Multiple sclerosis refers to chronic autoimmune diseases of the nervous system, as a result of which the myelin sheath of nerve fibers is affected. The pathological process leads to a gradual loss of physical skills and psycho-emotional functions. The quality of life of patients with multiple sclerosis is sharply worsening, in case of severe illness the person constantly needs help from relatives.
The disease most often affects young people aged 20 to 45 years, if the treatment is scheduled on time, MS patients live only 7 years less than people of the appropriate age group and without such a disease. Nevertheless, there is a lightning-fast form of the disease, in which irreversible changes occur in a few years.
Causes of Multiple Sclerosis
There is no reliable data on the main causes of the disease. Numerous studies have allowed scientists to assume that multiple sclerosis occurs with adverse effects on the immune system of external and internal factors. The external causes of the disease include:
- Bacterial infections.
- Viral infections - measles, rubella, rabies.
- Poisoning by toxic substances, exposure to radiation.
- Injuries.
- Features of the diet.
- Psychoemotional disorders. Race and geoecological place of residence. Near the equator the prevalence of multiple sclerosis is the lowest, the number of patients grows in the north and south.
There is also some genetic predisposition to the disease, that is, multiple sclerosis can be inherited. If one parent has more sclerosis, then the probability of its development in children is about 5%, which is considered a low indicator of hereditary predisposition.
Viruses can live for years in nerve cells, gradually destroying their membrane and replacing myelin with prion - an alien protein. Prion is an antigen for the body and the immune system in response to it produces antibodies, which leads to a severe autoimmune reaction.
Viruses in the body can act for a long time without causing much anxiety, but with a combination of several provoking factors, the disease begins to progress dramatically.
Initial symptoms and signs of
Multiple sclerosis is characterized by a prolonged latent period. With the defeat of a small number of nerve fibers, their function is partially compensated for by healthy fibers, focal symptoms begin to appear when the percentage of damage is close to 40%.
The early signs of the disease include:
- Increased fatigue of the lower limbs, their weakness. Such lesions of the upper limbs are determined only in 6% of cases.
- Feeling of periodic numbness in arms and legs, crawling "goose bumps".
- Hot flushes or a sudden cold snap of the body.
- Some patients with multiple sclerosis have pain in the abdomen, lower back, a sense of their contraction.
- The optic nerve is broken - short-term, mostly one-sided visual acuity reduction
- Peripheral paresis of the facial nerve. Dizziness, accompanied by nausea and vomiting.
- Micturition disorders - urges or vice versa its delay.
- 80% of patients in the early stages of emotional instability - the mood can change several times in one hour.
In far-reaching stages of the disease, multiple sclerosis is manifested:
- by paresis, a violation of muscle tone.
- Violation of coordination in movements - unsteadiness of a gait, instability of a body in an upright position, trembling of limbs.
- Disturbance in sensitivity - tingling, numbness, pain.
- Decreased visual acuity, nystagmus, narrowing of visual fields.
- Slow speech.
- Emotional instability - euphoria, depression.
- Reduction of intellectual activity and concentration of attention. Disinhibition of behavior.
- In the last stages there is a violation of the pelvic organs function - incontinence of urine and feces, in men impotence.
We present to your attention the video from the release of the program "Live healthy" with Julia Malysheva, dedicated to multiple sclerosis:
Multiple sclerosis and pregnancy
. In pregnancy, the rapid progression of multiple sclerosis is practically not observed. This is due to the fact that the woman's immune system does not work at full strength. If the multiple sclerosis becomes aggravated during the gestation period, the therapy scheme differs significantly. Do not prescribe corticosteroids, mainly use plasmaphoresis.
At the same time, multiple sclerosis can manifest immediately after the birth of the baby and in the first six months of his life. Affect the exacerbation of the disease, heavy, prolonged labor, stress and difficulties in caring for the child.
Multiple sclerosis in children
The diagnosis of multiple sclerosis is often presently placed by adolescents from 10 to 15 years, often the disease affects children of the youngest age. Studies have shown that sclerosis in children develops gradually and in most cases, its onset is provoked by hypothermia, severe respiratory infections, and stressful situations. At the beginning of the illness, the child complains of the following symptoms:
- Flicker flies before the eyes, foggy shroud. Usually, with these signs, parents take the child to the oculist, and the doctor most often diagnoses neuritis.
- On weakness in the limbs, difficulty in walking.
- Young children have more incontinence.
- On tremor of the fingers, tingling and numbness in the limbs.
After the first manifestations of the disease, children may undergo many months of remission, but at this time the nerve fibers continue to be affected. The next attack manifests itself as a more extensive symptomatology and a number of examinations are required to establish an accurate diagnosis. It was found that children born with hypoxic encephalopathy are most prone to multiple sclerosis.
Forms and course of the disease
- Recurrent form is considered a typical manifestation of the disease - periods of exacerbation are replaced by remission.
- Recurrent - progressive form is characterized by not complete restoration of neurological functions after each exacerbation. In the intervals between remissions there is an increase in the symptoms of the disease.
- Primary-progressive form of sclerosis - the onset of the disease is slow without significant symptoms, there are no obvious exacerbations. Nevertheless, several neurological changes develop over several years.
- Secondarily progressing form - a variant of the course of a recurring and recessive - progressive course of the disease a few years after the first exacerbation. With this form, there is a gradual and irreversible development of neurological disorders.
- Clinically isolated form of multiple sclerosis is put at the first debut of the disease and in the future it can develop in different variants of its course.
Multiple sclerosis is characterized by the parallel development of two pathological processes:
- The emergence of sites of inflammation - sclerotic plaques in the spinal cord and brain. Similar foci of inflammation precede the exacerbation of the disease or develop directly during it.
- Degenerative changes leading to atrophy of different parts of the brain and spinal cord.
With relapsing forms of sclerosis, the presence of symptoms is explained by the formation of plaques, and with a progressive version of the disease progress, degenerative phenomena come to the fore.
With a prolonged course of the disease, atrophic changes begin to predominate, and inflammatory ones become secondary. Determining the form of the disease is necessary for choosing the right treatment regimen.
The aggravation of multiple sclerosis is an outbreak of the disease, during which a person's neurological disorders increase for several days or weeks. Symptoms of exacerbation can be troubling for several weeks, after which a remission occurs.
There is a direct link in the course of the illness due to the duration of exacerbations and remissions. The less acute the exacerbation occurs, the greater the chance that the myelin sheath of nerves will recover completely, which means that the symptoms of the disease will not be so pronounced, and the quality of life of the patient will not change. That is why it is important to begin treatment immediately after exacerbation, and during the remission to conduct preventive therapy.
Diagnosis of the disease
The diagnosis of multiple sclerosis is established on the basis of an anamnesis, a neurological symptomatology. The diagnosis must be confirmed by instrumental studies, among which the leading role is given to the MRI of the brain.
Plaques are detected during the tomography, although their absence is not an indication to the removal of the diagnosis. MRI also allows to detect conduction disorders in auditory, motor, visual, somatosensory ways.
Forecasts and consequences
The prognosis for the course of multiple sclerosis depends on the form of the disease, the time it is detected, and the frequency of exacerbations. Early diagnosis and the appointment of appropriate treatment contribute to the fact that the sick person practically does not change his way of life - he works on previous work, leads active communication and externally signs are not noticeable.
In rare cases, exacerbation of the disease occurs with worsening of cardiac and respiratory activity and the lack of medical care at this time can lead to death.
Treatment of Multiple Sclerosis
The sooner the treatment of multiple sclerosis is started, the greater the chance for the patient to a long life expectancy with the preservation of most vital functions. A good prognostic sign is considered to be the onset of MS and the presence of only a few symptoms of the disease.
Unfortunately, at present it is not possible to fully cure multiple sclerosis, but it is possible to reduce the frequency of exacerbations and their course by taking appropriate medications.
Medications
Patients with newly diagnosed sclerosis are hospitalized in specialized centers, where they are selected the most effective therapy regimen. Basically, the treatment is based on the admission of the following drug groups:
- Hormones. Corticosteroids are prescribed in the first days of illness by a short course. Hormones inhibit immunity, reduce inflammatory reactions and accelerate the recovery of nerve fibers.
- Antiviral drugs Betaferon, Reaferon, Avoneks.
- Cytotoxic agents are Mitoxantrone.
- Symptomatic therapy includes the use of nootropics, B group vitamins, muscle relaxants, antioxidants. Also with multiple sclerosis, antimetabolites are sometimes used, for example cladribine. The price of this medicine varies within reason.
- Immunomodulator Copaxone prevents further destruction of myelin.
- Plasmophoresis.
Massage
Massage with MS is used to relieve pain, relieve muscle spasms, to restore movements in the affected limbs. The main purpose of the massage is to fight spastic paralysis. The technique of massage movements with MS has its own subtleties, therefore, only a qualified specialist should perform the procedures.
Nutrition and diet
Many diets have been developed for patients with multiple sclerosis, some doctors say that proper nutrition affects both the course of the disease and life expectancy.
It is recommended to use vegetable fiber, vegetables, fruits in fresh form, this speeds up the metabolic processes. Useful for MS is linoleic acid, it is found in vegetable oil, nuts, vegetable margarine, whole grains.
Patients with multiple sclerosis who are restricted in physical activity should pay attention to the calorie content of the food. A set of extra pounds leads to obesity and to a worsening of all the symptoms of the disease.
Video about the treatment of multiple sclerosis patients:
Folk remedies
Folk remedies for sclerosis will not naturally lead to complete recovery, but can affect the reduction of exacerbations and their severity.
- It is recommended to use sprouted wheat, it contains a large group of B vitamins, some hormones and trace elements.
- Bee products improve the conductivity of nerve impulses, contribute to the removal of inflammation. Use propolis, royal jelly, pergu.
Modern methods of
The treatment of sclerosis with stem cells has been carried out since 2003, in Russia this method is certified. Table cells restore the myelin sheath, dissolve scar tissue and thus improve the passage of nerve impulses. After the introduction of stem cells, the damaged functions are quickly restored.
Stem cells are taken from the patient from the biomaterial, then grown in sterile conditions for several weeks. After cultivation, part of the stem cells is injected immediately, the second a few months later. The introduction of cells is usually performed in an outpatient setting, the patient perfectly tolerates the procedure. The first positive shifts can be seen after about three months
Drugs based on monoclonal antibodies reduce the frequency of periods of exacerbation and lead to less progression of the disease, which also affects the patient's better quality of life. Monoclonal antibodies inhibit the activity of lymphocytes, which cause damage to the nerve endings of the brain. When they are used, the number of lesions of sclerosis decreases, and new ones do not appear.
Drugs based on monoclonal antibodies are prescribed when other therapies are ineffective, but their use should be approached after evaluating all risks. In patients with weakened immunity, there is a possibility of developing infectious complications.
Multiple sclerosis is a serious disease, but it must always be remembered that its manifestations depend on the patient's desire to be cured. If the therapy of the disease is started on time, the patient takes all medications, both during exacerbations and for prevention, then the probability of his normal life is close to 90%.Opens prospects in the treatment and use of new drugs and techniques.
Clinics in St. Petersburg and Moscow
Special centers for patients with multiple sclerosis have been created and are functioning perfectly, where they carry out full diagnostics, select a treatment regimen, and carry out rehabilitation measures.
There are several centers of multiple sclerosis in St. Petersburg. The city center of the RS is located at Dynamics Ave., 3, you can get advice by calling 812-235-20-45.Center at the State Medical University. Pavlova on the street. Leo Tolstoy 6/8 cor.10.
In Moscow is the Moscow city center of multiple sclerosis, located at ul. Dvintsev, 6. You can make an appointment by phone.8( 499) 940-19-47.