How to understand that I have cured the rs test. Multiple sclerosis: diagnosis of the disease

Most often, the lesion is localized at the level of the white matter of the cerebral hemispheres, but can also be observed in the cerebellum, brain stem, and spinal cord. The lesions have a denser consistency, they are called multiple sclerosis plaques. On CT scans they appear as lighter lesions in the substance of the brain or spinal cord. The symptoms of the lesion largely depend on the area affected by autoimmune inflammation.

Symptoms and signs of multiple sclerosis

Chronic fatigue. May manifest as constant drowsiness and decreased performance. Symptoms of fatigue most often appear in the afternoon. In this case, the patient feels signs of asthenia - a decrease in the strength of muscle contraction, rapid fatigue during physical activity. Mental stress is also difficult for such patients; mental acuity, attentiveness, and the ability to assimilate new information are lost.
Increased sensitivity to increased body temperature - taking a hot bath or shower, being in a bathhouse or in a heated room can provoke an exacerbation of symptoms of the disease, a sharp deterioration in overall health.
Muscle spasms can occur as complications of the inflammatory process of the central nervous system pathways. In this case, a tendency to spasm of certain muscle groups develops.
Dizziness occurs against the background of normal blood supply to the brain and normal blood glucose levels. Typically, patients complain that it is difficult for them to maintain balance due to the fact that the environment is in motion.
Impaired intelligence and cognitive ability. Increased fatigue leads to the fact that it becomes difficult for the patient to perceive new information, but at the same time, even once perceived information can be lost by the patient after a short period of time. This manifestation of multiple sclerosis, along with movement disorders, is the main reason for the patient’s loss of ability to work.
Visual impairment is usually felt acutely by the patient. Most often, only one eye is affected. First of all, the patient loses the color of the image and says that the surrounding objects have faded. He also complains that the vision in the affected eye is blurry and lacks clarity. As a rule, after a course of treatment, visual acuity is restored, but color impairment may remain at the same level.
Tremors in the limbs - involuntary hand tremors. It is, of course, not as pronounced as in Parkinson's disease and differs from it in that it has a small amplitude. It is difficult for the patient to do delicate work - thread a needle into the eye, draw, change handwriting, draw, etc.
Gait disturbance – from the outside, such patients walk as if they are very tired. This is associated with a pronounced feeling of fatigue, although the patient did not have any physical activity during the day.

Diagnosis of multiple sclerosis, MRI diagnostics, spinal puncture, cerebrospinal fluid analysis, evoked potentials

Nuclear magnetic resonance in the diagnosis of multiple sclerosis

This research method allows you to obtain layer-by-layer images of sections of certain parts of the body. To diagnose the topography of lesions in multiple sclerosis, MNR is performed in the head region or certain areas of the spinal column.

The tomogram reveals foci of increased density with clearly defined edges of a rounded shape, about 5 mm in size. , no more than 25 mm. The lesions are usually located near the ventricles of the brain in the area where the white medulla is located.

Currently, when performing MRI, preference is given to a technique in which preliminary contrasting of lesions is performed by introducing a special contrast agent (gadolinium), which reveals lesions that have arisen as a result of the blood-brain barrier being broken. When the blood-brain barrier is disrupted, blood plasma, which normally should not penetrate the brain tissue, leaves the vascular bed and penetrates the brain tissue. Violation of this barrier is the main sign of the inflammatory process in brain tissue. Therefore, it is possible to detect the activity of the inflammatory process.

Cerebrospinal fluid examination

To confirm the diagnosis of multiple sclerosis, in some cases, against the background of an exacerbation of the disease, a spinal puncture, sampling of cerebrospinal fluid and its biochemical and microscopic examination are required.

What is a spinal tap?

A spinal puncture is a manipulation performed by a neurologist. During a spinal puncture, a puncture is made with a long special needle in the lumbar region of the spine between the vertebrae. When a needle enters the spinal canal, cerebral fluid flows out of the canal, which washes the spinal cord and brain.

What is revealed by microscopy of cerebrospinal fluid?

After the spinal fluid is collected, it is sent to the laboratory for special analysis.

Microscopic examination of the spinal fluid determines the color and cellular composition of the fluid.

In multiple sclerosis, as a rule, the number of red blood cells in the fluid is normal, but there is a moderate increase in the level of lymphocytes.

What does a biochemical analysis of cerebrospinal fluid reveal?

The protein content in multiple sclerosis in the acute phase may be slightly increased. However, the increase in protein levels rarely exceeds 1.0 grams/liter

Determination of myelin basic protein is a key indicator in diagnosing multiple sclerosis and assessing its activity at the time of examination. The fact is that with multiple sclerosis, the myelin sheath is damaged by the immune system. Accordingly, during an active process, the first thing that occurs is the breakdown of myelin tissue with the release of free myelin protein into the cerebrospinal fluid. Therefore, during the first two weeks from the moment of exacerbation of the autoimmune process in multiple sclerosis, myelin basic protein is found in large quantities in the spinal fluid. This indicator is the most reliable criterion in the diagnosis of multiple sclerosis.

Study of bioelectrical activity of the brain (evoked potentials)

When examining visual, somatosensory or auditory evoked potentials, signs may be observed that indicate this. That there is a violation in the conduction of tactile, auditory or visual information along the pathways.

Treatment of multiple sclerosis, drugs used in treatment

Unfortunately, curing multiple sclerosis is currently an impossible task. The thing is that damage to the nervous tissue that led to the destruction of certain areas takes a long time to recover, and in some cases cannot be restored at all. Therefore, the consequences of multiple sclerosis can lead to irreversible consequences. All that a neurologist can do for this disease is to reduce the likelihood of re-exacerbation of multiple sclerosis, minimize the consequences of damage to the brain pathways, and stimulate the regenerative properties of nervous tissue.

Treatment tactics for different forms and stages of the disease are different and are determined individually by the attending neurologist, depending on the dynamics of the process and the general condition of the patient.

Prevention of exacerbations of multiple sclerosis

It is produced using drugs that suppress the activity of the immune system.

The drugs in this group are varied: steroid hormones, drugs that slow down cell division processes (cytostatics), certain types of interferons.

Steroid drugs(prednisolone, Kenalog, dexamethasone) have an immunosuppressive effect. These drugs reduce the activity of the entire immune system, suppress the processes of immune cell division, the activity of antibody synthesis, and reduce the permeability of the vascular wall. But along with all the positive properties, steroid drugs have a number of side effects that do not allow the use of this group of drugs for long-term treatment. Side effects of steroid drugs: gastritis, increased intraocular and blood pressure, increased body weight, psychosis, etc.

Drugs from the group of cytostatics(azathioprine, cyclophosphamide and cyclosporine, methotrexate and cladribine). I have an immunosuppressive effect, but the high level of side effects similar to those when using steroid drugs makes this class of medications unsuitable for long-term use.

Interferon-r(IFN-p) This drug has an immunomodulatory effect, influencing the activity of the immune system. The list of side effects is acceptable in order to recommend this drug as a preventive treatment for multiple sclerosis.

Multiple sclerosis is a chronic disease that affects the spinal cord and brain. It occurs as a result of the occurrence of inflammatory foci on the myelin. This is fatty tissue located around the spine and brain that protects them like the insulation of electrical wires. Damage to the myelin sheath leads to further spread of inflammatory foci throughout the central nervous system.

This disease should not be confused with the word “scattered” contained in its name means nothing more than the presence of small foci of the disease, which seem to be scattered throughout the nervous system. But “sclerosis” indicates the nature of the disorders. This is scar tissue that looks like a plaque. In medicine it is called sclerotized.

Prevalence of pathology

Patients with multiple sclerosis are, as a rule, young people aged between fifteen and forty years. But the disease has exceptions. Sometimes it is observed both in childhood and in adulthood. However, when a person has crossed his fifty-year mark, the risk of this pathology decreases significantly.

Multiple sclerosis occurs three times more often in women than in men. But at the same time they tolerate the disease more easily.

Geographical and ethnic factors influence the prevalence of the disease. Thus, people from North America and Northern Europe suffer most from multiple sclerosis. This is due to a lack of vitamin D, which is produced in the human body under the influence of sunlight. But Koreans, Chinese and Japanese practically do not know about this pathology.

Who else is affected by multiple sclerosis? The risk group is people living in large cities. In rural areas, pathology occurs less frequently. All these facts indicate that the development of multiple sclerosis is influenced by an unfavorable environment.

The disease is quite common. This is from 20 to 30 cases for every hundred thousand people in the population. Moreover, many young people diagnosed with multiple sclerosis become disabled after injuries they have sustained.

Why does the disease occur?

The reason why multiple sclerosis occurs is still not clear. But in recent years, scientists have associated the development of this pathology with disturbances in the functioning of genetics and the immune system.

In a normal state, our “body defense” reacts sharply to the penetration of an unknown object into the body, which can be any virus or microorganism. She first attacks the “invader” and then removes him. The speed of this process is influenced by the speed of connection between the links of immunity, as well as the production of cells designed to eliminate danger.

What happens with multiple sclerosis? Scientists believe that the immune system is altered by the virus. She begins to perceive myelin as a dangerous object and attacks the cells of this fatty tissue. This phenomenon is called “autoimmunity.”

4. Mental and emotional disorders. The reason for contacting a doctor may be a feeling of fatigue after a long rest. This is an early sign of multiple sclerosis. The disease also manifests itself in cases where it is difficult for a person to remember or retell information. Signs of pathology are also constant irritability and dissatisfaction, lack of former ambitions and depression, as well as excessive “playing to the public.” Of course, after 40-45 years, any person will attribute all these signs to impending old age. However, young people in this case should consult a doctor.

5. Feeling constantly tired. Of course, it is familiar to workaholics, young mothers and students. However, if it persists, you should consult a doctor. A feeling of constant fatigue overtakes patients with multiple sclerosis already in the morning hours. While still lying in bed, they have a feeling of heaviness, like after working a triple shift. Sometimes a similar feeling comes over the patient right on the street.

6. Failure of the menstrual cycle in women. The presence of foci of pathology on nerve fibers leads to hormonal imbalance and general disorder of the reproductive system.

7. Intestinal dysfunction. A person’s digestive system can tell them about the first signs of multiple sclerosis. If, despite eating little flour products, he rarely goes to the toilet for a long time and constipation has become more frequent, then this should be a cause for concern. Of course, such symptoms often occur during sudden weight gain, when changing a diet to lose weight, or during pregnancy. And here it is necessary to analyze whether you have any other signs of multiple sclerosis.

8. Hand trembling. If a person notices that he has difficulty fastening buttons or threading a needle, this may be the first sign of multiple sclerosis. After all, one of the symptoms of pathology is hand trembling.

Multiple sclerosis is an insidious disease due to the variability of symptoms.

Today a person may have a sore eye, but tomorrow he will feel only dizziness and weakness. Then everything may stop, and the patient will begin to feel quite normal.

Diagnostics

In order to determine the presence of the disease, a specialist conducts a neurological examination of the patient and an oral interview. Additional research methods are also used.

The most informative of them today is considered to be magnetic resonance imaging of the spinal cord and brain. In addition, while monitoring the patient, the doctor refers him to immunological monitoring, that is, regular blood tests.

Treatment of multiple sclerosis

To date, scientists have not yet found a cure to save people from this disease. Doctors for patients diagnosed with multiple sclerosis prescribe medications during the course of therapy that relieve the symptoms of the disease, alleviate the condition, and also prolong the period of remission and prevent the occurrence of various complications.

Treatment for exacerbations

Today, two types of therapy are used to eliminate multiple sclerosis. The first of them is taking medications for exacerbations and deterioration of the patient’s condition. The second type of therapy is interval therapy. It is used for those patients who experience long-term improvement in their condition after being diagnosed with multiple sclerosis. In this case, patients take the medicine for a long time.

An exacerbation is a deterioration in health that lasts more than a day. In this case, the patient is prescribed adrenocorticotropic hormone and cortisone in the form of injections or tablets. This allows not only to relieve inflammation, but also to prevent the occurrence of functional disorders. The greatest effect with this therapy is provided by a combination of drugs such as Cortisone and Cyclophosphamide. The doctor will also individually select medications to eliminate the patient’s symptoms.

Integral treatment

The goal of this therapy is to restore nerve cells in the period between exacerbations. At the same time, medications prescribed by a doctor protect the spinal cord and brain from attacks by the immune system.

During this period and when multiple sclerosis is in remission, treatment is carried out using drugs such as Cyclosporin A, Azathioprine, Mitoxatron and others.

Sometimes the patient is offered surgical treatment. In order to reduce the immune attack, his spleen may be removed or sometimes such patients undergo a bone marrow transplant.

You can also support the patient at home. How, then, is multiple sclerosis treated? Folk remedies recommended by healers:

1. Garlic oil. To prepare it, the chopped head of the vegetable is infused in sunflower oil. Consume with lemon juice.
2. Honey with onions. This remedy strengthens the blood vessels of the extremities and resolves blood clots. To prepare it, squeezed onion juice is mixed with honey.
3. Alcohol tincture of garlic. This remedy fights sclerotic formations and helps relieve vascular spasms.

In addition, traditional medicine recommends that all patients with multiple sclerosis not include sweets in their daily diet. The menu should include foods with low cholesterol levels, as well as those that do not cause high blood pressure. In this case, it is advisable to season the dishes with vegetable oils. Frequent drinking of green tea and natural juices is also recommended.

Life expectancy of people with multiple sclerosis

How many years are measured for patients suffering from this neurological disease? It depends on the:

Timely diagnosis;
- age at which the disease began;
- effectiveness of treatment;
- development of various complications;
- presence of other pathologies.

How long do people live with multiple sclerosis? At the beginning of the 20th century, patients with this diagnosis were given a maximum of thirty years. And this is only if the course of the disease was favorable.

How many people live with multiple sclerosis today? In the 21st century, due to the development of medicine, these people receive more comprehensive treatment. On average, their lives are seven years shorter than their peers. However, every rule has its exceptions, so it is very difficult to reliably predict the development of events.

Multiple sclerosis is a disease of the nervous system that occurs in young and middle age (15-40 years).

A feature of the disease is the simultaneous damage to several different parts of the nervous system, which leads to the appearance of a variety of neurological symptoms in patients. Another feature of the disease is its remitting course. This means alternating periods of deterioration (exacerbation) and improvement (remission).

The basis of the disease is the formation of foci of destruction of the nerve sheath (myelin) in the brain and spinal cord. These lesions are called multiple sclerosis plaques.

The size of the plaques is usually small, from a few millimeters to several centimeters, but as the disease progresses, the formation of large confluent plaques is possible.

Causes

The exact cause of multiple sclerosis is not clearly understood. Today, the most generally accepted opinion is that multiple sclerosis can arise as a result of a random combination of a number of unfavorable external and internal factors in a given person.

Unfavorable external factors include

frequent viral and bacterial infections;
influence of toxic substances and radiation;
nutritional features;
geo-ecological place of residence, its influence on the body of children is especially great;
injuries;
frequent stressful situations;
genetic predisposition, probably associated with a combination of several genes that cause disturbances primarily in the immunoregulatory system.

In each person, several genes simultaneously participate in the regulation of the immune response. In this case, the number of interacting genes can be large.

Recent studies have confirmed the mandatory participation of the immune system - primary or secondary - in the development of multiple sclerosis. Disorders in the immune system are associated with the characteristics of the set of genes that control the immune response.

The most widespread is the autoimmune theory of the occurrence of multiple sclerosis (recognition of nerve cells by the immune system as “foreign” and their destruction).

Considering the leading role of immunological disorders, treatment of this disease is primarily based on the correction of immune disorders.

In multiple sclerosis, the NTU-1 virus (or a related unknown pathogen) is considered as the causative agent. It is believed that a virus or a group of viruses causes serious disturbances in immune regulation in the patient’s body with the development of an inflammatory process and the breakdown of the myelin structures of the nervous system.

Manifestations of multiple sclerosis

Multiple sclerosis symptoms involve damage to several different parts of the brain and spinal cord.

Signs of damage to the pyramidal tract can be expressed by an increase in pyramidal reflexes without a decrease or with a slight decrease in muscle strength or the appearance of fatigue in the muscles when performing movements, but while maintaining basic functions.

Signs of damage to the cerebellum and its conductors are manifested by tremors and impaired coordination of movements.

The severity of these signs can vary from minimal to the inability to perform any movements.

Typical for cerebellar damage is a decrease in muscle tone.

In patients with multiple sclerosis, lesions of the cranial nerves may be detected, most often the oculomotor, trigeminal, facial, and hypoglossal nerves.

Signs of impairment of deep and superficial sensitivity are detected in 60% of patients. Along with this, a feeling of tingling and burning in the fingers and toes may be detected.

Frequent signs of multiple sclerosis are dysfunctions of the pelvic organs: urgent urges, increased frequency, retention of urine and stool, and in later stages - incontinence.

Possible incomplete emptying of the bladder, which is often the cause of genitourinary infection. Some patients may experience problems associated with sexual function, which may coincide with dysfunction of the pelvic organs or be an independent symptom.

In 70% of patients, symptoms of visual impairment are detected: decreased visual acuity in one or both eyes, changes in visual fields, blurred images of objects, loss of vision brightness, color distortion, and contrast disturbance.

Neuropsychological changes in multiple sclerosis include decreased intelligence and behavioral disturbances. More often, depression predominates in patients with multiple sclerosis. In multiple sclerosis, euphoria is often combined with decreased intelligence, underestimation of the severity of one’s condition, and disinhibition of behavior.

About 80% of patients with multiple sclerosis in the early stages of the disease have signs of emotional instability with repeated sudden changes in mood in a short period of time.

The deterioration of the patient's condition with increasing ambient temperature is associated with increased sensitivity of the affected nerve cells to changes in electrolyte balance.

Some patients may experience pain:

pain along the spine and intercostal spaces in the form of a “belt”,
muscle pain caused by increased tone.

In typical cases, multiple sclerosis occurs as follows: the sudden appearance of signs of the disease in the midst of complete health.

They can be visual, motor or any other disorders, the severity of which ranges from barely noticeable to grossly disrupting the functions of the body.

The general condition remains good. Following an exacerbation, a remission occurs, during which the patient feels almost healthy, then an exacerbation occurs again.

It becomes more severe, leaving behind a neurological defect, and this is repeated until disability occurs.

Diagnostics

Diagnosis of multiple sclerosis is based on data from a patient interview, neurological examination and the results of additional examination methods.

Today, magnetic resonance imaging of the brain and spinal cord and the presence of oligoclonal immunoglobulins in the cerebrospinal fluid are considered to be the most informative.

Considering the leading role of immunological reactions in the development of multiple sclerosis, regular blood testing in patients—the so-called immunological monitoring—is especially important for monitoring the disease.

It is necessary to compare immunity indicators with previous indicators of the same patient, but not healthy people.

Treatment of multiple sclerosis

Antiviral drugs are used in treatment. The basis for their use is the assumption of the viral nature of the disease.

The most effective drug for multiple sclerosis is betaferon. The total duration of treatment is up to 2 years; has strict indications: it is prescribed to patients with a relapsing-remitting form of the course and mild neurological deficit.

Experience with the use of betaferon has shown a significant reduction in the number of exacerbations, their milder course, and a decrease in the total area of inflammatory foci according to magnetic resonance imaging.

Reaferon-A has a similar effect. Reaferon is prescribed 1.0 IM 4 times a day for 10 days, then 1.0 IM once a week for 6 months.

Interferon inducers are also used:

proper-mil (proper myl),
prodigiosan,
zymosan,
dipyridamole,
non-steroidal anti-inflammatory drugs (indomethacin, voltaren).

Ribonuclease, an enzyme preparation obtained from the pancreas of cattle, inhibits the reproduction of a number of RNA-containing viruses.

Ribonuclease is administered 25 mg intramuscularly 4-6 times a day for 10 days.

The drug is used after the test: a working solution of RNase in a dose of 0.1 is injected subcutaneously on the inner surface of the forearm. 0.1 ml of saline solution is injected into the symmetrical area in the same way (control). The reaction is read after 24 hours. Negative - in the absence of local manifestations.

If there is redness or swelling at the site of RNase injection, the drug should not be used.

Dibazol has an antiviral and immunomodulatory effect. It is prescribed in microdoses of 5-8 mg (0.005-0.008) in the form of pills every 2 hours for 5-10 days.

Hormone therapy

For multiple sclerosis, hormones - glucocorticoids - are used. There are many schemes for the use of glucocorticoids in multiple sclerosis.

Synacthen-depot is a synthetic analogue of the hormone corticotropin, consisting of its first 24 amino acids, and is a very effective drug for the treatment of multiple sclerosis.

Can be used as an independent remedy and in combination with glucocorticoids. The action of synacthen depot continues after a single administration for 48 hours.

There are several options for its use: the drug is administered 1 mg once a day for a week, then at the same dose after 2-3 days 3-4 times, then once a week 3-4 times or administered 1 mg 3 days, then 2 days later on the 3rd course of treatment of 20 injections.

Complications when taking drugs of this group are Itsenko-Cushing syndrome, increased blood sugar, edema, asthenia, bacterial infections, gastric bleeding, cataracts, cardiac failure, hirsutism, vegetative-vascular disorders.

When taking large doses of glucocorticoids, it is necessary to simultaneously prescribe almagel, a diet low in sodium and carbohydrates, rich in potassium and protein, and potassium supplements.

Ascorbic acid takes part in the synthesis of glucocorticoids. Its dosage varies widely and depends on the patient's condition.

Etimizole activates the hormonal function of the pituitary gland, which leads to an increase in the level of glucocorticosteroids in the blood, and has anti-inflammatory and antiallergic effects. Prescribe 0.1 g 3-4 times a day.

Additional Treatments

Nootropil (piracetam) is prescribed orally, 1 capsule 3 times a day and the dose is adjusted to 2 capsules 3 times a day; when a therapeutic effect is achieved, the dose is reduced to 1 capsule 3 times a day.

When treated with piracetam, complications in the form of allergic reactions are possible, which is largely due to the presence of sugar in the drug. Therefore, when carrying out the course, it is necessary to limit the amount of sugar in food and exclude sweets from the diet. The course of treatment with nootropil is 1-3 months.

Glutamic acid - up to 1 g 3 times a day.

Actovegin is indicated to improve metabolic processes in the brain. The drug is administered intravenously in the amount of 1 ampoule with glucose at a rate of 2 ml/min.

Solcoseryl, which is prescribed intravenously, has a similar effect. Improves metabolic processes and tissue regeneration.

Plasma transfusion is a very effective treatment method. Native and fresh frozen plasma is used, 150-200 ml IV 2-3 times with intervals between infusions of 5-6 days.

Desensitizing therapy: calcium gluconate intravenously or in tablets, suprastin, tavegil, etc. are widely used.

Decongestants are used relatively rarely.

Of the diuretics, preference is given to furosemide - 1 tablet (40 mg) once a day in the morning. If the effect is insufficient, the dose is repeated the next day or the following course of treatment is carried out: 1 tablet for 3 days, then a 4-day break and then taken for another 3 days according to the same regimen.

Hemodez can be added to drugs that increase urination. This drug also has an anti-intoxication effect. Hemodez is administered intravenously at 200-500 (adults) in a warm form (at a temperature of 35-36 ° C, 40-80 drops per minute, a total of 5 injections with an interval of 24 hours. In some cases, it is useful to alternate hemodez injections with the administration of rheopolyglucin.

In addition to its detoxification effect, Reopolyglucin improves blood counts and restores blood flow in the capillaries.

Dalargin normalizes regulatory proteins, is an immunomodulator, and affects the functional state of cell membranes and nerve conduction. It is recommended to take 1 mg IM 2 times a day for 20 days.

T-activin is used at a dose of 100 mcg daily for 5 days, then after a 10-day break, another 100 mcg for 2 days.

Plasmapheresis in the treatment of multiple sclerosis

This method is used in especially severe cases during exacerbation. Recommended from 3 to 5 sessions.

There are a lot of options for using plasmapheresis: from 700 ml to 3 liters of plasma during each session (at the rate of 40 ml per 1 kg of body weight), on average 1000 ml. The removed fluid is replaced with albumin, polyionic solutions, and rheopolyglucin. Course 5-10 sessions.

Method of using plasmapheresis: after 2 days for the 3rd 5 times or every other day.

Typically, plasmapheresis is combined with the administration of metypred (after a plasmapheresis session, 500-1000 mg is administered intravenously per 500 ml of saline solution) 5 times, followed by switching to taking prednisolone every other day at the rate of 1 mg/kg with a dose reduction of 5 mg each subsequent take up to a maintenance dose (10 mg 2 times a week).

Cytochrome-C is an enzyme obtained from bovine heart tissue. It is prescribed 4-8 ml of a 0.25% solution 1-2 times a day intramuscularly. Before starting to use cytochrome, individual sensitivity to it is determined: 0.1 ml of the drug is administered intravenously. If facial redness, itching, and urticaria are not observed within 30 minutes, then treatment can begin.

Means to improve blood circulation

Nicotinic acid has a pronounced vasodilating effect. The drug is administered in increasing doses from 0.5 (1.0) to 7.0 ml IM and from 7.0 to 1.0.

Xanthinol nicotinate has a similar effect. Synonyms: teonicol, complamin. The drug combines the properties of substances from the theophylline and nicotinic acid groups, acts on peripheral blood circulation, and enhances cerebral circulation.

Cinnarizine has a multifaceted effect: improves cerebral and coronary circulation, microcirculation, has a positive effect on the state of the blood, relieves vasospasm, etc.

Cavinton is used in the treatment of multiple sclerosis. If there are no contraindications (pregnancy, arrhythmias), it is prescribed orally 1-2 tablets (0.02) 3 times a day. It selectively dilates the blood vessels of the brain, improves the supply of oxygen to the brain, and promotes the absorption of glucose by the brain.

There is information about the possibility of using Cavinton in the form of intravenous injections (drips). It is administered in a dose of 10-20 mg (1-2) ampoules in 500 ml of isotonic solution.

Trental, chimes, pentamer, and agapurin have similar effects to Cavinton. Trental is prescribed in a dose of 0.2 (2 tablets) 3 times a day after meals. After the therapeutic effect occurs, the dose is reduced to 1 tablet 3 times a day. 0.1 mg (1 ampoule) is administered intravenously in 250-500 ml of isotonic solution over 90-180 minutes. In the future, the dose may be increased.

A remedy that improves cerebral and coronary circulation is chimes. It is well tolerated and should not be prescribed only for severe forms of coronary atherosclerosis and precollaptoid conditions. It is usually taken in a dose of 25 mg for several months, 1-2 tablets an hour before meals, 3 times a day.

A tonic that improves brain function is phytin, a complex organic phosphorus preparation containing a mixture of calcium and magnesium salts of various inositol phosphoric acids. For multiple sclerosis, take 1-2 tablets 3 times a day.

Tocopherol acetate (vitamin E) is an antioxidant, protects various tissues from oxidative changes, participates in protein biosynthesis, cell division, and tissue respiration. Has the ability to inhibit lipid peroxidation. Daily intake - 50-100 mg for 1-2 months (one drop of 5%, 10% or 30% solution of the drug from an eye pipette contains 1, 2, 6.5 mg of tocopherol acetate, respectively).

Folk remedies in the treatment of multiple sclerosis

Sprouted wheat seeds: 1 tablespoon of wheat is washed with warm water, placed between layers of canvas or other fabric, and placed in a warm place. After 1-2 days, sprouts 1-2 mm in size appear.

Sprouted wheat is passed through a meat grinder, poured with hot milk, and a paste is prepared. Should be eaten in the morning, on an empty stomach. Take daily for a month, then 2 times a week. Course - 3 months. Sprouted wheat seeds contain B vitamins, hormonal substances, and microelements.

Propolis is a waste product of bees. A 10% solution is prepared: 10.0 propolis is crushed, mixed with 90.0 butter heated to 90 °, mixed thoroughly. Take 1/2 teaspoon with honey (if tolerated) 3 times a day. Gradually, the intake can be increased to 1 teaspoon 3 times a day. The course of treatment is 1 month.

Multiple sclerosis is a demyelinating disease characterized by loss of the outer layer (myelin) of nerve cell processes (neurons). This process occurs due to an autoimmune failure caused mainly by infectious diseases. People of all ages suffer from MS, but particularly severe manifestations are observed from 15 to 55 years of age. This phenomenon is associated with hormonal activity characteristic of this period. If the development of the disease is not slowed down, it will progress and can be fatal. This can be prevented by timely familiarization with the diagnosis of multiple sclerosis, as it will allow you to find out in time about the presence of a pathological process. In this case, there will be a chance to stop the disease and prolong the patient’s life.

It is quite difficult to recognize the presence of multiple sclerosis in the early stages, since the symptoms are still mild. However, in the case of its rapidly progressive forms, signs may appear already in the first weeks of development. If neurological manifestations of the disease are detected, it is necessary to stop diagnosing yourself and go to the doctor, since they may be characteristic of other pathological processes.

Among the main features are the following:

General weakness;
Deterioration of vision in one eyeball or both at once;
Paresis (weakening) of the limbs;
A sharp loss of sensitivity in a certain area of the body;
Dizziness;
Problems with the urinary system;
Epileptic seizures;
Fast fatiguability;
Double image before the eyes;
Problems with fine motor skills;
Failures in coordination of movements;
Impotence;
A feeling of current passing throughout the body when the head is sharply bent;
Involuntary twitching of the eyelid;
Impaired cognitive functions.

Several symptoms may appear, or all at once in varying combinations and degrees of intensity. Over time, the severity of the symptoms will increase, so it is important to detect them in time in order to be able to undergo examination and begin a course of therapy. Especially if the problem occurs in women, since in them MS manifests itself 2-3 times more often and is more severe.

Patient interview

Identified signs of a pathological process should be a signal to go to the doctor. Initially, you will have to make an appointment with a therapist at the hospital at your place of residence. If the specialist has good reasons, he will refer you to a neurologist who will conduct an initial examination.

The doctor will ask about the symptoms that appear, so before going to see him, it is advisable to remember all the signs that you had. This must be done so that the specialist can assess the development of the pathological process. An important detail is the time of onset of symptoms and the reasons why they worsen.

During the conversation, you will need to clarify whether this is your first visit to a neurologist and at the same time the doctor will ask about the following points:

The presence of other pathologies or any health problems;
List of previous diseases;
Medicines used;
The presence of similar pathological processes in the family;
Abuse of bad habits.

All these points are important for the doctor, since based on them, he will be able to assess the presence of multiple sclerosis. That is why it is extremely important to provide him with all the necessary information and not hide any details from the specialist.

Examination by a neurologist

After receiving the necessary data, the specialist will need to verify what he has heard and for this he will need to examine the patient. The essence of the procedure is to identify neurological abnormalities in order to find out the severity of the functional disorder of the nervous system.

During the examination, the neurologist will need to evaluate the following functions:

Functionality of cranial nerve pathways;
Muscle tissue tone;
Motor functions;
Degree of sensitivity;
Expressiveness of reflexes.

Detected disorders will allow us to talk about malfunctions in the central nervous system.

However, they can also be characteristic of many other pathological processes, for example, compression of the spinal canal due to osteochondrosis or hernia, etc. That is why you will have to undergo tests and undergo instrumental diagnostic methods in order to accurately identify or refute MS.

Diagnostic methods

Diagnosis of multiple sclerosis consists of differentiating it from other pathological processes, since there is no specific test for its detection. For this purpose, the patient will have to undergo many different examinations, among which the most basic can be identified:

Lumbar puncture;
Determination of the degree of evoked potentials;
Proton magnetic resonance spectroscopy (PMRS);
Blood test to determine the presence of third-party pathological processes;
Tomography (computer and magnetic resonance imaging);
Superposition electromagnetic scanning (SPEMS).

Passing all the tests will take more than one day, so you will have to be patient and prepare for the upcoming procedures. In any case, they will be required to accurately make such a diagnosis or refute it.

CT and MRI

CT and MRI for multiple sclerosis are prescribed regularly to assess the course of the pathology and determine the effectiveness of therapy. They are also used for diagnostic purposes, since these devices make it possible to accurately examine foci of demyelination in the spinal cord and brain.

These types of tomography are extremely sensitive and show the presence of pathology with an accuracy of 95% percent. If there are no lesions during CT or MRI, the doctor eliminates multiple sclerosis from the list of possible pathologies.

During the examination, a contrast agent is often used. In this case, the quality of the image of certain tissues improves and it will be easier for the doctor to make a diagnosis, because it accumulates mainly in areas of demyelination. This phenomenon indicates an acute stage of the disease. This is why sclerosis is most often found on MRI and CT.

Evoked potentials

It is necessary to diagnose MS in a comprehensive manner, so it is impossible to do without conducting a study of evoked somatosensory, auditory and visual potentials. For this purpose, special wires from an electroencephalograph are connected to the patient’s head. This device is used to record the brain's reaction to stimuli. If it is insignificant, the doctor will suspect the presence of damage to nerve brain tissue.

PMRS

Proton magnetic resonance spectroscopy is designed to determine the stage of development of MS. The essence of this hardware examination is to visualize certain metabolites in brain tissue. If the doctor has already diagnosed multiple sclerosis, then PMRS is used to assess the amount of N-acetylaspartate, since in the presence of this disease its concentration decreases significantly.

This method is also used for diagnostic purposes, because it will allow identifying pathological deviations in the early stages.

It is usually carried out in combination with CT and MRI for an accurate diagnosis.

SPEMS

The superposition electromagnetic scanner is an innovative research method, but it has only recently begun to be used to determine the presence of MS. The main difference between SPEM and other examination methods is the ability to recognize the disease in the early stages of development, when it does not actually manifest itself.

Using this device you can find out the degree of activity of brain tissue, namely:
Functionality of enzymes and neurotransmitters;
The degree of demyelination and the rate of growth of lesions;

Density of ion channels.

SPEMS was invented by domestic scientists and today it is almost always used in the diagnosis of multiple sclerosis. However, it must be used in conjunction with other examination methods. Otherwise, it will not be possible to make an accurate diagnosis.

Lumbar puncture

A puncture (puncture) is performed in the lumbar region to remove cerebrospinal fluid for analysis. In its results, special attention should be paid to the globulin index, since in MS it is often elevated. Occasionally, high levels of oligoclonal bands may also be seen. These results of the analysis indicate an autoimmune failure that is characteristic of multiple sclerosis.

Blood tests

A blood test cannot be called the main method for diagnosing multiple sclerosis, but it allows you to ensure the absence of other pathologies, such as:

Encephalomyelitis;
Sarcoidosis;
Tick-borne borreliosis;
Lupus;
Osteomyelitis.

A blood test is carried out along with other examination methods, and only after the diagnosis is fully completed, the doctor will be able to accurately make a diagnosis. Treatment will be based on the data obtained about the form and type of course of multiple sclerosis.

Diagnosing MS is not so easy and in some cases you will need to be observed by a neurologist for a long time. This is especially true for the early stages of development. You should not be upset or happy about the intermediate result, since only a combination of research methods can help the doctor make an accurate diagnosis.

25.10.2016

Multiple sclerosis develops as a result of damage to the myelin tissue that protects the spinal cord and brain from external influences, like duct tape around wires.

This type of disease should not be confused with senile sclerosis. The word “scattered” means multiple lesions, as if scattered over the entire surface. Multiple sclerosis also occurs at a young age - from 15 to 40 years. Of course, there are cases of the disease occurring at 50 years of age, but this is an exception.

According to statistics, the disease occurs twice as often in women as in men.

Causes

Additional reasons may be:

Increased intoxication of the body;
Radiation exposure;
Abuse of ultraviolet radiation (sunbathers);
Unsuitable climatic conditions (cold);
Mental stress;
Allergies;
Genetic factor;
Measles virus (the condition of patients improves after a dose of interferons).

Some researchers suggest that multiple sclerosis can be triggered by the hepatitis B vaccine. But this theory has not been confirmed.

Symptoms

The signals given by the body about the onset of multiple sclerosis are different. The process depends on the form and phase of the disease. The first symptoms can occur in different ways - either moderately and unclearly, or progress rapidly.

The following symptoms are reasons to consult a doctor:

weakness in all limbs (or in just one);
gradual decrease in vision or sudden loss (in one or both eyes);
constant feeling of fatigue;
dizziness that occurs for no apparent reason;
uncontrolled urination;
pain in the spine when tilting the head;
nervous tics (eye twitching, eyebrow twitching);
epilepsy attacks.

Symptoms of multiple sclerosis can appear alternately or as a group (several). Those at risk should immediately contact a specialist, even if the symptoms are mild. Multiple sclerosis progresses gradually.

Who to contact

At the first signs of the disease, you must visit a neurologist or neurologist at the clinic.

At the first appointment, the doctor diagnoses:

evaluates the functional functioning of cranial nerve endings;
determines muscle tone affecting the motor system;
assesses sensitivity and reflexivity.

After the initial examination, the specialist will prescribe a number of mandatory tests. For the final diagnosis of multiple sclerosis, patients are usually sent to a hospital, where additional diagnostics and immediate treatment are carried out.

Types of diagnostics

It includes:

Hardware examination (MRI, tomography).

This study helps to assess the beginning changes in the spinal cord and brain. Before the procedure begins, the patient is injected with a contrast liquid (gadolinium), which makes it possible to increase the clarity of the image of the affected tissue.

Gadolinium accumulating in lesions indicates the progression of multiple sclerosis.

Lumbar puncture.

CSF collection(cerebrospinal fluid) from the lumbar region is necessary for laboratory analysis, during which an unacceptable increase in the antibody index is detected. Contrary to various rumors, this procedure is not dangerous for the patient. A needle placed inside the vertebrae does not touch the spinal cord.

Measuring the potential activity of brain cells.

This type of diagnosis analyzes three important potentials: hearing, vision and sensory functions.

During the procedure, electrodes attached to the patient's head record the brain's response to certain stimuli. The doctor's job is to assess the speed with which the brain responds to the signals given. A slow reaction indicates a “problem” in the functioning of the brain.

SPEMS.

Diagnosing a disease using a medical scanner is the youngest and most modern diagnostic method. Its advantage lies in identifying the disease in the early stages, when external manifestations are almost invisible. Using a brain scan, the functioning of all metabolic processes in brain tissue is revealed. Based on the indicators, the nature of the predisposition to multiple sclerosis is determined.

Blood tests.

It is impossible to diagnose multiple sclerosis using a blood test. But this analysis helps to identify diseases in the patient whose symptoms are similar to the disease being detected.

These diseases include: lupus erythematosus, osteomyelitis, Lyme disease, sarcoma.

The blood test is carried out in combination with the above methods.

Differential diagnosis.

There are many diseases similar to multiple sclerosis. After completing the examination and studying the patient’s tests, the specialist needs to make an appropriate diagnosis. The method of differential diagnosis consists in the fact that the doctor, having compared all the facts with each other, identifies the main ones and establishes a single conclusion. Currently, there are computer programs that allow accurate differential diagnosis.

Treatment

Treatment options for multiple sclerosis depend on its stage. However, in medicine there are general principles prescribed by a specialist:

The most effective and latest technology has been and remains the transplantation of stem cells, which, when entering the patient’s blood, actively restore the myelin sheath to its normal state. But unfortunately this method is not available to everyone.

How long do you live with the disease?

Unfortunately, multiple sclerosis cannot be cured. The life expectancy of such patients does not have an exact figure. It all depends on the factors influencing the progression of the disease:

timeliness of the diagnosis;
age at which the disease begins;
effectiveness of treatment measures;
complications;
accompanying pathologies.

Life expectancy with multiple sclerosis often does not exceed 30 years. With serious complications and rapid progression, a person may not live even 5 years. But most often this figure is 12-16 years.

Sometimes, to determine the correct diagnosis at an early stage, the doctor needs time to monitor the course of the disease. But this does not negatively affect the patient’s condition.

Methods for diagnosing multiple sclerosis at an early stage updated: October 27, 2016 by: vitenega

Stroke Probability Calculator

Is there a risk of stroke?

Prevention

Age

1. Increased (over 140) blood pressure:

3. Smoking and alcohol:

4. Heart disease:

5. Undergoing medical examination and MRI diagnostics:

Total: 0%

Stroke is a rather dangerous disease that affects people not only of old age, but also of middle age and even very young people.

A stroke is a dangerous emergency that requires immediate help. It often ends in disability, in many cases even death. In addition to blockage of a blood vessel in the ischemic type, the cause of an attack can also be a hemorrhage in the brain against the background of high blood pressure, in other words, a hemorrhagic stroke.

Risk factors

A number of factors increase the likelihood of having a stroke. For example, genes or age are not always to blame, although after 60 years the threat increases significantly. However, everyone can do something to prevent it.

1. Avoid hypertension

High blood pressure is a major risk factor for stroke. Insidious hypertension does not show symptoms at the initial stage. Therefore, patients notice it late. It is important to measure your blood pressure regularly and take medications if levels are elevated.

2. Quit smoking

Nicotine constricts blood vessels and increases blood pressure. The risk of stroke for a smoker is twice as high as for a non-smoker. However, there is good news: those who quit smoking noticeably reduce this danger.

3. If you are overweight: lose weight

Obesity is an important factor in the development of cerebral infarction. Obese people should think about a weight loss program: eat less and better, add physical activity. Older adults should discuss with their doctor how much weight loss they would benefit from.

4. Keep your cholesterol levels normal

Elevated levels of “bad” LDL cholesterol lead to deposits of plaques and emboli in blood vessels. What should the values be? Everyone should find out individually with their doctor. Since the limits depend, for example, on the presence of concomitant diseases. Additionally, high values of “good” HDL cholesterol are considered positive. A healthy lifestyle, especially a balanced diet and plenty of exercise, can have a positive effect on your cholesterol levels.

5. Eat healthy food

A diet that is generally known as “Mediterranean” is beneficial for blood vessels. That is: lots of fruits and vegetables, nuts, olive oil instead of frying oil, less sausage and meat and lots of fish. Good news for gourmets: you can afford to deviate from the rules for one day. It is important to eat healthily in general.

6. Moderate alcohol consumption

Excessive alcohol consumption increases the death of stroke-affected brain cells, which is not acceptable. It is not necessary to abstain completely. A glass of red wine a day is even beneficial.

7. Move actively

Movement is sometimes the best thing you can do for your health to lose weight, normalize blood pressure and maintain the elasticity of blood vessels. Endurance exercises such as swimming or brisk walking are ideal for this. Duration and intensity depend on personal fitness. Important note: Untrained individuals over 35 years of age should be initially examined by a physician before starting to exercise.

8. Listen to the rhythm of your heart

A number of heart diseases contribute to the likelihood of a stroke. These include atrial fibrillation, birth defects, and other rhythm disorders. Possible early signs of heart problems should not be ignored under any circumstances.

9. Control your blood sugar

People with diabetes are twice as likely to suffer a cerebral infarction than the rest of the population. The reason is that elevated glucose levels can damage blood vessels and promote plaque deposits. In addition, people with diabetes often have other risk factors for stroke, such as hypertension or too high blood lipids. Therefore, diabetic patients should take care to regulate their sugar levels.

10. Avoid stress

Sometimes stress has nothing wrong with it and can even motivate you. However, prolonged stress can increase blood pressure and susceptibility to disease. It can indirectly cause the development of a stroke. There is no panacea for chronic stress. Think about what is best for your psyche: sports, an interesting hobby, or perhaps relaxation exercises.