{"id":11670,"date":"2024-07-08T12:33:21","date_gmt":"2024-07-08T16:33:21","guid":{"rendered":"https:\/\/www.neuro-concept.ca\/?p=11670"},"modified":"2026-05-05T14:56:03","modified_gmt":"2026-05-05T18:56:03","slug":"le-traitement-de-la-sclerose-en-plaques-sep-et-la-progression-de-l-incapacite","status":"publish","type":"post","link":"https:\/\/www.neuro-concept.ca\/fr\/le-traitement-de-la-sclerose-en-plaques-sep-et-la-progression-de-l-incapacite\/","title":{"rendered":"Le traitement de la scl\u00e9rose en plaques (SEP) et la progression de l’incapacit\u00e9"},"content":{"rendered":"\t\t
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Comment l\u2019incapacit\u00e9 est-elle mesur\u00e9e dans le cas de la SEP?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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La scl\u00e9rose en plaques \u00a0(SEP) est une maladie auto-immune qui affecte le syst\u00e8me nerveux central, entra\u00eenant une vari\u00e9t\u00e9 de sympt\u00f4mes tels que la fatigue, des probl\u00e8mes de vision, des troubles de l’\u00e9quilibre et des difficult\u00e9s cognitives. Dans 85 % des cas, la SEP \u00e9volue d\u2019embl\u00e9e par pouss\u00e9es r\u00e9gressives (+\/- compl\u00e8tes) de sympt\u00f4mes neurologiques bien d\u00e9limit\u00e9s s\u00e9par\u00e9es par des phases de r\u00e9mission (forme r\u00e9mittente). Certaines formes r\u00e9mittentes peuvent \u00e9voluer vers une aggravation r\u00e9guli\u00e8re et irr\u00e9versible des l\u00e9sions (forme secondairement progressive). Dans 15 % des cas, surtout lorsque la maladie d\u00e9bute apr\u00e8s 40 ans, la SEP est d\u2019embl\u00e9e progressive (forme progressive primaire) avec une expression clinique avant tout m\u00e9dullaire, avec ou sans pouss\u00e9es surajout\u00e9es. Dans les formes \u00e9volu\u00e9es, les signes cliniques ont tendance \u00e0 s\u2019aggraver et \u00e0 coexister (fatigue, troubles moteurs, sensitifs, cognitifs, visuels, v\u00e9sicosphinct\u00e9riens, etc.), \u00e0 l\u2019origine d\u2019une incapacit\u00e9 importante.<\/p>

L’\u00e9volution de la maladie peut varier d’une personne \u00e0 l’autre, mais il existe des outils pour mesurer la progression de l’incapacit\u00e9 caus\u00e9e par la scl\u00e9rose en plaques, dont l’\u00c9chelle d’Incapacit\u00e9 \u00c9largie (EDSS). L’\u00c9chelle EDSS, ou \u00c9chelle d’Incapacit\u00e9 \u00c9largie de Kurtzke, est un outil largement utilis\u00e9 par les neurologues pour \u00e9valuer le niveau d’incapacit\u00e9 d’une personne atteinte de scl\u00e9rose en plaques. Cette \u00e9chelle va de 0 \u00e0 10, o\u00f9 0 repr\u00e9sente l’absence d’incapacit\u00e9 et 10 la mort due \u00e0 la scl\u00e9rose en plaques. Plus le score est \u00e9lev\u00e9, plus l’incapacit\u00e9 est importante.<\/p>

L’\u00c9chelle EDSS prend en compte diff\u00e9rents aspects de la maladie. Plus pr\u00e9cis\u00e9ment, il \u00e9value 7 fonctions neurologiques:<\/p>

  1. La fonction pyramidale (sch\u00e9matiquement les troubles moteurs, en tenant compte du p\u00e9rim\u00e8tre de marche, autrement dit le nombre de m\u00e8tres effectu\u00e9s et de la n\u00e9cessit\u00e9 d’utiliser ou pas une aide, telle qu’une canne) ;<\/li>
  2. La fonction c\u00e9r\u00e9belleuse (\u00e9valu\u00e9e par l’\u00e9quilibre, la coordination et la maladresse dans les mouvements rapides) ;<\/li>
  3. La fonction sensitive (qui est d\u00e9termin\u00e9e par la sensibilit\u00e9 de la peau au toucher et les sensations anormales) ;<\/li>
  4. La fonction du tronc c\u00e9r\u00e9bral. Ce dernier est situ\u00e9 entre le cerveau et la moelle \u00e9pini\u00e8re. Il g\u00e8re les fonctions de base du corps, comme la respiration, le rythme cardiaque, la d\u00e9glutition, etc. ;<\/li>
  5. Les sphincters (troubles urinaires et intestinaux) ;<\/li>
  6. La vision ;<\/li>
  7. Les fonctions cognitives (la m\u00e9moire, la concentration, l’humeur, etc.).<\/li><\/ol>

    En corr\u00e9lant le score de cette \u00e9chelle avec d\u2019autres tests comme une \u00e9preuve de marche chronom\u00e9tr\u00e9e, Les neurologues suivent l’\u00e9volution de la maladie chez les patients, ajustent les traitements si n\u00e9cessaire et \u00e9valuent l’efficacit\u00e9 des interventions. Le moment de l\u2019instauration d\u2019un traitement joue un r\u00f4le important dans le freinage de la progression de l\u2019incapacit\u00e9 associ\u00e9e \u00e0 la SEP. Les chercheurs ont constat\u00e9 que les patients ayant entrepris un traitement d\u00e8s le diagnostic de la SEP ont pr\u00e9sent\u00e9 de meilleurs r\u00e9sultats th\u00e9rapeutiques \u00e0 long terme que les patients ayant commenc\u00e9 un traitement plus tard. Le pronostic \u00e0 long terme \u00e9tait pire chez les patients ne recevant aucun traitement. Si la prise en charge de la SEP comprend des traitements m\u00e9dicamenteux pour traiter les pouss\u00e9es, des traitements de fond pour ralentir la maladie et des traitements symptomatiques pour les complications (spasticit\u00e9, douleurs, troubles sphinct\u00e9riens et g\u00e9nito-sexuels notamment), les traitements non m\u00e9dicamenteux sont tout aussi importants notamment la r\u00e9adaptation, l\u2019activit\u00e9 physique, l\u2019\u00e9ducation th\u00e9rapeutique et l\u2019accompagnement m\u00e9dico-social et psychologique. Et pourtant, d\u00e8s les phases initiales de la maladie, ces patients ont tendance \u00e0 restreindre ou \u00e0 arr\u00eater leur activit\u00e9 physique et les exercices, en lien avec une alt\u00e9ration de leur condition physique, une fatigabilit\u00e9 et la peur non justifi\u00e9e de d\u00e9clencher de nouvelles pouss\u00e9es (fausses croyances).<\/p>

    Il est donc important de consulter des professionnels de la sant\u00e9 sp\u00e9cialis\u00e9s en r\u00e9adaptation neurologique et conditionnement physique adapt\u00e9 pour l\u2019adapter \u00e0 votre condition et \u00e9viter les facteurs aggravants. Prenez contact avec un sp\u00e9cialiste en r\u00e9adaptation neurologique ici<\/a>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

    Comment l\u2019incapacit\u00e9 est-elle mesur\u00e9e dans le cas de la SEP? La scl\u00e9rose en plaques \u00a0(SEP) est une maladie auto-immune qui affecte le syst\u00e8me nerveux central, entra\u00eenant une vari\u00e9t\u00e9 de sympt\u00f4mes tels que la fatigue, des probl\u00e8mes de vision, des troubles de l’\u00e9quilibre et des difficult\u00e9s cognitives. Dans 85 % des cas, la SEP \u00e9volue d\u2019embl\u00e9e…<\/p>\n","protected":false},"author":1,"featured_media":11675,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[239,15,83],"tags":[],"class_list":["post-11670","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-mrehabilitation","category-sclerose-en-plaques-sep"],"yoast_head":"\nLe traitement de la scl\u00e9rose en plaques (SEP) et la progression de l'incapacit\u00e9 | Neuro-Concept r\u00e9adaptation neurologique<\/title>\n<meta name=\"description\" content=\"Quelles sont les options susceptibles de pr\u00e9venir ou de ralentir la progression de l\u2019incapacit\u00e9 dans la scl\u00e9rose en plaques?\" \/>\n<meta name=\"robots\" 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