Multiple Sclerosis

Multiple sclerosis is an autoimmune disease that affects the central nervous system. It can manifest itself as disorders of vision, strength, balance, coordination, tactile sensitivity, which may be associated with pathological fatigability and cognitive disturbances.

What it is

Multiple sclerosis is an inflammatory disease that affects the so-called 'white matter' of the central nervous system (brain and spinal cord), making it difficult for the brain and spinal cord to communicate with the 'periphery' (muscles, receptors of sensory stimuli). Nerve cells transmit electrical signals through long fibres called axons, which are covered by an insulating substance, the myelin sheath. In multiple sclerosis, cells from the patient's immune system attack and damage this sheath, rendering the axons unable to transmit signals effectively.

Symptoms
The disease can manifest itself with a very wide range of neurological symptoms, such as visual disturbances such as loss of vision in one eye, changes in part of the visual field in both eyes or splitting of images, difficulty in coordinating movements, fatigue with loss of muscle strength, loss of sensitivity to heat, cold or touch, pain, cognitive disturbances (level of attention, reasoning, learning and memory), language difficulties. Multiple sclerosis can have a variable course, particularly with acute attacks and subsequent remission or porgressive remission.

Causes
There is still no certainty about the causes of the disease, although available data suggest that in a genetically predisposed individual environmental factors and autoimmunity contribute to triggering demyelination and the resulting symptoms.

Diagnosis
To diagnose Multiple Sclerosis, in addition to knowing the patient's medical history, an MRI of the brain is necessary. In some cases, on the advice of the neurologist, other tests may also be necessary, such as an MRI of the spinal cord, a sampling of the CSF (the fluid surrounding the brain and spinal cord) and sometimes special tests such as evoked potentials.

Therapies
There is currently no definitive cure for the disease. However, there are drug therapies that can modify the course of the disease, both in reducing the frequency and severity of relapses and in slowing down the progression of disability.

Some factsMSMS mainly affects young adults (20-40 years), with a greater preference for females (about 2-3:1 compared to males). Pediatric onset is not uncommon, with approximately 3-5% of cases beginning before the age of 16.
Worldwide, the distribution of the disease is not uniform: it is more common in areas far from the equator with a temperate climate, particularly Northern Europe, the United States, New Zealand and Australia. Globally, there are an estimated 2.3 million people affected by MS, of which about 600,000 in Europe and 113,000 in Italy (Atlas of Multiple Sclerosis, 2013). In the Emilia-Romagna region, the estimated number of people affected is 8130 (Multiple Sclerosis Barometer 2017, AISM).

The Multiple Sclerosis Centre

The ISNB Multiple Sclerosis Centre offers:

• Diagnostic tests
• Administering infusional drugs or drugs requiring prolonged clinical/laboratory monitoring
• Rehabilitation treatment

How to access the Centre:

• If the Azienda USL (local health authority) is in Bologna, a referral from a local neurologist is required. It is usually the family doctor who prescribes the neurological examination.
• If you do not belong to the Bologna Azienda USL, you can refer to the contacts below.

Contact

For information or requests for pick-up
mail: centrosm@ausl.bologna.it (please include the name of the doctor you are sending the message to in the subject line)
fax: 051-496.62.22
Telephone: 051-496.62.11 (from 1:00 p.m. to 2:30 p.m., Monday to Friday)

For emergencies (e.g. suspected relapse)
telephone: 051-496.62.11
(9.30-10.30 a.m., Monday to Friday)

Headquarters

IRCCS Istituto delle Scienze Neurologiche di Bologna
via Altura 3/A, Bologna
Pad. Tinozzi (Bellaria Hospital), first floor.

The ISNB Multiple Sclerosis Centre is a point of reference in the metropolitan area of Bologna for the diagnosis and treatment of patients with Multiple Sclerosis. Activities include the diagnostic process, psychological support, initiation of basic and symptomatic therapies, and rehabilitation interventions aimed at recovering in the post-relapse phases and subsequently maintaining present abilities.

The Centre develops personalised therapeutic strategies to limit the development of disabilities as far as possible and reduce the need for hospitalisation, thanks to a multi-specialist team comprising neurologists, physiatrists, physiotherapists, nurses, psychologists and speech therapists. External specialists such as psychiatrists, neurophysiologists, urologists, ophthalmologists, cardiologists, gynaecologists, nutritionists and rheumatologists also contribute to the team's activities, depending on the patient's treatment and care needs.

The centre collaborates with the main Italian and international organisations involved in multiple sclerosis research and participates in clinical trials for the testing of new drugs and the optimisation of the use of those already available. It promotes research activities in the field of re-education and rehabilitation, in synergy with other operating units of the Azienda USL di Bologna, with the University of Bologna and with numerous Italian healthcare companies. It also hosts internships for students on the degree courses in Medicine and Surgery, Physiotherapy and Nursing Sciences, and for postgraduates on the degree courses in Neurology and Psychology.

The team

Alessandra Lugaresi, neurologist and director of the Multiple Sclerosis Centre
Mara Barbieri, nurse
Emilia Basta, nurse
Micaela Burzi, nursing coordinator
Federico Camilli, postgraduate student in Neurology
Michela Crisci, neurologist
Francesca Falzone, neurologist
Elisa Ferriani, psychologist
Barbara Mengoli, speech therapist
Antonella Paioli, rehabilitation coordinator at Bellaria Hospital
Federica Pinardi, neurologist
Stefania Pozzi, physiotherapist
Francesca Rizzi, speech therapist
Loredana Sabattini, physiatrist
Cinzia Scandellari, neurologist
Angela Tabellini, nurse
Emilio Taricone, physiotherapist
Luca Venturi, physiotherapist

The operational units of reference

UOSI Multiple Sclerosis Rehabilitation

Multiple Sclerosis and pregnancy, fertility and postpartum
Will I be able to have a baby? Will I be a mother like all the others? Will I be able to breastfeed?
Once they have been diagnosed with Multiple Sclerosis, many women have many questions, especially about pregnancy, fertility and childbirth. The Centre's professionals answer the most frequently asked questions on this page.

Acknowledgements

In 2019, the ISNB was awarded by ONDA (the National Observatory for Women's Health) with two pink seals, valid for the two-year period 2020-2021, for the excellence of the services offered to women with multiple sclerosis.
In April 2019, the ISNB received a plaque as part of the "A Cigogna for Multiple Sclerosis" initiative, promoted by ONDA, handed over to testify to the excellence of the care pathway for patients with multiple sclerosis wishing to become pregnant.
In 2018, the Multiple Sclerosis Centre was awarded in the Best Practice for Multiple Sclerosis competition, thanks to the efficiency of the Listening Point, a service available to patients, looked after by a multidisciplinary team, able to follow patients at particular times in their lives, such as during pregnancy or the menopause period.

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