Prof. Oded Abramsky

The Center for Multiple Sclerosis provides the patient with the best treatment and required care. In the Center are a neurologist who is an expert in multiple sclerosis, a nurse and a social worker, and advisors on vision problems and aural problems. In addition the Center is located in close contact with the Center for Rehabilitation at Har HaTsofim. The follow-up on the patient is done in the clinic which is open twice a week on Monday and Wednesday. The clinic may be reached by telephone at 02-6776939.

What is multiple sclerosis?

Multiple sclerosis is a chronic disease of demyelination of the central nervous system. That is, a disease in which the myelin sheath of the nerves in the brain and the spinal cord are injured at a number of foci (called "plaques"). These "plaques" are concentrated in the "white material" of the brain and the spinal cord, in particular surrounding the chambers of the brain and the visual nerves. The white material of the brain is all the area in which there is a high density of myelin-enveloped fibers; in the nature of things, since in these same areas there are few neurons (which are located in the "grey matter" in the brain covering), multiple sclerosis affects only the branching of the fiber cells, and in most cases, therefore, does not cause severe cognitive damage as is found in Alzheimer's.

What causes the disease?

Multiple sclerosis is considered an inflammatory autoimmune disease in which the immune system attacks the myelin self proteins. Due to the injury in the myelin which acts as a protective envelope on all the fibers of the nerves and as "insulation" material which enables the transfer of electrical signals, this will result in disturbances in the transfer of electrical "messages" within the brain and the spinal cord and defects/disturbances in the functioning of one or more nervous systems like the motoric system, perception, stability and coordination system, vision, sphinters, eye movement, etc.

Who gets multiple sclerosis?

Multiple sclerosis generally strikes people in their twenties and thirties. The disease is more common in people of European extraction than in people of African or Far Eastern extraction. There is a connection between the disease and the geographical area in which the patient lived in the first years of his life. There is a higher frequency of the disease in women than in men.

What are the symptoms of the disease?

The common symptoms (the clinical phenomena) of multiple sclerosis include sense disturbances ("pins and needles"), vision disturbances (blurring and double vision), limb weakness, instability and lack of coordination and disturbances in sphincter control.

Disease Process:

Multiple sclerosis is a variable disease and its progression differs greatly from patient to patient. Not all patients hit with the disease will get to a stage of needing assistance in walking or paralysis. A significant number of patients do not suffer from disturbances in essential functions even many years after the onset of the disease and perhaps never will. The rest of the patients suffer from an acute disease (benign multiple sclerosis) or an advancing/progressive disease. In some of the patients the disease begins as an acute disease and then with time becomes progressive (secondary progressive).

Are there treatments for the disease?

The Center for Multiple Sclerosis today offers a range of drugs whose purpose is to ease the symptoms and slow the progress of damage in the central nervous system. Three preparations of Interferon-b (Evonax, Ravif, Betaferon) and Copaxone are more or less efficient in slowing the disease process, reducing the number of attacks and the damage to the white material in the brain. These preparations are given by injection only (1-3 injections per week) and it is recommended to start taking them with the start of clinical symptoms and following unequivoccal diagnosis of multiple sclerosis.

Mitoxanatron: Administered in the case of worsening and rapidly progressing disease.

Steroids: Administered in acute cases of attack or as a chronic treatment.

Immunosuppressive preparations: cyclophosphamide, methotrexate and Imuran are administered for deteriorating conditions.

Other treatments: plasmapheresis (filtration of blood fluids)

Immunoglobulin preparation which is administered intravenously.

There are many other treatments which are administered to ease the different symptoms which derive from the disease and one may consult with the treating doctor about these.