Multiple sclerosis causes, symptoms and medications list
Multiple sclerosis is a neurological pathology characterized by a progressive course with multiple lesions in the central nervous system and fewer lesions in the peripheral nervous system. In neurology, you can find the terms "multiple sclerosis", "spotted sclerosis", "plaque sclerosis", "multiple sclerosing encephalomyelitis", all of them are the designation of the same disease. The course of the pathology is undulating, the character is chronic.
If earlier most of the people with multiple sclerosis lived in countries far from the equator, then at the moment there is no clear geographical distribution. In the past few decades, there has been an increase in pathology in most regions of the world, although countries with a temperate climate continue to lead. There, the indicators reach from 50 to 100 people per 100,000 population.
Most often, women are sick, although about a third of cases of multiple sclerosis occur in the male population of the planet. Pathology manifests more often at a young age, affecting active people from 20 to 45 years old - this is almost 60% of all cases. Most often, multiple sclerosis is diagnosed in people engaged in intellectual work.
In addition, scientists at this point in time are revising the age boundaries of the onset of the disease in the direction of their expansion. So, in medicine, cases of the development of multiple sclerosis are described at the age of two, as well as at the age of 10-15 years. The number of patients in childhood varies according to various data from 2 to 8% of the total number of cases. The risk group now includes persons over 50 years old.
- Multiple sclerosis causes
- The first signs of multiple sclerosis
- The main symptoms of multiple sclerosis
- The consequences of multiple sclerosis
- Multiple sclerosis diagnostics
- Answers to popular questions
- Drugs and medicines for multiple sclerosis
Multiple sclerosis causes
As a result of the influence of a number of factors, there is an increase in the permeability of the blood-brain barrier (its main function is to protect the brain antigens from the destructive effects of the immune system's own cells). As a result, more T-lymphocytes enter the brain tissue and the process of inflammation starts. The result of this inflammation is the destruction of the myelin sheath of the nerve, since the immune system perceives myelin antigens as foreign. The transmission of nerve impulses in the same volume becomes impossible and the person begins to suffer from the symptoms of the disease.
The causes of multiple sclerosis are multiple external and internal factors, therefore it is considered as a multifactorial pathology.
Special attention of scientists is attracted by the following etiological circumstances:
- Influence of viruses on the onset of the disease. These are retroviruses, herpes viruses, measles and rubella virus, infectious mononucleosis, especially in combination with endogenous retroviruses. The transferred bacterial infections - streptococcal, staphylococcal, etc. have a negative impact. Nevertheless, scientists have come to the conclusion that there is not a single virus that would directly lead to the development of the disease. However, they are trigger factors that support and induce the development of the inflammatory and autoimmune processes, thereby stimulating neurodegenerative changes.
The influence of chronic intoxication on the human body. Poisoning with chemicals, organic solvents, metals, gasoline, etc. is especially dangerous. Living in an environmentally unfavorable zone, especially in childhood, is considered a negative factor.
- Features of the diet. In this regard, animal fats and proteins are dangerous, their excessive consumption under the age of 15 years. If a person suffers from obesity from the age of 20, then the risk of developing the disease increases by 2 times. It has also been proven that excessive consumption of table salt leads to the pathological activity of the immune system.
- Frequent psychoemotional stress, chronic stress.
- Physical stress.
- Head and back injuries, surgical operations.
- Genetic predisposition to the development of the disease. This is especially evident in the family history of multiple sclerosis. Risks of disease in blood relatives range from 3 to 10%.
- Taking oral contraceptives increases the risk of developing the disease by 35%.
- Elevated blood sugar levels lead to rapid disease progression.
Also, scientists have identified epidemiological risk factors for the development of the disease:
- Belonging to the European race. So, for example, among the Eskimos, native Indians, Majori and some other races, the disease is extremely rare.
- Familial multiple sclerosis
- Belonging to the female sex, in all populations of patients, it is women that prevail, however, the unfavorable course of the disease is characteristic of men.
- Changing the area of residence affects the change in the incidence of the disease among the migrated population.
There are known cases of a sharp increase in the incidence in a limited area in a certain time period.
The first signs of multiple sclerosis
Symptoms of multiple sclerosis in 40% of cases of the disease are disorders in motor functions, such as weakness in muscles, impaired coordination of movement. Also, in 40% of cases, there are violations in the sensitivity of the extremities - for example, numbness, colic sensation in the hands and feet.
In 20% of cases of multiple sclerosis, there are visual impairments, movement disorders when walking, voluntary urination, fatigue, and sexual dysfunction. With a long course of the disease, a decrease in intelligence is observed.
The signs of the development of multiple sclerosis depend on where the demyelination focus is located. Therefore, the symptomatology in different patients is varied and often unpredictable. It is never possible to simultaneously detect the whole complex of symptoms in one patient at the same time.
The first signs of the disease are the result of demyelination, which causes impairment of the passage of electrical impulses along nerve fibers. They most often manifest themselves violently; doctors rarely observe an imperceptible, latent course of the disease.
So, the most common early signs of multiple sclerosis are:
- The resulting feeling of tingling and numbness in the limbs.
- Periodic feeling of weakness in the limbs, which is most often observed, on the one hand.
- Deterioration of vision, decreased clarity, double vision. In addition, a veil may appear before the eyes, passing blindness to one or both eyes. Oculomotor disorders such as strabismus, diplopia, vertical nystagmus, and internuclear ophthalmoplegia are common early signs of the onset of the disease.
Pelvic disorders. It is the violation of the process of urination that is observed in almost half of all patients. This symptom in 15% of people with multiple sclerosis is the only symptom. Possible incomplete emptying of the bladder, nocturia (when more urine is excreted at night than during the day), difficulty urinating, urinary incontinence, the occurrence of sudden urge to empty it, intermittent urination.
- Already in the initial stages of the disease, there is an increase in fatigue or the so-called "chronic fatigue syndrome".
- The first signs of an impending disease may be: neuritis of the facial nerve, dizziness, staggering while walking, ataxia (static and dynamic), horizontal nystagmus, hypotension, etc.
The main symptoms of multiple sclerosis
As the disease progresses, the following symptoms of multiple sclerosis are noted:
Sensory impairment. Sensations uncharacteristic for a healthy person: numbness, itching, burning of the skin, tingling, passing pains - all these signs begin to bother the patient more often. Sensory disturbance begins from the distal parts, namely from the fingers of the limb with its gradual complete capture. Violations are often one-sided, but sometimes there is a transition to the second limb. Weakness in the initial stages of the development of the disease can be confused with fatigue, but as sclerosis progresses, it will become more difficult for a person to perform even simple movements. The limbs become strangers, there is no ability to maintain muscle strength.
- Visual disturbances. On the part of the organ of vision, there is a violation of color perception, the development of optic neuritis, an acute decrease in vision is possible. Most often, the defeat is also one-sided. Blurred vision and double vision, lack of friendly eye movement when trying to take them aside are all symptoms of the disease.
- Limb tremor. This symptom significantly disrupts the patient's quality of life. It is possible that not only the limbs, but also the human body will be subject to tremors. This occurs as a result of uncontrolled muscle contractions, which leads to the inability to carry out labor and social activities.
Headaches. Headache is a very common symptom of the disease. Scientists suggest that its occurrence is associated with muscle disorders and depression. It is with multiple sclerosis that headache occurs three times more often than with other diseases of a neurological nature. Sometimes it can act as a harbinger of an impending exacerbation of the disease or a sign of the onset of pathology. (read also: causes, signs and symptoms of headache, consequences)
- Swallowing dysfunctions and speech disorders. These symptoms usually appear in parallel. If in 50% of cases patients do not pay attention to swallowing disorders, then it is impossible not to notice failures in speech. This is manifested in her stiffness, blur, indistinctness.
- Gait disorders. Difficulty walking can be caused by numbness in the feet, imbalance, muscle spasms, muscle weakness, tremors.
- Muscle spasm. It is this symptom that often becomes the cause of the patient's disability. As a result of the resulting spasms, a person is not able to adequately control the movements of the arms and legs.
- Increased sensitivity to heat. Exacerbation of the symptoms of the disease is possible when the body overheats. Such situations often happen on the beach, in the sauna, in the bathhouse.
Mental disorders, decreased cognitive abilities. This symptom is typical for 50% of all patients with multiple sclerosis. They experience mental retardation, memory impairment, decreased concentration, difficulties in perceiving information, and it is difficult to switch from one type of activity to another. As a result, the patient becomes unable to perform even basic daily tasks.
- Dizziness. This symptom occurs early in the development of the disease and gets worse as it progresses. A person can feel both his own instability and suffer from the "movement" of his environment. (read also: dizziness - types and causes)
- Chronic fatigue syndrome. Excessive fatigue is most pronounced in the afternoon. The patient experiences not only muscle, but also emotional weakness, mental exhaustion, drowsiness and lethargy.
- Sex drive disorders. Up to 90% of men and up to 70% of women suffer from sexual disorders. This violation can be the result of both psychological problems and the result of damage to the central nervous system. Libido falls, the process of erection and ejaculation is disrupted. However, up to 50% of men do not lose their morning erection. Women are unable to achieve orgasm, intercourse can be painful, and there is often a decrease in sensitivity in the genital area.
- Problems with night rest. It becomes more difficult for patients to fall asleep, which is most often caused by spasms of the limbs and other tactile sensations. Sleep becomes restless, as a result, during the day, a person experiences a dullness of consciousness, a lack of clarity of thought.
- Autonomic regulation disorders. The longer the disease exists, the higher the risk of developing autonomic disorders. A person suffers from morning hypothermia, from foot hyperhidrosis in combination with muscle weakness, from arterial hypotension, dizziness and cardiac arrhythmias.
- Depressive moods, increased levels of anxiety. Depression can be a consequence of an underlying medical condition or a person's reaction to a diagnosed problem. In this regard, there are frequent cases of suicide attempts, alcoholism. As a result, a person becomes completely socially maladjusted, his personality is destroyed.
- Violations of the process of urination. All symptoms associated with the process of urination at the initial stages of the development of the disease, as it progresses, is aggravated.
- Intestinal dysfunction. This problem can be manifested by either fecal incontinence or recurrent constipation.
- Rare symptoms of the disease. About 6% of all patients with multiple sclerosis suffer from hearing impairment, more often than not deafness develops, but hearing loss, which occurs as a result of damage to the auditory nerve.
Smell disorder is another rare but common symptom of the disease. The causes may be damage to the mucous membranes of the nose, bone deformities.
Epileptic seizures occur in 2-3% of patients. This may be due to the periodically occurring excessive excitation of neurons as a result of the impact on them of a nearby focus of demyelination.
Emotional lability, which manifests itself in unexpected mood swings.
In addition, against the background of the existing symptoms, secondary symptoms of the disease may occur. So, the risk of urinary tract infection increases due to dysfunction of the genitourinary system, pneumonia and pressure sores may develop, which becomes the result of a sedentary lifestyle, etc.
The consequences of multiple sclerosis
- If multiple sclerosis is initially characterized by a severe course, then the risk of death with impaired respiratory function and cardiac activity is not excluded.
- Often the causes of death of patients are pneumonia, which are characterized by a severe course, and replace one another.
- The occurrence of pressure sores is another consequence of multiple sclerosis. They, in turn, are capable of leading to severe sepsis, which causes the death of the patient. Bedsores and diaper rash are susceptible to seriously ill people who have been in an immobilized state for a long time.
Disability awaits all patients with multiple sclerosis, however, with proper therapy, it can be avoided for a long time.
Multiple sclerosis diagnostics
Doctors use special diagnostic criteria to determine the disease:
- The presence of signs of multiple focal lesions of the central nervous system - white matter of the brain and spinal cord;
- Progressive development of the disease with the gradual addition of various symptoms;
- Instability of symptoms;
- The progressive nature of the disease.
MRI of the brain and some parts of the spinal column can reveal the presence of foci of demyelination and detect their distribution. Most often, they are localized near the ventricles of the brain, where its white matter is located. Priority is given to performing MRI with the introduction of a contrast agent, which makes it possible to more accurately identify foci in which the blood-brain barrier is disturbed. This allows you to determine the activity of the inflammatory process at the time of the study.
Sometimes, to confirm the diagnosis, a spinal puncture is required and its biochemical and microscopic examination. The composition of the fluid during the disease changes in it, a moderate increase in the number of lymphocytes is observed, the number of erythrocytes remains normal - this can be seen from microscopic examination.
The key point in the biochemical analysis of fluid is the determination of myelin and the degree of its activity. Its amount during exacerbation of multiple sclerosis in the cerebrospinal fluid will be increased, especially in the first 2 weeks after the onset of the acute phase of the disease.
It may be necessary to study the bioelectric activity of the brain, study VEP, SSEP, auditory evoked potentials, audiometry and stabilography.
Ophthalmological examination is mandatory in the early stages of the development of the disease.
Answers to popular questions
- How long do people live with multiple sclerosis? The patient's life expectancy depends on the timeliness of the initiation of therapy, on the nature of the course of the disease, on the presence of concomitant pathologies. If there is no therapy, then the patient will not live more than 20 years from the date of diagnosis. When negative factors of influence are minimized, the average life expectancy of a person is reduced by an average of 7 years in comparison with the life expectancy of a healthy person. In addition, the age at which the disease manifests itself affects life expectancy. The older the person, the higher the risk of rapid development of sclerosis and death during the first five years.
- Is multiple sclerosis inherited? Multiple sclerosis is not considered a hereditary disease, although there is a tendency to have an intrafamilial predisposition to it. Doctors explain this by the monotony of provocative factors influencing the development of the disease in the conditions of one family.
- Can I drink alcohol for multiple sclerosis? A study was carried out by Bulgarian scientists, which revealed that low alcohol consumption has an anti-inflammatory effect in multiple sclerosis. However, in this regard, doses are important. With the onset of intoxication in patients, coordination and speech disorders are more pronounced, with alcohol abuse, the number of exacerbations of the disease increases. In addition, some doctors insist that the prognosis worsens even with small doses. Therefore, the question of the compatibility of alcohol and multiple sclerosis is still open and each person makes a decision independently.
- Is it possible to take a steam bath with multiple sclerosis? No. Any increase in body temperature (while in a bath, with summer heat, with fever, etc.) leads to a deterioration in the patient's condition, to a violation of nerve conduction. During a visit to the bath, the feeling of numbness of the limbs, fatigue, tremors will increase. In addition, visual impairment worsens and cognitive decline. However, it is worth considering that the symptoms of the disease will decrease as the body temperature decreases. That is, being in the bath will not lead to persistent organic lesions in sclerosis.
Dr. Myasnikov on multiple sclerosis:
Drugs and medicines for multiple sclerosis
Multiple sclerosis is considered incurable at this point in time. However, symptomatic therapy is shown to people, which can improve the patient's quality of life. He is prescribed hormonal drugs, means to increase immunity. Spa treatment has a positive effect on the condition of such people. All these measures can increase the time of remission.
- Treatment with hormonal drugs is performed according to the pulse therapy scheme. That is, the patient is prescribed high dosages of drugs for up to 5 days.
- The intake of corticosteroids is determined by the appointment of magnesium and potassium preparations. It could be Panangin and Asparkam.
- To protect the gastrointestinal tract, Omeprazole, Omez, Ortanol, Losek, Ultop are prescribed.
- It is possible to use an immunosuppressant - Mitoxantrone, which is prescribed for a recurrent and intensely progressive form of the disease.
- To eliminate depression, Ixel, Paxil, Tsipramil, Fluoxetine are prescribed, as well as tranquilizers, for example, Fenozemap.
- Detrusitol, Proserin, Amitriptyline help to cope with pelvic disorders.
- Auxiliary agents that can reduce the symptoms of the disease include nootropic drugs, vitamins of group B and E, enterosorbents, antioxidants.
- A drug from the group of immunomodulators - Copaxone helps to reduce the number of exacerbations.
- Drugs help to cope with pain - Lyrica, Gabapentin, Finlepsin.
Gliatilin for multiple sclerosis
It is a nootropic drug. It is able to have a direct effect on the central nervous system, accelerate the transmission of nerve impulses, improve the elasticity of membranes, and increase the functionality of receptors. In addition, Gliatilin enhances cerebral blood flow, activates the brain. It is taken for the prevention and correction of the disease.
A contraindication to the appointment is individual intolerance to the components of the drug, the time of breastfeeding and pregnancy. In the acute period, intramuscular administration of 1 ampoule per day is indicated. The course of therapy, as a rule, is 10 days, however, an increase in the duration of treatment is possible if it is not possible to achieve positive dynamics at this time.
For the prevention of the disease, the drug is taken in the form of capsules, the dose is calculated by the doctor. The course of treatment can last up to six months.
Sermion with multiple sclerosis
Sermion belongs to the alpha-blocker drugs that improve the cerebral and peripheral blood supply. During its long-term use, cognitive abilities noticeably improve, behavioral deviations decrease.
The drug is prescribed in a dosage of 30 mg twice a day, or 5-10 mg three times a day. Sermion is prescribed for a long term, which cannot be less than 3 months.
Postponed myocardial infarction, acute bleeding, gestation period, breastfeeding, age up to 18 years and bradycardia are contraindications to the prescription of the drug. In case of impaired renal function, a dosage reduction is required.
Novantrone for multiple sclerosis
Novantrone refers to drugs prescribed for cancer. However, it is recommended for multiple sclerosis, as a means of depressing the immune system. As a result, it is possible to reduce the activity of the inflammatory process and reduce the symptoms of the disease. The drug is recommended for admission with a rapidly deteriorating patient's condition, as well as with a progressive-relapsing form of the disease.
The drug is administered intravenously once every 90 days, or up to 4 times a year. The maximum allowable number of doses is from 8 to 12.
Side effects of Novantrone treatment are quite serious, including nausea, hair thinning, up to hair loss, a drop in the number of leukocytes in the blood.
In addition, the drug is prohibited from administration for gout, for viral infections, for sick teeth, for liver pathologies, during pregnancy and lactation, and for some other diseases. It should be borne in mind that the drug suppresses the immune system, so the risk of developing other infections increases. Any deterioration in the condition should see a doctor.
Abagio with multiple sclerosis
Abagio or teriflumonide is used to treat recurrent forms of multiple sclerosis. This drug is taken by mouth every day. It belongs to the group of immunomodulators, has anti-inflammatory properties.
Possible side effects include nausea, diarrhea, abnormal liver function, and loss of hair. For multiple sclerosis, take 1 tablet daily. The course of treatment is determined by the doctor.
Prolips are purified bovine myelin proteins. Its reception helps to prevent the body's autoimmune aggression. Prolips is prescribed in a dosage of 150 mg, the frequency of administration is in 1 day. To prevent exacerbations of the disease, it must be taken throughout the year.
A combination of the drug with Omega 3 and Omega 6 polyunsaturated fatty acids is recommended, as well as with vitamin complexes, which include B vitamins.
Author of the article: Sokov Andrey Vladimirovich | Neurologist
Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".