Multiple sclerosis

Multiple sclerosis

Description of multiple sclerosis

Multiple sclerosis is a disease of the central nervous system.For each of the symptoms and the disease course they are totally different, because it depends on the affected areas of the brain and spinal cord. The process is completely unpredictable – someone experiencing slight physical problem and someone can occur only in severe disability.

Most often occurs in young people between twenty and forty years of life. In the Czech Republic, there are about 10,000 people suffering from multiple sclerosis. There is still no known cause, and therefore has not been found and no cure.

Multiple sclerosis attacks the white matter of the brain, which leads to nerve vzruchům the senses and to the muscles.Violations and the disintegration of the myelin sheath that insulates and envelops nerve fibers (axons). Places where the interruption of the myelin sheath, called plaques.

Myelin helps transmit nerve impulses. If axons loose some myelin transmitted pulses are not correctly transmitted, resulting in the symptoms of multiple sclerosis. Although the CNS cells are able to some extent to restore the myelin sheath, produced on the scars. With the increase in the number of scars are the symptoms become more pronounced and noticeable.

With the destruction of the myelin sheath in some cases related to the loss of nerve fibers known asaxonal loss. You can not replace.

Gray matter, responsible for thinking, memory and consciousness, is not attacked.


Cause and risk factors for multiple sclerosis

Multiple sclerosis is defined as an autoimmune disease where the immune system attacks its own organs and tissues. In this case, the immune system attacks the myelin sheath of nerve fibers.

Although the cause of the disease is still unknown, it is believed several potential factors:
Its development may play a role hitherto unknown virus. It could even be called. Retrovirus that may scrape along in our body for several years without symptoms. This rise could encourage infectious diseases, strenuous physical exertion, hypothermia, sunbathing and mental stress.

The actual condition is often exacerbated by childbirth, breastfeeding and during pregnancy. Woman suffering from multiple sclerosis are entitled to free abortion, since they are high-risk pregnancies. On the other hand, just after abortion cause deterioration.

It is also envisaged certain hereditary disposition, which is determined by susceptibility to reactions of the immune system. If a family member occurs with multiple sclerosis have its close relatives risk of disease outbreak of from about 1:50 to 1: 100. However, only 20% of patients with MS is among the closest relatives of a patient with MS.

Some studies work on the connection between vitamin deficiency (especially D, B) and RS.Furthermore, considering the heavy metals, excess fatty acids in the diet, neuroalergiích and disorders of blood vessel walls.

Multiple sclerosis affects women almost twice as likely as men (about 3: 2).

Studies have shown that the risk of greatly influences the environment in which we live. In a world in tropical and subtropical regions of RS almost non-existent, which could be related with that lack of vitamin D. The greatest incidence of multiple sclerosis in the Czech Republic in North Bohemia, which could in turn have links with impaired environment. Doctors suggest that people in this area have compromised immune system and are prone to autoagresivnímu behavior.


Signs and symptoms of multiple sclerosis

Multiple sclerosis has no specific symptoms. May exhibit a variety of symptoms, it may be shot any region of the central nervous system.

The most common symptoms include decreased sensitivity and tingling in the extremities.

Overall coordination of movements and mobility can be more or less affected. One of the characters is so frequent. Lhermitte’s sign, that sick feeling in the form of electrical pulses during překlonění head.

It might also disturbed vision, for example, uncontrolled oscillations eyes or double vision. One of the first symptoms may be inflammation of the optic nerve – called. Optic neuritis or retrobulbar.Sick of feeling pain behind the eye, blurred vision or double, has a field of view outages and reduced perception of sharpness.

In some cases, the patient may have trouble with pronunciation and fluent speech.

The illness often accompanies chronic fatigue. Dizziness may occur and seizures. Multiple sclerosis is often accompanied by depression and disgust to life.

These problems can persist for weeks or months.


Examination of multiple sclerosis

It is not easy to diagnose multiple sclerosis, because there are no reliable tests. The doctor must rule out all possible diseases.

First, we discuss your personal history, where it will be most interested symptoms.

Then uses some of the available tests:
Magnetic resonance imaging provides three-dimensional images of organs and structures without radiation ray. Investigations are carried out in a narrow tunnel, which can cause unpleasant feelings of uneasiness. But do not worry, the doctor puts the device in your hand, which you can immediately call in case of trouble. The tunnel is also illuminated the darkness worsen an already uncomfortable.

Suspicious changes (inflammation, scarring) in the central nervous system appear in a light color.
Magnetic resonance imaging is a valuable aid in the diagnosis, but not sufficient to confirm the disease MS.

Using computed tomography (CT) can be combined with X-rays and computerized evaluation, and thereby obtain cuts in body and organs from many perspectives. Cross-sections are shown and soft tissue with eventual tumors that plain radiograph miss. The advantage of this test is low radiation burden.

CSF examination is performed lumbar puncture, so. Lumbálkou. Here, the determined level of gamma-globulin, plasma cells, lymphocytes and total protein.

Evoked Potentials (EP) means record the electrical activity in the brain to certain stimuli. Getting throughput impulses to the cerebral cortex based on the evaluation of the time between the stimulus and the response. Investigations last approximately one hour and is similar to EEG, which puts you on the head several electrodes. They will reflect the changing chessboard, then venturing into the headphone sounds of different intensity and pain perception test using electrodes on the wrist and ankle. This method is used in addition, because the result is not always conclusive.

The course of MS can be divided into two classes: benign when there are few attacks, and the defect may be minimized and years; and malignant, which leads to frequent attacks, a rapid increase in disability.

The doctor can tell you the stage RS:

  1. Remitting – relapsing (RR) are among the most common forms of illness and disease that usually begins. Usually it lasts several years and is accompanied by attacks or relapses,which means worsening neurological disorders. Half of patients have had troubles and do not visit a doctor until it comes heavier attack. To have suffered atakách there is a partial or full recovery if the body replaces the damaged myelin.

The less attack patient undergoes and what have lighter periods, the better the forecast for the future. There may be only one attack, and the disease may not manifest for a long time. Only at this stage can influence disease drugs.

  1. In the secondary stage chronickoprogresivním leads to permanent disability because the body is no longer able to regenerate. This form is referred to as secondary, although remitting – relapsing stage to this stage may not go. Even at this stage a person is able to live normally and work – it depends on the affected brain function.

At this stage it is important attitude and cooperation of the patient, because the correct habits (diet, exercise) can better keep his skills.

  1. Primary progressive form occurs mainly in patients who become sick after the 40th year of life. Disability is gradually increasing, and it is not possible to influence him drugs.
  1. Relapsing – progressive stage is a very rare form when, after atakách have minimal healing. The goal of treatment is to stop the progression of the disease at any cost.

For assessment of the advancement of multiple sclerosis is most often used for the Kurtzke disability scale or EDSS.

0 – normal neurological findings

1 – moderate difficulty, only small differences in neurological findings

2 – a slight problem, minimum limitation, weakness lightweight, easy gait disturbances, and oculomotor disturbances,
neurological finding small

3 – significant impairment, impaired mobility and performance, maintaining work ability

4 – heavier disability, reduced working capacity, a normal way of life possible, worse sexual

5 – significant disability, inability to work, maybe a separate walk for short distances

6 – movements with the help of a cane or crutches, moving short distances, small household chores

7 – momentum even impossible, dependence on a wheelchair, maintaining basic self-sufficiency

8 – lying, limited self-sufficiency unable movements in wheelchair

9 – helpless, helpless

10 – Death

This scale may be supplemented NRS scale. Its advantage is that, unlike the EDSS reflects mood and cognitive skills. Normal neurological finding a zero score, grade 1+, 2+, 3+ and 4+ indicate improving and steps -1, -2, -3 and -4 deterioration.


Treatment of multiple sclerosis

To treat doctors have different opinions. Some support conservative treatment using means of support during the attacks, while others radical dormancy. However, the sooner MS is discovered, the greater the chance to slow down the development of the disease.

Treatment consists in preventing attacks, disease progression, and relief from the hassles.Concurrently with the appropriate drug therapy and physical therapy, the patient should undergopsychotherapy and supportive.

There are several options in pharmacotherapy:

Treatment of acute attack (relapse) is solved by administering high doses of corticosteroids(dexamethasone, metylprednizol). Inflammatory effects and accelerate recovery from attacks.However suspensive progression of the disease or relapse nezbraňují.

To reduce the number of relapses are used so. drugs of first choice, that fight against the development of the disease and the extent of relapse.
They are used to interferons (beta 1b, beta-1a), which have anti-inflammatory effect. Stimulates the central nervous system, thereby reducing penetration of inflammatory cells. But treatment is accompanied by side effects such as painful redness at the injection site, flu-like symptoms, elevated liver tests, reduced blood cells and platelets. There are several types that differ in the number of doses per week, mode of administration and the amount of substance. Is needed regular blood tests.

Also important is symptomatic therapy, which leads to mastery of MS symptoms.

Administered painkillers, antidepressants, anti-vertigo (Theadryl, Medrin) against difficulties with urination (Ditropan, Mictonorm) and for sexual difficulty (Apomorphine, Tadalafil, Vardenafil, Sildenafil).

In the treatment of multiple sclerosis and uses the help of physiotherapists. Physiotherapists are fighting against the weakness of muscles and stretching shortened muscles. They use many methods such as exercises, physical training, Vojta method, Bobathova method, Kabat exercises, hippotherapy, electrotherapy, hydrotherapy and massage. A person suffering from MS is entitled to every two years to stay in the spa – going in Vráž near Pisek, Dubi near Teplice, Klimkovice near Ostrava, Piestany and Trencianske Teplice.


How can I help myself

The patient should avoid stress, because it was confirmed by the studies of the relationship between increasing stress and neural brain damage.

Sick benefits sunbathing reasonably. Conversely, intensive sunbathing, overexertion and hot baths may worsen symptoms.

It is also appropriate light exercises to improve muscle strength and flexibility. Never Do not exercise if you have acute symptoms. Certainly not suitable physically demanding job.

Not only patients but also family members can help to specialized clinics.

Your doctor can advise you how to eat well. There are many special diets that help slow the progression of the disease.

Food supplements are designed to increase the antioxidant activity for protecting nerve cells against free radicals to promote formation of fatty acids and other substances involved in the construction of the nerves and relieve inflammation.

You can start multivitamin preparations or the advice of his doctor to create your own dose of vitamins. You do not have a favorable effect noticeable immediately, but after a certain time.

Antioxidants are important during the treatment of multiple sclerosis are the vitamins C and E.The recommended dosage is about 500mg of vitamin C and vitamin E 250mg twice per day.

It may also be recommended by the B-complex and vitamin B12 as they help in maintaining the structure and function of nerves.

The studies done on animals have revealed a possible relationship between vitamin D to multiple sclerosis. Multiple sclerosis is rare in tropical areas, where levels of vitamin D increases and sunbathing on the Norwegian coast, where they often eat seafood full of vitamin D. Too much vitamin D can be toxic, so further studies are required.

Suitable supplements also include fish oil, evening primrose oil and ginkgo biloba (ginkgo biloba) to improve blood flow to the nervous system. Vegetarians can substitute fish oil, linseed oil.

You can also try zinc, lecithin, carnitine, St. John’s wort, black cohosh, ginseng, ginger and oats.

From the experience of patients, each patient should be careful when crossing the road. It may happen that you see the car running, but you do not have to be that on the road you do not enter.

You can also lose the sensitivity of the skin and clothes you can greatly annoy – biting, scratching like. In this case, try to find you the most comfortable clothes made of natural substances.

Other Names: multiple sclerosis, RS ereska, multiple sclerosis

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