Features of diagnostics and treatment of multiple sclerosis
One of the most dangerous diseases in neurology is multiple sclerosis, diagnosis is based on clinical data and the results of the study of the brain. The disease is chronic. Most often it is found in young persons aged 15 to 40 years. The disease progresses steadily and has a poor prognosis for health. The basis of multiple sclerosis is a malfunction in the immune system, against which there is damage to nerve fibers throughout the body. What is the etiology, clinical picture and diagnosis of the disease?
Multiple sclerosis is a pathology of autoimmune origin occurring in the chronic form and is characterized by lesions of the nervous tissue (myelin sheaths of the fibers). In the process may involve any structure of the brain and spinal cord. Older persons suffer from this disease is very rare. Also rarely discovered multiple sclerosis in young children. The disease occurs almost in all countries of the world. Currently the total number of patients is estimated to be two million. The incidence rate is on average 20-30 patients per 100 thousand population. In some areas of our country the incidence is up to 70 cases per 100 thousand.
Defines a pattern between disease and living conditions. Urban residents suffer from this disease more often. Women suffer more often than men. In childhood among patients prevail girls. Europeans suffer from this disease more often people of African, Asian and other countries. The disease in neurological practice, is one of the leading causes of disability in the population. To date, there are 2 main clinical types of the disease: diffuse sclerosis Schilder disease and Marburg. The second variant is characterized by severe course and high percentage of lethal outcome.
Multiple sclerosis refers to the diseases of unspecified etiology. The exact cause of the disease is not established. The basic theory of developing the disease based on autoimmune disorders. In healthy people, the lesions of the Central nervous system (brain and spinal cord) precludes the blood-brain barrier. Patients patients fail in the functioning of the immune system. Against this background, cells of the immune system (lymphocytes) have a damaging effect on the nerve fibres by destroying myelin sheath. There is inflammation and in the damage scar tissue forms. Normal nerve tissue is replaced by connective.
Scar plaques impede the transmission of signals through the body, which leads to the dysregulation of the functions of other organs. Almost always in multiple sclerosis lost the ability to move. Possible contributing factors are:
- genetic susceptibility
- bad environmental conditions;
- insufficient exposure to sunlight
- infection of the body by bacteria or viruses;
- exposure to radiation
- negative influence of toxic substances.
People living in the Nordic countries, have multiple sclerosis much more often. This is due to the deficiency of vitamin D.
The Disease for a long time may be imperceptible to humans. Early symptoms can be absent at all. Neurological manifestations occur when the affected 40-50% of the nerve fibers. The symptoms of multiple sclerosis can be:
- speech disorders
- oculomotor disorders (nystagmus);
- neuritis of the 2nd pair of cranial nerves
- decreased visual acuity in one or both eyes;
- pain in the eye apples;
- violation of skin sensitivity
- sexual dysfunction.
Often, multiple sclerosis suffers function of pelvic organs. Thus there is a violation of the chair according to the type of constipation or diarrhea, incontinence, frequent urge to the toilet. With the defeat of the fibers of the brain can impair memory, attention, intelligence decrease. Patients are changeable in mood. In multiple sclerosis can be determined by positive pyramidal signs (increased tendon reflexes). Multiple sclerosis can cause partial paralysis of the limbs. More often affects the lower limbs. In the case of cerebellar patients complain of poor coordination, tremor.
How is diagnosed with multiple sclerosis? Diagnosis of multiple sclerosis include:
- external examination
- neurological examination
- research tool
- laboratory investigation.
The Diagnostic value has the character of the disease. Multiple sclerosis develops slowly, in waves with periods of exacerbation. There are clinical criteria by which to recognize it. These include:
- the presence of 2 or more exacerbations;
- the interval between exacerbations than 1 month;
- duration of exacerbation for at least a day;
- slow the progression of the disease (lasting more than six months).
Today in the diagnosis of multiple sclerosis used the method of evoked potentials.
A Study to assess the condition of visual, somatosensory and auditory systems. Recorded potentials that occur in response to various stimuli. Additional methods of diagnosis include examination of blood for presence of antibodies and electromyography. The condition of the nervous tissues is assessed by means of MRI. When demyelination occurs the redistribution of water. When MRI is determined by the change in the density of nerve tissue. Today special paramagnetic contrast substance. The diagnosis of multiple sclerosis is placed in the presence of foci that accumulate contrast agent and those that do not accumulate.
Therapeutic measures depend on the nature of the course of multiple sclerosis. Therapy should be aimed at addressing the underlying symptoms, prevention of exacerbations. Etiotropic treatment has not been developed. In the period of exacerbation of the disease following drugs: glucocorticoids for systemic effects, beta-interferon ("Rebif, Avonex, Betaseron"), cytostatics and monoclonal antibodies. These drugs alleviate the symptoms of the disease and reduce the number of attacks. To strengthen the body and improve nutrition of the nervous tissue are used angioprotectors, antiplatelet agents, enzyme preparations, antioxidants, nootropics.
To eliminate the spasm of the muscles being exercises, massage. Patients are encouraged to optimal physical activity. It is recommended swimming. To improve motor functions recommended physical therapy. With timely treatment, patients can live for years. In advanced cases, patients need constant care. Thus, multiple sclerosis is a terrible disease which, in the absence of adequate therapy leads to disability.