the immune system and the oligodendrocytes that produce it are unable to regenerate it, the body sends stem cells to the damaged areas. Over time, these cells change into new oligodendrocytes and generate new myelin.

This new myelin is not as effective or resistant as the original due to the presence of axon damage, so that subsequent attacks by the immune system will weaken the connections and subsequent recovery will be less, leading to progressive degeneration in the long run.


As we have said before, multiple sclerosis is an autoimmune disease , which through the attack and elimination of myelin from the neuronal axons causes a whole series of effects derived from the poor transmission of the nerve impulse. Thus, the mechanisms through which it acts are already in our body.However, the causes of this attack continue to be unknown today, and there is no clear reason for this affectation.

Some of the most accepted theories indicate that those who suffer from multiple sclerosis have a genetic vulnerability that in the face of the arrival of some type of stimulus from the environment such as an infection causes the immune system to react in the wall of the blood vessels that irrigate the brain, crossing the blood-brain barrier and attacking the myelin of the neurons.

Types of Multiple Sclerosis

As indicated, multiple sclerosis is a disease that occurs in the form of outbreaks. But these outbreaks do not always occur in the same way or with the same intensity, and there may be different courses of the disorder. Based on the course it takes, the existence of different subtypes of this disease can be considered .

1. Recurrent remitting multiple sclerosis

The most frequent subtype and course , in this modality of multiple sclerosis, unexpected and unforeseeable symptomatological outbreaks arise which, with the passage of time, end up disappearing, with both remission and symptomatic recovery. This recovery between outbreaks can be partial or even complete. The symptoms do not worsen during the intermediate periods.

2. Primary progressive multiple sclerosis

One of the less frequent types, in this subtype of sclerosis no specific outbreaks can be identified , but in a progressive way symptoms are seen that are gradually worsening. In this case there are no periods of remission or recovery (or at least not of great importance). However, on some occasions it can become stationary.

3. Secondary progressive multiple sclerosis

As in the remitting-recurrent form, in this type of multiple sclerosis different unexpected and unpredictable outbreaks are observed. However, in the periods in which the outbreak has ceased the degree of disability of the patient does not improve but in fact a worsening can be observed, this being progressive.

4. Recurrent or Recurrent Progressive Multiple Sclerosis

As with the primary progressive form, in this rare subtype there is a progressive worsening and no periods of remission, with the difference that in this case there are concrete outbreaks recognizable.

5. Benign multiple sclerosis

Sometimes identified with relapsing-remitting sclerosis, this type of multiple sclerosis receives its name because, in spite of the presence of outbreaks, the patient’s recovery from them is complete , having milder symptoms and which does not seem to get worse over time. The disability it causes is very small.

In search of a treatment

Although there is currently no cure for multiple sclerosis, there are a large number of drug treatments that can be used to palliate and delay the progression of the disease . They can control the symptoms, reduce the severity of the symptoms and help the patient maintain his or her quality of life.

Some of the medications used include corticosteroids to reduce the severity of outbreaks, pain relievers in cases of pain, or immunosuppressants to alter the course of the disease and reduce the level of deterioration.


But while these treatments do not cure the disease, research and progress continue in the search for a cure for multiple sclerosis. Some of the latest research has gone as far as testing and conducting trials with a drug called Ocrelizumab, which has been shown to delay the progression of symptoms in the early stages of the disorder.

Although the problem itself is neurological and therefore treated by medicine, the difficulties produced by multiple sclerosis often cause difficulties and problems that affect the psyche of those who suffer from it. It is frequent that when the disease is detected, patients suffer mourning processes due to the progressive loss of faculties, and even that they suffer from depressive episodes.

Therefore, it can be useful to work from a psychological point of view, increasing the level of emotional expression of the patient with respect to their situation and working on it, as well as seeing the situation in a realistic way and not producing behavioural avoidance, isolation or self-destructive behaviour.

Occupational therapy

In particular, the use of occupational therapy has been shown to be useful in increasing the autonomy and activity level of the patient and participation in support groups as a method of expressing and sharing feelings and views regarding the disease, its consequences and ways of coping with life with other people with multiple sclerosis. It is one of the most effective therapies in mitigating the psychological impact of symptoms.

Family and social support is essential in cases of multiple sclerosis, since it allows the person to cope with everyday life and makes him/her see that he/she is not alone or helpless. The use of devices such as wheelchairs and bars can also help the patient to maintain a certain level of autonomy for longer, as well as helping to reduce the level of disability caused by the disease.

Bibliographic references:

  • Bermejo, P.E.; Blasco, M.R.; Sánchez, A.J. and García, A. (2011). Clinical manifestations, natural history, prognosis and complications of multiple sclerosis. Medicine; 10 (75) : 5079-86
  • Compston, A.; Coles, A. (2008). Multiple sclerosis. The Lancet, 372 (9648): 1502-1517
  • World Health Organization (2006) Neurological disorders. Challenges to public health. WHO. 45-188.
  • Rubin, S.M. (2013). Management of multiple sclerosis: an overview. Dis Mon.;59(7):253-260
  • Widener, G.L. (2013). Multiple sclerosis. In: Umphred DA, Burton GU, Lazaro RT, Roller ML, eds. Umphred’s Neurological Rehabilitation. 6th ed. Philadelphia, PA: Elsevier Mosby: chap 19.