Over the last few years significant advances have been made in knowing and treating neurological diseases. Despite these advances, the cause of some of these diseases remains unknown and their only common characteristic is their progressive and gradual effect on the Central Nervous System (CNS) in part or as a whole.
This neurological disorder mainly shows in motor or sensory deficits or both, causing disability and handicap. In some cases, cognitive deterioration (speech, attention, memory and intellectual ability disorders, etc.) increases frailty and changes both patient and family’s quality of life.
The complexity of both symptoms and complications, their variability and the lack of effective cure make it impossible for one health practitioner alone to deal with these patients. Therefore, these diseases currently are treated in hospitals or units specialized in neurological diseases. With the help of multidisciplinary teams, these organizations provide the services needed by patients and their families to treat symptoms and help neurorehabilitation, for maintenance and adaptation to the environment.
MULTIPLE SCLEROSIS -MS-
This is a chronic CNS disease. Its cause is unknown, although it is suggested to come from a virally triggered immune system disorder.
MS attacks the myelin sheath surrounding the nerve fibres transmitting impulses to the brain and to the spinal cord. Plaques of hardened tissue (sclerosis) replace destroyed myelin sheath areas in various parts of the NS. This deranges nerve conduction.
Although the disease usually sets in as consecutive flaring and abating outbreaks, it commonly develops to progression or to stable neurological consequences which accumulate over time. Clinical signs vary and depend on the location and extent of the damage. Plaques can be located on the spinal cord, the brain and the cerebellum. They can cause various signs and symptoms: weakening, fatigue, lack of coordination, visual disorders, sensory disturbances, toileting dysfunction and sexual, cognitive and emotional disorders.
Although MS progression is altered by the newest pharmaceuticals, complication diagnosis and treatment is complex. It requires the help of a multidisciplinary team with various specialists working together to unify treatments for each individual in a plan providing for each patient’s disease.
INCIDENCE: This disease primarily affects young adults. It usually starts around the age of 30. Incidence is between 2.5 and 3 people per 100,000 inhabitants per year. Its prevalence in Spain is estimated to be between 40-60 people per 100,000 inhabitants. The male/female ratio is 50%.
This CNS disease was first described in 1817 by J. Parkinson. It affects the structures responsible for movement, balance and maintenance of muscle tone and posture.
One of these structures is the substantia nigra, a core at the base of the brain that contains dopamine, a neurotransmitter essential for movement regulation. Disease signs are tremors, sluggishness, rigidity and disturbed balance, posture and walking.
It is treated with medication. Surgery is suitable in some cases. However, physiotherapy can greatly help to correct or alleviate patients’ motor function problems.
INCIDENCE: Incidence is 1-2 people per 100,000 inhabitants, mostly in the 60-80 year old age group.
AMYOTROPHIC LATERAL SCLEROSIS -ALS-
This is usually described as a disease causing atrophy and progressive weakness of the skeletal, spinal and bulbar muscles. This is due to the degeneration of motor neurons in the spinal cord anterior horn and in the corticospinal system. Sensory functions generally remain undamaged. It is accompanied by speech disorders (dysarthria) and difficulties in swallowing. Emotional lability is also a frequent symptom.
As in other progressive neurological diseases, its aetiology is still unknown. However, possible causes of a viral, toxic, genetic or endocrine nature have been suggested.
Currently, no medication acts effectively on the development of this disease. However, some medications can help to alleviate symptoms. These patients’ quality of life can be improved by rehabilitation, with the help of various health practitioners from the very first onset of the illness.
INCIDENCE: Incidence on a global scale is variable. Every year, 0.75 cases per 100,000 inhabitants occur. The average onset age is between 40 and 50. Prevalence of this disease is approximately 4-6 cases per 100,000 inhabitants per year.