01811nam a2200289   4500001000800000005001700008007000300025008004100028040000800069041000800077100003000085245003500115300002100150520101400171650001201185650002601197650002601223650002901249650002801278650002401306650001301330650001901343650001701362650002001379650001901399773010301418ESSALUD20260804124411.0ta      t        pe ||||| |||| 00| 0 spa d  aBMG  aeng  aHauser, Stephen L.eAutor  aAdvances in multiple sclerosis  apáginas: 54-68  aMultiple sclerosis is a chronic autoimmune disorder that affects the central nervous system, causing episodes of neurologic dysfunction and often gradual disease progression. The immune system primarily targets myelin, the protective covering of nerve fibers, leading to inflammation and damage, and secondary neurodegeneration is a major cause of long-term disability. Common symptoms include vision problems, sensory disturbances, muscle weakness, balance difficulties, and bladder dysfunction. Important advances in treatment have improved outcomes in patients with relapsing forms of multiple sclerosis, particularly through highly effective immune-modifying therapies such as CD20-targeting monoclonal antibodies. However, treatment options for progressive forms remain limited, which highlights the need for therapies that can prevent progression and promote myelin repair. Comprehensive symptom management and lifestyle support are also essential to maintaining quality of life and reducing disability.  aALERGIA  aINMUNOLOGÍA GENERAL  aENFERMEDAD AUTOINMUNE  aMEDICINA CLINICA GENERAL  aENFERMEDAD INFLAMATORIA  aESCLEROSIS MULTIPLE  aGENETICA  aREUMATOLOGÍA  aNEUROLOGÍA  aNEUROCIRUGÍA   aOFTALMOLOGÍA0 022717dMassachusetts NEJM GroupoNEJM001tThe New England Journal of Medicine wESSALUDx0028-4793