Multiple sclerosis: symptoms, treatment, signs, causes

What is it, and how many live with it - multiple sclerosis is a serious neurological pathology, characterized by the presence of foci of demyelination in the structures of the brain.

Foci of lesion are located chaotically. The pathological process involves: the brain, spinal cord, optic nerves and nerve endings.

What is this: Multiple sclerosis refers to a group of rapidly progressing neurological pathologies that, without timely treatment, will soon lead to a disability in the patient due to rapid development.

This disease usually begins at a young age. The average age of patients varies between 15-40 years. Cases of the disease were also reported in children and 1-2 years of life. With regard to gender predisposition, this diagnosis is most common among the female population.

The disease has a chronic nature of the course, and therefore can occur with alternating periods of remission and exacerbation. In the early stages of development, remission periods can occur independently without pharmacological support. However, at present, cases of malignant course of the disease, which is characterized by a rapid steady progression of the pathological process, are not uncommon.

The risk factors for the development of this disease include: young age( mainly from 20 to 40 years), female gender, genetic predisposition( weighed hereditary history - the presence of multiple relatives diagnosis of multiple sclerosis), carrier of the Epstein-Barr virus, the Europoid race,endocrine diseases( various pathologies of the thyroid gland, diabetes mellitus type I).

Causes of Multiple Sclerosis

At the moment there is no clear unambiguous theory that would confirm the direct influence of one or another factor on the development of multiple sclerosis.

However, there are many eligible opinions about possible etiologic causes. Among modern hypotheses of the etiology of this pathology, the following factors are distinguished:

• infections of viral origin transferred in childhood and adolescence;
  
• autoimmune processes localized directly in the structures of the central nervous system;
  
• frequent infections of viral and bacterial origin;
  
• genetic predisposition;
  
• effects on the body of certain toxic substances;
  
• deficiency of vitamin D;
  
• exposure to radiation;
  
• introduction of a vaccine against viral hepatitis.

Symptoms of Multiple Sclerosis

The first signs and symptoms of multiple sclerosis can be completely different and heterogeneous for each new case. The individuality of the symptoms of the disease is explained by the fact that the symptoms of developing pathology directly depend on the location of the pathological foci of demyelination.

So, violations can be observed in absolutely any of the neurological spheres: motor, sensory, mental. The development of multiple sclerosis should be suspected if there are several of the following symptoms:

• muscle weakness;
  
• violation of coordination of movements, asynergia( impossibility to produce combined movements);
  
• tremor and trembling of limbs;
  
• stiffness / spasticity of limbs during motion, their incomplete paralysis;
  
• feeling of numbness, burning, tingling, "crawling crawling" in the distal parts of the upper and lower extremities( brushes, feet);
  
• diplopia( double vision), blurred vision, decreased brightness of the visual image, contrast violation and incorrect distorted perception of the color scale, nystagmus;
  
• dysarthria;
  
• epileptic seizures( see symptoms of epilepsy);
  
• pain syndrome of different localization and severity( headache, muscle pain, shingles along the intercostal spaces and the spinal column - radicular pain, trigeminal neuralgia, pain in the periorbital area);
  
• vibrational movements of eyeballs of a rhythmic type;
  
• rapid fatigue, initially appears only when performing physical exertion, and subsequently arising and in a state of complete rest - a syndrome of chronic fatigue;
  
• sexual and erectile dysfunction;
  
• violation of an arbitrary act of urination( loss of control over it: emergency urges, increased urination, urinary incontinence);
  
• decrease in intellectual abilities, violation of behavioral aspects( unreasonable euphoria, disinhibited behavior, sudden change of mood);
  
• stool retention or incontinence.

Forms of the disease

Depending on the nature of the course, multiple sclerosis is divided into several main forms:

1. 1) Remitting - most common in the early stages of the disease. It is characterized by clear restrictions between the periods of remission and exacerbation. During the periods of calm( remission), the progression of the disease is not observed, all the disturbed functions are restored partially or completely;
   
2. 2) Secondary-progressive - neurological symptoms increase, periods of stabilization of normal functions are less noticeable, the boundaries between periods of exacerbation and remission are gradually erased;
   
3. 3) Primary-progressive - the most severe form, which is characterized by the continuous progression of the pathological process from the very beginning of its development. The periods of stabilization and improvement are extremely rare.

Possible complications of

Early and rapidly progressing multiple sclerosis can lead to death at a young age.

To less threatening, but no less significant complications of this disease include: arterial hypotension, rapid wear of joints, personality change, fluctuations in daily health, loss of body weight, infectious processes localized in the organs of the urinary system, pneumonia, and pressure sores.

Diagnosis of multiple sclerosis

Diagnostic search is based on careful collection of anamnesis, patient complaints, conducting a thorough neurological examination.

To confirm the diagnosis of multiple sclerosis, the following studies should be performed:

• MRI( magnetic resonance imaging) of the brain and spinal cord;
  
• electromyography;
  
• study of cerebrospinal fluid for the presence of immunoglobulins and an estimate of their quantity;
  
• immunological monitoring( blood test for the presence of antibodies);
  
• study of evoked potentials: auditory, visual, somatosensory.

Treatment of multiple sclerosis

Unfortunately, at the moment there is no clinically proven effective scheme for drug treatment of multiple sclerosis.

Thus, the main groups of drugs used to treat this disease include:

• antiviral and immunomodulating medications( Betaferon, Reaferon A, Dibasol, Dalargin);
  
• inducers of interferons( Zymosin, Propper-Nile, Dipyridamole);
  
• cytostatics( Azathioprine, Cyclophosphamide);
  
• glucocorticosteroids( Sinacten Depot, Methylprednisolone, Dexamethasone, Prednisolone);
  
• nootropics, and tissue regenerators, as well as drugs that improve metabolic processes( Piracetam, Actovegin, Cerebrolysin, Solcoseryl);
  
• antihistamines( Suprastin, Calcium gluconate, Tavegil, Claritin);
  
• diuretics( Furosemide);
  
• drugs that improve microcirculation( Nicotinic acid, Toenikol, Tsinarizin, Cavinton, Trental, Curantil, Agapurin) - improve blood flow in the cerebral vessels;
  
• drugs that improve the tone of the vascular wall( Fitin, vitamin E);
  
• muscle relaxants( Tizanidine, Baclofen);
  
• freshly frozen and native plasma;
  
• plasmapheresis( used in severe and extremely severe cases);
  
• detoxification therapy with Hemodesis.

Treatment of multiple sclerosis depending on the degree of severity and time of disease progression can be divided into several types:

1. 1) Treatment aimed at direct slowing down the progression of the pathological process;
   
2. 2) Treatment aimed at reducing the severity and duration of periods of exacerbation;
   
3. 3) Symptomatic treatment of the disease;
   
4. 4) Supportive rehabilitation, which allows to extend the periods of remission.

In no case should we neglect complex supportive rehabilitation, which includes: physical therapy with the use of an individual problem approach, adaptation to neurological deficits and occupational activities( occupational therapy), psychological and social adaptation, resolution of issues related to the violationspeech, swallowing, functioning of the intestine and organs of the urinary system.

Preventative measures

Specific prevention of multiple sclerosis does not exist. This is due to the lack of specific etiological factors.

At the moment, experts recommend a healthy active lifestyle, avoid stressful situations, monitor body weight, do not overheat and do not overcool, conduct active prophylaxis in the periods of epidemics of infectious diseases, not allowing infection by viral and bacterial infections.

Lifetime with Multiple Sclerosis

With the help of adequate treatment, the likelihood of death or ilavidization can be minimized, and the life expectancy of multiple sclerosis will not significantly differ from the usual and can be up to 35 years or more.

How many will live with it will also depend on the form of the disease, as in ¼ of patients there is an acute form of pathology, which significantly shortens the life span to 5-6 years. With the usual course of sclerosis and without the appointment of timely treatment, disability can occur in the first 8 years from the onset of the disease.

Do not forget about modern technology, which every year move forward and give a chance to cure for multiple sclerosis.

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