Article

A growing body of literature indicates that the natural course of multiple
sclerosis can be influenced by a number of factors. Strong evidence suggests that
relapses can be triggered by infections, the postpartum period and stressful life
events. Vaccinations against influenza, hepatitis B and tetanus appear to be
safe. Surgery, general and epidural anaesthesia, and physical trauma are not
associated with an increased risk of relapses. Factors that have been associated
with a reduced relapse rate are pregnancy, exclusive breastfeeding, sunlight
exposure and higher vitamin D levels. A number of medications, including hormonal
fertility treatment, seem to be able to trigger relapses. Factors that may worsen
progression of disability include stressful life events, radiotherapy to the
head, low levels of physical activity and low vitamin D levels. Strong evidence
suggests that smoking promotes disease progression, both clinically and on brain
magnetic resonance imaging. There is no evidence for an increased progression of
disability following childbirth in women with multiple sclerosis. Moderate
alcohol intake and exercise might have a neuroprotective effect, but this needs
to be confirmed.

Langue : ANGLAIS