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Multiple sclerosis shows its worst face in adolescents. Say, News of Biscay



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A report by Nekane Lauzirika – Monday, December 31, 2018 – Updated at 07:12 p.m.

L Multiple sclerosis (MS) is not a contagious or lethal disease, but its current prevalence in the Spanish State estimates between 70-80 for every 10,000 people, some 47,000 people affected, and an incidence of # 39, about 1,800 new cases per year. The pathology is associated with a cumulative loss of the physical and cognitive function and against it in the present day healing treatment is not available. It is diagnosed in 70% of cases between 20 and 40 years, being the most common illness in young adults and the second cause of disability in the State, behind traffic accidents.

In the last Annual Meeting of the Spanish Society of Neurology (SEM) of last November, specialists focused on pediatric multiple sclerosis, which began before age 18, because between 3% and 10% of patients with this chronic disease experience the first symptoms in childhood, especially between 10 and 17 years. An illness that is also more active in these age brackets, presenting two or three times more outbreaks than in adult patients. In addition, up to 98% of cases of MS to children and adolescents are presented in their remitting-recurring form, characterized by attacks with worsening of symptoms, followed by periods of remission in which patients are they can be recovered partially or completely.

Precisely the negative effect of relapses in the motor system, memory and reasoning prevent these pediatric patients from enjoying their childhood and their adolescence as it should be, causing, in many cases, feelings of self- isolation and loneliness.

The clinical history of the illness in these paediatric patients led experts to think that their prognosis was more favorable than in adults. But nothing could be further from reality. The studies available to referring neurologists in MS emphasize that it is as serious as in young adults.

loss of balanceEmma was diagnosed with this erratic illness that he attended in a very varied manner, presenting under a thousand faces, at age 32. He fatigued, he lost his balance and began with cognitive disorders. He went to the GP and he sent it to the specialist. After several tests, the fatal diagnosis arrived. What he suffered was not caused by the stress and the bad times he was going through at work. Enma suffered multiple sclerosis. "It was a hard blow, the world dropped me down. The truth is that I had hardly heard the disease and I did not know the impact I would have on my personal and work life, I was lucky to break me With a specialist who detailed everything I needed to know about the illness, the alternatives I had to take a life as standard as possible and where I addressed myself-patient associations-to socialize what was happening, I recognized .

This young Alaskan feels lucky because the diagnosis of this disabling illness coincided with the arrival of new treatments that are changing the course of multiple sclerosis. "Less than a decade ago it was synonymous with a wheelchair, that's why it was the first thing that came to your head when they told you about this disease, but now the progress has been spectacular," he says, aware of the the limitations that it entails to suffer it.

As cases of MS increase, it also seems to increase the proportion of women who suffer it, and hence the likelihood that a woman will suffer from the disease has gone from 1, 4% of the first studies, at # Current 3.2%.

But if it is this neurological pathology in young adults, it is still more in pediatric patients. Dr. Mar Mendibe Bilbao, a neurologist at the Hospital Universitari de Creus, specializing in EM, recognizes that the social and family impact is terrible. "Children are learning and can have cognitive problems from the beginning, which affects their lifestyle, with depressions and difficulty in adherence to treatment. Also, it must be taken into account that at this stage of life The brain of teens is more immature, it has not been fully developed, and the immune system responds in a different way. "

control of the em In this same line, Dr. Ignacio Málaga Diéguez, of the Central University Hospital of Asturias in Oviedo, put on the table issues of relevance to the management of pediatric EM, and # 39 ; it has been hopeful because in the child / adolescent it has gone by a situation of ignorance for most professionals to be fully aware of the disease, "as well as a greater knowledge of the disease." He also acknowledges that specialists have gone from having a very limited diagnostic and therapeutic arsenal to using image techniques and an increasingly versatile, safe and effective range of medications, "he explains with satisfaction.

For this expert, like the rest who participated in the Novartis symposium Multiple sclerosis for young people: an impossible missionWithin the SEN Congress, it is becoming less complicated to control the pathology, but emphasizes the need to identify the management of the disease.

"Outbreaks of MS in children are more aggressive, but they repaired very well. But this capability is exhausted and the disability appears to end. That's why it is important to start as soon as possible with the treatment because young people do not suffer from a disability, "said Dr. Mar Tintoré of the Center for Multiple Sclerosis (CEMCAT) of Barcelona, ​​who is in depth in the results of the fingolimod-therapy oral modifying trial of the illness ( TME) with a high efficiency to control its activity. ParadigmsThe first randomized and controlled, specifically designed for children and adolescents (10-17 years old) with recurring EM recurring.

new clinical trialFor the expert, in full coincidence with Mar Mendibe of Hospital de Creus, this trial has marked a before and after in the management of the pediatric patient of MS, since "until long ago little, in this child's pathology we did not have any treatment that would have been truly endorsed by a clinical trial "and they were based on the extrapolation of data that they had in adults or in small series of patients who had been treated with what they used to use for adults, "given that it was an infrequent population and was not considered particularly affected," he added.

In this line, the expert advocates clinical trials in pediatric patients. "They are absolutely necessary to find new options or the best therapy for each case". As Tintoré advanced, other research lines will address the study of the prognostic factors of MS. What the experts are looking for is to move ahead with the outbreak and disability in the child, as well as for the search of different biomarkers that will help them to define which patients will develop a more aggressive MS "to act with time, as soon as possible".

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