Causes of development, manifestations, diagnosis and treatment of multiple sclerosis

1 Development of multiple sclerosis in adults and children

Not everyone knows what is multiple sclerosis, the causes, symptoms, treatment of this ailment. This is a chronic autoimmune pathology, in which the myelin sheath of nerve fibers is affected. The disease is systemic, that is, pathological foci are common throughout the body. The human nervous system is arranged in such a way that various electrical impulses constantly pass through the processes of nerve cells.

Nerve cell processes( axons) are coated with a shell containing myelin. It is a substance that promotes electrical insulation and the conduct of a nerve impulse along the body. With multiple sclerosis myelin sheath is affected. In its place, connective tissue is formed. This is called sclerosis.

Multiple Sclerosis: What is this pathology and who does it arise from? Scattered this disease is called because the areas without myelin are observed throughout the body. Until recently, this disease was more often found in females aged 20 to 40 years. In recent years, the number of sick men has increased. It is important that the severity of the course of this disease depends on the age of the patient.

The later developed multiple sclerosis, the less dangerous it is. The disease does not occur immediately, but develops gradually over several years. It is constantly progressing and often causes death of patients. The disease proceeds undulating.

2 Basic etiological factors

The causes of this pathology are different. Multiple sclerosis is common. In all states there is an increase in the incidence rate. In Russia, the number of patients is estimated at 150,000.The greatest number of patients is observed in European countries, Australia, Canada, USA.

Very rare disease occurs in residents of Asian countries( Korea, Japan, China).There are the following possible causes of the disease:

• viral infections( measles, herpes, rubella, mumps, rabies);
• hereditary predisposition;
• autoimmune disorders;
• mechanical damage to the brain and spinal cord;
• back injury.

All the aforementioned etiological factors are only a guess of the scientists. With multiple sclerosis, the cause can not be identified. This disease is an unspecified etiology. Possible predisposing factors include obesity, stress, ingestion of various toxic compounds, exposure to radiation, and inadequate nutrition.

The state of the child's organism is greatly influenced by the ecological situation. This pathology is diagnosed more often in individuals who live far from the equator. There is information about the possible impact of vaccination and smoking on the development of this disease. The following categories of persons are at increased risk:

• suffering from overweight;
• smokers;
• consuming salt in large quantities;
• suffering from diabetes.

Men and women, whose parents or close relatives suffered from this pathology, the risk of developing multiple sclerosis is 2-4 times higher.

3 How is the disease

The mechanism of the disease is rather complicated. There are 4 main clinical forms of the course of multiple sclerosis:

• recurrent;
• primary-progressive;
• is a second-progressive;
• progressing with obvious exacerbations.

The first form is diagnosed most often. With her during the remission, there is an improvement in the patient's condition. In the period between exacerbations the symptoms do not increase. Depending on the level of damage and clinical manifestations, the cerebellum, spinal, cerebrospinal, stem and optical forms of the disease are isolated.

Not always the first signs of multiple sclerosis are pronounced brightly. Even in the presence of lesions of nerve fibers, they may be absent. With multiple sclerosis, symptoms are determined by the massiveness of the lesion. Vivid symptomatology is observed with sclerosis of more than 40% of nerve fibers. In this situation, focal symptoms appear.

4 Clinical signs of

Multiple sclerosis is manifested in men and women in different ways. The most common signs of multiple sclerosis in young people are:

• numbness of the hands;
• gait violation;
• pareses;
• paralysis;
• tremor;
• decreased vision until complete blindness;
• dysfunction of the pelvic organs( enuresis);
• increased muscle tone;
• violent movements;
• visual disorders;
• impaired sensitivity;
• disorders in the emotional sphere;
• weakness;
• fatigue.

In the early stages of this pathology, pelvic disorders are often observed. On frequency they occupy a leading position. These include nighttime urination, urinary incontinence, severe urge to enter the toilet, obstructing urine outflow. In men, urination becomes intermittent. Such patients do not always manage to reach the restroom.

As the disease progresses, motor disorders appear. These include paresis, paralysis, gait disturbance, and tension in the limbs. Patients lose the feeling of the ground under their feet. In paresis, one or all 4 limbs can be affected. The interval between exacerbations may be several months. With multiple sclerosis, symptoms include impaired sensation.

This is manifested by tingling in the hands or feet, a decrease in tactile sensitivity, a feeling of crawling. Men and women often develop paralysis of the cranial nerves. Most often affects 3, 5, 7 and 12 pairs of cranial nerves. Sometimes pseudobulbar syndrome develops. It manifests itself in dysarthria( pronunciation disorder), dysphonia( decrease in sonority of the voice) and dysphagia( difficulty swallowing).This is due to the defeat of the sky, tongue and throat.

5 Concomitant symptomatology

If a person has multiple sclerosis, the symptoms may include visual disturbances( horizontal vertical uncontrolled movements of the eyeballs, decreased visual acuity, the appearance of black dots before the eyes, twitching of the eyelids, doubling).The appearance of the veil before the eyes is a sign of the defeat of the oculomotor nerve. In the late stages of the disease, the appearance of the patient may change. Perhaps incomplete closure of the eyes, distortion of the face and mouth.

This occurs when unilateral reduction in the tone of mimic muscles. If there is multiple sclerosis, the symptoms may include ataxia. This is a condition in which instability( unsteadiness) of gait is observed. Coordination disorder and movement instability indicate involvement in the cerebellum process. Neurologists with experience know how multiple sclerosis develops.

Additional signs of the disease include dementia, memory loss, headache, dizziness, weakness. Some people develop epilepsy. The emotional sphere also suffers. It manifests as a decrease in mood, anxiety, depression. Perhaps the negation of one's own illness.

6 Diagnosis and diagnosis of

Patients should be treated after a comprehensive examination. Diagnosis includes a patient questioning, objective examination, neurological examination, magnetic resonance imaging, field examination and visual acuity. Foci of sclerosis of the nervous tissue can be identified in the process of magnetic resonance imaging. Instrumental diagnosis is the most informative.

In the picture, when MRI is performed, zones with reduced density are determined. These are the areas of demyelination. If necessary, contrasting is done. Differential diagnostics with another neurological pathology is necessarily carried out. There are McDonald's criteria. They include:

• the presence of 2 or more exacerbations;
• defeats several areas;
• 1 exacerbation and objective data on the presence of 2 or more foci;
• 1 exacerbation and severe symptoms of 1 foci;
• worsening the general condition of the patient.

Diagnostics must include a person's questionnaire. The time of appearance of the first symptoms, the presence of this disease in the family, the fact of the previously transmitted infectious diseases, complaints to the present time is established. In the process of neurologic examination the following parameters are evaluated:

• reflexes;
• muscle tone;
• volume of movements in the limbs;
• state of eyeballs;
• speech function;
• coordination of movements.

Consultation of other specialists( urologist, ophthalmologist, immunologist) may be required.

7 Therapeutic tactics of

Not everyone has an idea why people suffer from multiple sclerosis, symptoms and treatment of this pathology. After the diagnosis is performed and the diagnosis is made, the doctor prescribes treatment. If symptoms occur for the first time, then hospitalization is required. Therapy has the following objectives:

• elimination of neurologic symptoms;
• prolongation of the period of remission;
• slowing the progression of the disease;
• increased immunity and compensatory mechanisms;
• is a relief to a person's life.

No etiotropic treatment is performed. In the acute phase, glucocorticoids( Dexamethasone, Prednisolone, Methylprednisolone), cytostatics( Azathioprine, Methotrexate, Cyclophosphamide) are used. In severe cases, glucocorticoids are combined with cytostatics. Most often, hormones are used in a large dosage. They use a short course.

Beta-interferons( Betaferon, Avonex, Rebif) are shown to change the course of the disease and lengthen the remission.

They are used to prevent complications. Betaferon is most effective in secondary-progressive and remitting multiple sclerosis.

Kopakson-Teva is prescribed to alleviate the severity of the disease and prevent sclerosis. This immunomodulator. In case of development of renal insufficiency blood purification( hemodialysis, plasmapheresis) can be carried out. The scheme of treatment of patients includes symptomatic medications, vitamins, antioxidants, preparations based on potassium and magnesium. With frequent urge to urinate and increased excitability of the urinary bladder, Urotol tablets are taken.

With reduced memory and dementia, Piracetam is indicated. It improves the metabolism and circulation in the brain. In case of sleep disturbance, sedatives are indicated. In the treatment of patients with multiple sclerosis often include antiepileptic drugs( Gabapentin).

With increased anxiety of the patient and the development of depression, antidepressants are indicated( Amitriptyline, Fluoxetine).In the phase of remission, therapeutic gymnastics is performed. Rest in sanatoriums is recommended. With sclerosis, thermal procedures and sunbathing are contraindicated. The regimen includes a diet.

8 Can

be prevented? Specific prevention of multiple sclerosis is not developed, as there is no data on the causative agent of the disease. To reduce the likelihood of the disease, it is necessary to adhere to the following recommendations:

• to exclude or timely treat viral diseases( rubella, herpes, parotitis, influenza);
• eliminate stressful situations;
• to lead an active lifestyle;
• follow the body weight;
• fully nourished( there are more natural products rich in vitamins);
• to refuse from alcohol and cigarettes;
• exclude brain trauma.

In the event that the disease has nevertheless developed, it is necessary to adhere to the prescription of the doctor. It is completely impossible to cure the patient. The cause of death is most often vascular and respiratory failure. The disease almost always leads to a loss of ability to work. For such people need care. Thus, the detection of multiple sclerosis in humans is a dangerous verdict.