Multiple sclerosis, what is it? - Symptoms and Treatment

Information about multiple sclerosis accumulated in medicine gradually, and only by the 70th years of the XIX century these isolated data were summarized by the outstanding neurologist Jean Charcot. Since then, the "Charcot triad" is known, the detection of which by a neurologist can with a high degree of probability speak about a diagnosis.

It should be noted that the term has nothing to do with absent-mindedness, as a personality trait, and also is not a "sclerosis" in the domestic sense, when they want to recall forgetfulness.

In this case, the name "sclerosis" characterizes the morphological changes in the nervous tissue, in which the nerve shell is replaced by scar tissue, that is, it is sclerized. And the word "absent-minded" means that this disease does not have a single locus of localization, as, for example, in a stroke.

Multiple sclerosis - what is it and how much do they live with it?

Multiple sclerosis is a disease that has a long, chronic character, affecting only the central nervous system( the brain and spinal cord).In this case, the myelinated multilayered envelope of nerve conductors is disrupted, which disturbs the impulse, both downwards, to the executive organs and upwards, to the analytical centers of the cortex.

It is important that only white matter is affected, that is, conductive paths. The bodies of neurons that are in the gray matter of the brain and spinal cord are not subject to pathological changes.

The international name is SD( sclerosis disseminatus), which is translated from Latin and means "multiple sclerosis".The Russian medical literature adopted the abbreviation RS.

Many patients, after the diagnosis of multiple sclerosis, ask: what is it and how many live with it? The doctor should not hide the truth: disability with MS is inevitable, but if properly treated, then it can delay its appearance for decades, and live young years fully, and in the elderly, reduce its manifestation to a minimum.

So, for example, women with rare relapses, completely reversible, have the greatest chances, which had no progression of symptoms for 5 years, and fell ill at the age of 25 years. RS is a pathology in which a later onset indicates a more severe course.

Causes or to Who is Multiple Sclerosis?

The tragedy of the disease in many respects is that patients with multiple sclerosis are young people of the most blooming age. Many diseases of the central nervous system affect the elderly( strokes, parkinsonism, dementia).

RS "mows" the most able-bodied part of the population, at the age of 18 to 45 years. After 50 years, the risk of debut disease is significantly reduced.

Since the exact cause of multiple sclerosis has not yet been identified, the researchers pay attention to all the factors that can say anything about the increased risk of the disease.

It was found that:

• the population of northern countries is sick much more often than people in the tropics. Some scientists believe that this is due to the lack of solar radiation and vitamin D deficiency;
• also in women multiple sclerosis occurs almost three times more often than in men. But in this case, the male MS proceeds in a much heavier form;
• is more likely to get sick of people of European nationalities, and persons of the Mongoloid race are practically unfamiliar with this disease;
• living in large agglomerations and industrial centers suffer more often than in villages. Perhaps this is due to a poor environmental situation;
• in patients with MS almost always reduced the content of uric acid in the blood. Therefore, people with gout and hyperuricemia may not worry.
• also many researchers are inclined to consider the cause of severe and severe stress and depression, smoking and frequent infectious diseases.

As can be seen from the above facts, the nature of MS is still a mystery.

Symptoms of Multiple Sclerosis

In a disease such as multiple sclerosis, the symptoms are exactly the same as in many other neurological diseases. They can be found alone in case of strokes, and with diabetic nervous system damage. But MS is characterized by their specific alternation, combination, as well as the "influx" of some manifestations into others.

Symptoms of the initial stage of multiple sclerosis are quite typical:

1. Optic neuritis on the one hand, with a transient decrease in vision. Often, then a full recovery comes, and only a few years later begins a real "attack" of the RS.
2. Urination disorders. Sometimes they are so delicate that only careful examination of the doctor first draws the attention of the patient to this problem. As a rule, there is either a delay in urination when trying to urinate, or imperative urges, which require "hurry up to the toilet."
3. Various disorders of strength in arms and legs, more often unilateral, by type of mild paralysis - paresis.
4. There may be focal neurological symptoms: the appearance of nystagmus( jittery eyeballs), the appearance of a symptom of internal ophthalmoplegia, dizziness, cerebellar disorders, etc.
5. Extreme fatigue.

Often a real "attack" of the disease occurs after thermal procedures. It has long been noted that patients with the slightest suspicion of multiple sclerosis are prohibited from baths, saunas, hot baths and showers, trips to tropical countries. Also you can not be in the heat and sunbathe for a long time.

With increasing symptomatology and a clinically pronounced course, MS can give a variety of symptoms:

• Sensitive disorders: "crawling", decreased sensitivity to the skin, reduced temperature and pain sensitivity. Sometimes a sensitive ataxia develops - the patient needs to see his limbs to control their movement. So, in the dark, such a person can not walk and fall, because he needs to see his feet;
• Oculomotor disorders: double vision( diplopia), as well as multidirectional movements of the eyeballs when trying to look at a closely located object;
• Extrapyramidal disorders, which consist in the expressed tremor of extremities( tremor).This is a very difficult condition, in which patients are helpless, because, for example, they can not drink, because they can break a glass about teeth, can not eat, so the hand sometimes shakes so that the eye can be damaged by a spoon;
• Bulbarnaya symptomatology( swallowing disorders, puffing, blur and slurred speech);
• Paralytic limbs, flowing along the central type, with severe muscle spasm, painful pain;
• Perversion of sleep: sleeplessness at night and drowsiness during the day.

In addition to the above symptoms, there are other disorders.

Forms of RS

There are several forms of multiple sclerosis that differ in the course of the disease:

• Primary-progressive: all the time only worse, new symptoms join, and old ones do not go away. It happens infrequently;
• Remitting, with the presence of relapses. It happens very often: first there is an exacerbation, then it completely or almost completely passes. Then the exacerbation is repeated, perhaps more difficult than the past;
• Secondary-progressive: after the remitting course, progression occurs.

Other types of flow are possible, on which there is no reason to stop.

Treatment of Multiple Sclerosis

Currently, the treatment of multiple sclerosis is a very complex and expensive task. Suffice it to say that one injection may approach a hundred thousand rubles at a cost. But, in some cases, you can get by with more affordable drugs.

1. The main goal of therapy is to prevent the development of an exacerbation, and if it has arisen - to curtail its manifestations. For this, corticosteroid hormones are used in the regime of pulse therapy and cytostatics( cyclophosphamide).
2. The second goal is to change the course of the disease and achieve a stable remission. There is a group of drugs called PITRS - drugs that change the course of multiple sclerosis. These include interferon preparations, some cytostatics and monoclonal antibodies. All of them are very expensive, and domestic counterparts have many side effects. Getting Russian patients these medicines for free is a big problem.
3. The third goal is symptomatic treatment of neurological disorders( muscle relaxants, vitamins, massage, physiotherapy, treatment of urination disorders).
4. The fourth goal is the social adaptation of the patient, who is in the stage of disability.

The treatment of such patients is a complex task that requires the participation of many specialists: neurologists, rehabilitation specialists, masseurs, urologists, electrophysiologists.

In conclusion, it should be noted that multiple sclerosis is a "marker" of the healthcare success in the state. Treatment is expensive, adapting people with disabilities is a big social problem.

Nevertheless, the latest achievements of medicine allow us to hope that it will be possible to fully control the course of the disease without allowing exacerbations.