Institut Guttmann

Neurorehabilitation hospital

+34 93 497 77 00

Multiple sclerosis

Multiple Sclerosis is a chronic disease of the central nervous system of unknown cause, although it is believed to be due to a disorder of the immune system. It attacks the myelin sheath surrounding the nerve fibre responsible for transmitting impulses to the brain and spinal cord. In various parts of the nervous system where myelin has been destroyed, plaques of hardened tissue occur (sclerosis) and nerve conduction is altered.

Although at the onset it occurs in outbreaks, with exacerbations and remissions, it often evolves into a progressive form or permanent neurological effects appear that accumulate over time. The clinical manifestations are variable and depend on the location and extent of injuries. The plaques, which can form in the spinal cord, brain and cerebellum, produce a variety of signs and symptoms: loss of strength, fatigue, lack of coordination, visual impairments, sensory problems, bowel and bladder dysfunction, sexual disorders and cognitive and emotional problems.

Although the course of MS can be modified with the latest pharmacological resources, the diagnosis and treatment of the complications is complex and requires the involvement of an interdisciplinary team made up of various specialists who work together to bring individual treatments together in a plan that takes into account the patient’s problems.


References about Multiple sclerosis

  • Terré-Boliart R y Orient-López F. Tratamiento rehabilitador en la esclerosis múltiple. Rev Neurol 2007, 44(7): 426-431
  • Moti RW & Pilutti LA. The benefits of exercise training in multiple sclerosis. Nat Rev Neurol 8, 487-497 (2012)
  • Latimer-Cheung  AE, Pilutti LA, Hicks AL et al. Effects of Exercise Training on Fitness, Mobility, Fatigue, and Health-Related Quality of Life Among Adults With Multiple Sclerosis: A Systematic Review to Inform Guideline Development. Arch Phys Med Rehabil. 2013 Sep;94(9):1800-1828.
  • Flachenecker P. Clinical implications of neuroplasticity - the role of rehabilitation in multiple sclerosis. Front Neurol. 2015 Mar 3;6:36
  • Prosperini L, Piattella MC, Giannì C, Pantano P. Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis. Neural Plast. 2015;2015:481574.