Multiple sclerosis
Contents:
Description:
Multiple sclerosis represents the progressing disease affecting the central nervous system and having the autoimmune nature. In 1885 the French pathologist of J.Cruveijhier by drawing up the atlas of pathological anatomy of various diseases of the person included to it and the description for the first time of the changes in a nervous system found by it which he called pyatnisny, or insular, a sclerosis. 33 years later his compatriot the doctor-neuropathologist of J. Charcot gave the detailed clinical description of an illness and allocated it as an independent disease under the name "multiple sclerosis" which is known as the most widespread slow infection of TsNS of the person now.
Reasons of Multiple sclerosis:
Multiple sclerosis belongs to autoimmune diseases. The virus, or other etiological factors causing autoimmune reaction still are not revealed. It is supposed that cells of an oligodentrogliya of myelin covers, due to formation of autoantibodies to a myelin are surprised. There is a myelin dezintergration, synthesis of own gliozny cells changes. Recently the role is given to increase in peroxide oxidation of lipids of a nervous system.
The numerous centers of demyelination in head and back a brain come to light. In the place of the died fibers develops глиофиброз (sclerous plaques) at safety of axial cylinders, the most frequent localization of plaques – side cords, cerebellar ways, optic nerves.
Symptoms of Multiple sclerosis:
In a prodromal stage of a disease, when there is no strong indications of multiple sclerosis, the person paresthesias, tranzitorny paresis of eye muscles, sometimes – non-constant decrease in sight can disturb. These signs can be observed many years before development of a clear picture of a disease.
Allocate three main clinical forms of multiple sclerosis:
1. Cerebral (trunk, cerebellar, optical, hyperkinetic);
2. Spinal;
3. Cerebrospinal.
Carry to clinical symptoms of multiple sclerosis first of all Sharko's triad including a nystagmus, intentsionny trembling, a scanning speech. The pentade of Marburg has also important value (the lower spastic paraparesis, a nystagmus, intentsionny trembling, lack of belly reflexes, a partial atrophy of optic papillas – blanching of temporal half).
The diagnosis is made on the basis of a mnogoochagovost, "blinking" (inconstancy) of symptoms even for days, the wavy course of a disease with aggravations and remissions.
Differential diagnosis is carried out with a trembling form of hepatocerebral dystrophy (Konovala-Wilson's disease), acute infectious encephalomyelitis and a hereditary cerebellar ataxy.
Brain MRT at multiple sclerosis
Defeat of a myelin at multiple sclerosis
Treatment of Multiple sclerosis:
In the period of an exacerbation of multiple sclerosis corticosteroid drugs, cytostatics, nonsteroid immunodepressants, an exchange plasmapheresis, the desensibilizing therapy, antihistaminic drugs, antioxidants are shown.
During remission apply immunomodulators (T-aktvin, Thymalinum), the drugs improving a trophicity of a nervous system (фосфаден, group B vitamins, nootropil), vascular drugs (trental), AKTG and glucocorticoids, immunodepressants. The accompanying therapy is purpose of muscle relaxants at spasticity, Finlepsinum when trembling, a prozerin at disturbance of an urination.
