Neurology / / April 29, 2016
Disseminated Sclerosis video
What is multiple sclerosis?
Multiple sclerosis is a disease of the central nervous system (CNS).
CNS consists of the brain and spinal cord.They process information coming from the environment, controlling muscle contraction by preventing arbitrary muscles to control the movement of the body, to carry out coordinated movements.
Central nervous system works effectively, if not broken transmission of nerve impulses to the brain.Multiple sclerosis is one of the reasons that violate the efficiency of the pulse in the nervous system.The cause of MS is demyelination - the process that leads to the destruction of myelin.
Myelin - lipid substance that covers and insulates the nerves that improves the conduction of impulses in them, but is also essential for maintaining nerve health.Demyelination (lesions or plaques) is a zone of scarring (sclerosis) changes, where instead of the destroyed myelin occurs proliferation of connective tissue, that is, there are areas of sclero
Who gets multiple sclerosis?
In the world average prevalence of multiple sclerosis is 30 cases per 100,000 population.Typically, multiple sclerosis are diagnosed between the ages of 20 to 50 years, but he was also exposed to both children and the elderly.Multiple sclerosis depends on the geographic location.So it is more prevalent in areas with temperate climates than in rain, that is, the farther from the equator, the higher the incidence of Women are twice as likely as men to suffer from multiple sclerosis at a younger age.
narrated whether multiple sclerosis inherited?
Although his role of genetics is not clear, it can play a role in the treatment of multiple sclerosis.The likelihood of developing multiple sclerosis is less than 1%.Chance increases in families where the first line of a relative suffering from this disease.Higher risk for children and siblings of patients with multiple sclerosis may be caused by a similar susceptibility to the effects of the same environmental factors.In this case, the probability of risk of developing multiple sclerosis increases from 1% to 3% .. These statistics show that genetic factors play an important role in the treatment of multiple sclerosis.However, other evidence suggests that environmental factors also play an important role.
What causes multiple sclerosis?
reason MS is still unknown.In the past 20 years, researchers have focused on the study of disorders of the immune system and genetics, knowing that a virus alters the immune system so that the immune system perceives myelin as a foreign substance.At some point in time in the brain cells activate other elements of the immune system so that they begin to damage or destroy its own tissue - myelin.In this connection, the transmission of electrical impulses that travel along the nerves, disturbed and slowed down, healthy nerves are destroyed.Although myelin can be restored, it is very slow, by the time most of the nerve becomes demyelinated.There is scarring, scars and plaques appear.As more and more nerves are affected, a person violated functions which are under the control of the nervous system such as vision, speech, walking, writing, and memory.
final proof of this virus theory has not yet been found.However, the immune system attack on nervous tissue, based on reasonable evidence.Therefore, multiple sclerosis is an "autoimmune" disease.
What are the types of multiple sclerosis?
Every person suffering from multiple sclerosis, the disease occurs in several variants.Although nerve damage is always present, the disease depends on the individual patient.
Physicians and scientists have identified several major types of multiple sclerosis.Determining the type of disease is an important point, because it helps to predict the severity of the disease, and to select treatments.
Consider each type:
- remitting multiple sclerosis . 65% -80% of people with the disease begins remitting multiple sclerosis.This is the most common type of the disease.It is characterized by unpredictable relapses, worsening of symptoms, partial or total disruption of some functions.After an exacerbation, usually occur in remission - the disappearance of symptoms, accompanied by partial or complete recovery of function.Remission can last from weeks to decades until the next relapse.
- Primary-progressive multiple sclerosis is a type of MS, characterized by a gradual but steady progression of disability, without any obvious relapses and remissions.This form of the disease occurs in 15% of all people with multiple sclerosis, but it is the most common type of the disease in humans, occurring after 40 years.
- Secondary-progressive multiple sclerosis first begins with remitting, but later develops into a progressive disease, often with the preservation of exacerbations.Progression of the disease can begin soon after the start, or it may occur years or decades.Approximately 50% of people develop this type of multiple sclerosis for 10 years.
- Progressive-relapsing multiple sclerosis is the least common form of the disease and is characterized by a steady trend to an increase in disability or aggravation of symptoms.Typically, this type of susceptible people with primary progressive multiple sclerosis.
What are the symptoms of multiple sclerosis?
symptoms of multiple sclerosis can be both one and more, they can range from mild to severe intensity.
-Violation vision (blurred vision, color distortion, loss of vision in one eye, pain in the eyes).
How are diagnosed with multiple sclerosis?
Due to the wide range of symptoms and lack of clarity, multiple sclerosis can not be diagnosed for several months to several years after the onset of symptoms.Physicians, in particular, the neurologist should perform a thorough analysis and perform a complete physical and neurological examination, including an MRI, electrophysiologic tests, analysis of cerebrospinal fluid (lumbar puncture).
Taken together, these studies help the doctor to confirm the diagnosis of multiple sclerosis.For accurate diagnosis of multiple sclerosis, to perform, at least two separate MR examination, which would trace the dynamics of changes in the central nervous system.
What is multiple sclerosis on MRI?
left represented MRI brain images of 35-year-old man with relapsing multiple sclerosis.It shows multiple lesions of varying intensity (white spots).The right image shows a MRI cervical spinal cord 27-year-old woman.It is visible starting demyelination (see. Arrow).
How is multiple sclerosis?
There are several areas in the treatment of multiple sclerosis.The direction depends on the purpose of treatment:
- increasing the rate of recovery of myelin.
Once the targets have been set, conduct therapy comprising drugs for relief of symptoms.
medicine that affects the immune system, is given special attention in the fight against multiple sclerosis.Typically, this corticosteroids such as prednisone or methylprednisolone.However, their influence on the immune system is non-specific and can lead to numerous side effects, so the correct use corticosteroids only in the case of severe progression of the disease, leading to disability or causing pain.
C 1993 has been using drugs for the treatment of multiple sclerosis, which affect the immune system, particularly interferons.
Interferons for relapsing multiple sclerosis:
- Interferon beta-1b (Betaseron and Extavia)
- Interferon beta-1a (Rebif)
- Interferon beta-1a (Avonex)
Other drugs approvedfor relapsing multiple sclerosis:
- Glatiramer acetate (Copaxone)
- Natalizumab (Tysabri ®)
- Mitoxantrone (Novantrone ®)
- fingolimod (Gilenya ®)
prospects in the treatment of multiple sclerosis
There are many ongoing studiesin the treatment of multiple sclerosis, and they continue to focus on the immune system.In addition, scientists are trying to develop techniques that allow brain cells to generate new myelin or prevent the death of nerve.Other promising approaches include the use of precursor (stem neurons) - cells that can be implanted in the brain or spinal cord, to populate the region of destroyed cells.Future treatment may include methods to improve the pulses coming from the damaged nerves.Scientists are also studying the effects of diet and other environmental factors on multiple sclerosis.