Causes of delayed management of multiple sclerosis patients in Nasr city health insurance hospital

Abstract

Multiple sclerosis (MS), a progressive inflammatory disease of the central nervous system (CNS) is characterized by demyelination of axons in the brain and spinal cord, with axonal damage or destruction (Gold et al., 2010). Axonal transection is a consistent pathological feature of acute MS lesions and the incidence of neuronal damage correlates with the extent of inflammation within the lesion. Importantly, such damage may be present in the early stages of MS (Trapp et al., 1999) As the disease progresses, the balance between degenerative and reparative processes shifts, resulting in progressive neuroaxonal degeneration and increasing disability (Fig. 8) (Ziemssen et al., 2016). The initiation of disease-modifying therapy (DMT) early in the course of MS may improve the prognosis for patients with MS and reduce the occurrence of neurological damage (Kappos and Polman., 2006 and Kita et al., 2011). Delay often occur before a person with symptoms suggestive of MS sees a neurologist. Campaigns to raise awareness of MS are needed, as are initiatives to improve access to MS healthcare professionals and services. (Giovannoni, 2016).