Sá Maria José
Department of Neurology, Centro Hospitalar São João, Faculty of Health Sciences, Universidade Fernando Pessoa, Porto, Portugal.
Arq Neuropsiquiatr. 2012 Sep;70(9):733-40. doi: 10.1590/s0004-282x2012000900016.
The physiopathology of symptoms and signs in multiple sclerosis (MS) is a less divulged topic albeit its importance in the patients' management.
It was to summarize the main biophysical and biochemical mechanisms which produce the clinical manifestations in MS.
The mechanisms underpinning neurological deficits are described in the relapsing and in the progressive phases, stressing inflammatory and neurodegenerative components, especially demyelination, axonal damage and conduction impairment. Transient worsening based in Uhthoff's phenomenon, mechanisms producing positive symptoms, as paraesthesias and Lhermitte sign due to axonal hyperexcitability and ephaptic interactions, and development of cortical symptoms will also be addressed. The variety of processes leading to neural repair and functional recovery in the remitting phase is focused, as remyelination and adaptive changes due to neural plasticity.
The awareness of mechanisms producing symptoms in MS emphasises the role of symptomatic and rehabilitation therapies in the improvement of patients' well-being.
尽管症状和体征的生理病理学在多发性硬化症（MS）患者管理中具有重要意义，但它仍是一个较少被披露的话题。
总结导致MS临床表现的主要生物物理和生化机制。
描述了复发期和进展期神经功能缺损的机制，强调炎症和神经退行性成分，特别是脱髓鞘、轴突损伤和传导障碍。还将探讨基于乌托夫现象的短暂恶化、由于轴突兴奋性过高和短路交互作用产生阳性症状（如感觉异常和莱尔米特征）的机制以及皮质症状的发展。重点关注缓解期导致神经修复和功能恢复的各种过程，如再髓鞘化和神经可塑性引起的适应性变化。
对MS症状产生机制的认识强调了对症治疗和康复治疗在改善患者生活质量方面的作用。
