Multiple sclerosis is a chronic inflammatory progressive disease, which is based on damage to the central nervous system as a result of an autoimmune response. This response is a pathological reaction of our immune system to our own nerve cells and their connections in the brain and spinal cord.
Very often, the symptoms at the onset of the disease are not specific and may be similar to the symptoms of other diseases. Sometimes this causes a long diagnostic search. On the other hand, there are frequent cases when such a “non-specificity” of symptoms leads to overdiagnosis of multiple sclerosis.
The main manifestations:
- numbness, tingling in arms, legs, body;
- muscle weakness, which makes it difficult to hold items (in medicine this is called paresis);
- visual impairment, pain in the eyes (often in one, which is accompanied by a decrease in visual acuity and double vision);
- impaired coordination – shakiness and instability when walking;
- speech impairment;
- various disorders of urination.
Multiple sclerosis is characterized by a combination of several symptoms at once.
How fast can a doctor make a diagnosis?
Given the variety of symptoms that may appear implicitly at the onset of the disease, it can be difficult for a doctor to make a diagnosis. Of the examinations, a neurological examination, as well as an examination by an ophthalmologist to assess the condition of the optic nerve head disk, is most important. Prior to the era of MRI and CT, examining a doctor was the only diagnostic method.
Today, neuroimaging comes to the rescue: MRI of the brain and spinal cord, during which the administration of a special contrast fluid is often required in order to assess whether multiple sclerosis is in an exacerbated state or not. A study of evoked potentials can help a doctor – it refers to functional diagnostics, shows the conduction of nerve impulses in the spinal cord and brain. A spinal puncture will also be required to confirm the diagnosis.
Types of Multiple Sclerosis
The most common variant of the course is remitting. In this case, the symptoms come and go, when new symptoms occur or the resumption of those that were earlier, it is customary to talk about an exacerbation or attack. Each attack can last several days, sometimes weeks, then recovery begins gradually.
In the case when the symptoms after the first exacerbation do not go away, but constantly increase with each new attack, we are talking about a primary progressive course.
A secondary progressive course is also distinguished: at first the patient may notice obvious exacerbations and improvements (remitting type), but then gradually the symptoms do not go away completely, but continue to accumulate.
A more rare option is progressive with exacerbations : the severity of symptoms is gradually exacerbated, but there are attacks in which there is a sharp deterioration.
The nature of multiple sclerosis
The exact causes and development mechanism (pathogenesis) of multiple sclerosis are unknown. The following can be distinguished: an autoimmune mechanism that occurs as a result of an attack of our own nervous system by lymphocytes in our body; it is assumed that this process proceeds against the background of a chronic viral infection, for example, when cytomegalovirus, a herpes zoster, is activated, however, the studies conducted have not shown a clear relationship with any one virus.
The “non-immune, non-inflammatory” etiology (cause) against the background of genetic disorders leading to the degeneration of neuroglia (auxiliary cells of the nervous system) is also discussed. One of the reasons may be a deficiency of vitamin D. Of the environmental factors, one can distinguish a geographical one – there is an increase in the prevalence of multiple sclerosis from south to north, and this disease predominates in Russia,
More often, multiple sclerosis affects women, according to some reports, the ratio of “women – men” reaches 2: 1. Most often, this disease affects young people aged 20–35 years, but there are cases of earlier (in childhood) and later (after 50 years) onset of the disease.
What is the treatment
There are several treatment options: removal (relief) of exacerbations and prevention of exacerbations, treatment of symptoms, that is, individual disorders that significantly reduce the quality of life and rehabilitation. Different drugs are used to stop attacks, more often than other hormones, so-called pulse therapy with high doses of these drugs is carried out – usually this course takes 3-5 days.
To prevent exacerbations, the appearance of new lesions in the spinal cord and brain, there is a whole group of drugs belonging to different classes, they are combined under the name PITRS – drugs that change the course of multiple sclerosis. It is important to know what type of disease the patient is and the associated pathologies in order to choose the right drug. Some of these medicines are available at public facilities for free.
The treatment of individual symptoms is usually carried out jointly by several specialists – for example, urination disorders by a neurologist and urologist. Often, patients with multiple sclerosis need rehabilitation to improve coordination, muscle strength. However, unfortunately, it cannot be said yet that we can completely cure the patient from such a disease.
How to behave with a person who has been diagnosed with multiple sclerosis
Multiple sclerosis manifests itself differently in each patient: we can observe extremely rare exacerbations at the onset of the disease, but the disease progresses rapidly after a few years. There are reverse cases. Usually, at least 10-15 years elapse from the time of diagnosis to the patient’s steady, severe symptoms that affect the quality of life. There are many cases of very slow progression, when the symptoms intensify only after 20-25 or more years. Regardless of how multiple sclerosis proceeds, the diagnosis itself is perceived very hard. Moral support is needed for relatives and friends.
There are communities of patients with multiple sclerosis, where you can get not only emotional support, but also a lot of useful information about the treatment. It is important that the patient does not remain alone with the disease, he tries to actively fight it. Yes, and the lifestyle of patients with multiple sclerosis should not change dramatically, there are no strict restrictions other than avoiding insolation and increasing body temperature – that is, it is better to take an antipyretic with ARVI on time and not go to the sauna. A patient with multiple sclerosis is a person who is obliged to maintain an active lifestyle in order to maintain his health, receive vivid impressions, and, if possible, play sports.
A stereotype of a patient with multiple sclerosis is formed in society as a person who will certainly become disabled after some time, although this is far from the case.
This opinion affects others, making them feel sorry for such people. Patients themselves may feel lost, unable to continue their usual way of life, avoid communication, travel, interesting meetings. Therefore, my main advice: treat a patient with multiple sclerosis as before and certainly not with pity.