The prevalence of sclerosis depends on the form of the disease. For example, multiple sclerosis is diagnosed in approximately 2 million patients around the world; in Russia this figure is 150 thousand.
This form of sclerosis usually develops around age 30, but sometimes occurs in children.
Like most autoimmune diseases, it is diagnosed more often in women, with men usually developing rapidly progressive sclerosis.
After 50 years, the ratio of cases of the disease in men and women becomes approximately the same.
Kinds
The disease can affect different human organs and systems. That is why in medicine it is customary to distinguish different types of sclerosis.
| Absent-minded | Pathology is an inflammation occurring in the nervous system. This condition is characterized by the destruction of myelin, which surrounds nerve fibers. Gradually, the area of the affected areas increases, and subsequently multiple sclerosis of the spinal cord develops. This disease is diagnosed more often in women than in men. In addition, the disease sometimes occurs in children. |
| Lateral amyotrophic | This form of the disease is characterized by a progressive course, which is accompanied by damage to central and peripheral motor neurons. The pathology is usually diagnosed after 40 years, and in men it occurs 1.5 times more often. |
| Brain vessels | This form of sclerosis is provoked by cholesterol plaques, which lead to disruption of the blood circulation in the vessels. In this case, the pathology provokes a lack of oxygen and nutrients. As a result, the formation of cysts and scar changes is observed. |
| Subchondral endplate sclerosis | The pathological process affects the bone tissue of the joints. With chronic problems with the musculoskeletal system, active blood flow in the subchondral plate is disrupted. |
| Senile | Senile sclerosis is commonly understood as memory impairment that occurs in older people. This process is associated with the death of nerve cells. For different people, this process occurs at different speeds, and therefore the disease has individual manifestations. |
| Tuberose | This condition is characterized by a neuroectodermal disorder, which is based on problems in the functioning of the nervous system. This disease manifests itself in the form of skin defects and the appearance of benign tumors on internal organs. |
In addition to common types of sclerosis, in medicine there are diseases that are associated with certain organs. For example, cardiosclerosis leads to damage to the valves and muscles of the heart, and pneumosclerosis causes a decrease in oxygen supply to cells.
Classification of sclerosis by location of the lesion
Depending on the affected organ, there are many types of sclerosis:
| Liver | With liver sclerosis, a process of gradual decrease in volume and degenerative changes occur in this organ. As a result of the development of pathology, the liver tissue dies, and nodes form from the scar tissue. Most often, liver sclerosis develops under the influence of alcoholic beverages. Moreover, the toxic effect does not depend on the type of alcohol, but is determined solely by the ethanol content. |
| Bladder | With the development of sclerosis of the bladder, the scarring process is a consequence of inflammation in the area of the neck of this organ. The lesion may also partially affect the bladder wall. Typically, sclerotic changes occur as a result of a complicated period after surgery for prostate adenoma. Sometimes the cause of the development of such sclerosis cannot be established, and in this case Marion's disease, an idiopathic form of the disease, is diagnosed. |
| Prostate | Prostate sclerosis is the shrinking of the prostate gland, which occurs due to the replacement of its connective tissue. As a result, the urethra and the neck of the bladder are compressed. As a result, the outflow of urine is disrupted. Due to prolonged urinary retention, pressure in the ureters and kidneys increases. Over time, this can cause a decrease in kidney function. |
| Kidneys | Renal sclerosis is characterized by compaction and deformation of this organ due to the proliferation of connective tissue. As a result of the pathological process, the volume of metabolic products that must be removed by the kidneys increases. Typically, the development of such sclerosis is a consequence of dystrophic changes in the stroma, tubules or glomeruli. Chronic glomerulonephritis, pyelonephritis and other diseases can also lead to pathology. |
| Stromal damage | The stroma consists of connective tissue, which contains the special elements of the organ. This tissue contains blood and lymphatic vessels. In addition, stromas play a protective role; red and white blood cells are formed from their cells. With the development of stromal sclerosis, dystrophic changes occur in tissues, and the functioning of organs is disrupted. |
| Nodular | This type of sclerosis is considered the most common form of Hodgkin lymphoma. It is most often diagnosed in women and affects the lymph nodes. The disease is diagnosed at a young age and has a good prognosis in the early stages of development. |
| Hippocampus | This type of sclerosis involves the death of neurons. It also suggests gliosis of the neural tissue of the hippocampus. This disease usually accompanies temporal lobe epilepsy. According to statistics, 65% of patients are diagnosed with this condition. Hippocampal sclerosis also occurs in 16% of dementia cases. |
| Multiple | This type of sclerosis usually occurs between the ages of 20 and 50 and most cases occur in women. The causes of multiple sclerosis have not yet been established. At the same time, scientists suggest that the pathology is associated with malfunctions of the immune system. Defense systems perceive myelin sheaths and nerve fibers as foreign. |
Symptoms
Multiple sclerosis is accompanied by the following manifestations:
- visual impairment;
- problems with coordination of movements;
- changes in the functioning of the urinary tract;
- balance problems;
- cognitive impairment.
Also, a person suffering from multiple sclerosis complains of increased fatigue, a feeling of weakness in the legs, and sudden mood swings.
Amyotrophic lateral sclerosis is characterized by paresis caused by atrophy of muscle tissue and increased tone of the limbs. Also, the development of this disease leads to impaired movement of the tongue and vocal cords. As a result, the voice becomes hoarse. The gait loses stability, and atrophy of the hands is observed.
With the development of cerebral sclerosis, a person develops psycho-emotional disorders. These include irritability, sudden mood swings, and a decrease in the activity of mental processes. Headaches and dizziness often occur, which can lead to fainting.
If endplate sclerosis occurs, only a doctor can make a diagnosis. The fact is that the clinical picture resembles the symptoms of pathologies of the musculoskeletal system, and therefore a person often develops arthritis, osteochondrosis, and arthrosis.
The development of senile sclerosis is accompanied by a decrease in mnemonic functions. A person may complain of increased fatigue, numbness and tingling in the limbs. Speech inhibition is often observed.
Tuberous sclerosis is accompanied by the appearance of spots on the skin of the face. As the disease progresses, tooth enamel suffers, and cystic formations appear on the skin and internal organs.
Complications
If multiple sclerosis has a malignant course, it can cause death literally within a few months. If a person has a benign form of the disease, motor functions are gradually impaired. In this case, the disability may not be diagnosed for more than 15 years.
The appearance of amyotrophic lateral sclerosis has irreversible consequences for health, and already 3-4 years after the onset of the disease leads to death. In some cases, a person can live 12 years after the onset of the disease.
If treatment for cerebral vascular sclerosis is not started in time, it can cause heart attacks and strokes. It is also common for people to develop dementia.
Sclerosis of the endplates leads to the appearance of spurs and growths on the affected limbs, which ultimately leads to a complete loss of mobility. The senile form of the disease provokes complete memory loss.
Tuberous sclerosis leads to mental retardation, which manifests itself as autism. A person may also experience unreasonable outbursts of aggression and increased activity.
Prevention
To prevent the development of sclerosis, you need to lead an active and healthy lifestyle. Proper nutrition and a well-organized daily routine will help maintain the health of the nervous system.
You should definitely eliminate bad habits and physical inactivity. Excess weight is also unacceptable.
An effective method of prevention is the timely detection and treatment of vascular diseases. Subsequently, it is very important to be observed by specialized specialists - a neurologist, endocrinologist, cardiologist.
Treatment
Therapy for sclerosis involves the use of diuretics and hormonal drugs. The use of anti-inflammatory and immunostimulating agents may also be required.
In some cases, the prescription of sedatives is required.
In particularly difficult situations, patients are advised to use antidepressants.
Additional methods of therapy are the use of vitamin complexes and antioxidants.
Sclerosis is a fairly serious disease, some forms of which can be fatal. To prevent dangerous health consequences, you should consult a doctor when the first symptoms appear.
Most of us mistakenly believe that sclerosis is a disease of old people who lose memory due to age. Unfortunately, the reality is that this disease affects not only the elderly, but also the very young, and memory loss is just one of the symptoms, and even then it is quite rare.
What is sclerosis, what are its symptoms and types, who is at risk? This article will try to answer all the questions posed.
What is sclerosis?
The term “sclerosis” in medicine refers to a chronic inflammatory process that affects medium and large arteries due to their “overgrowth” with cholesterol deposits and manifests itself in the replacement of normal tissue of connective organs. The occurrence of sclerotic changes in the body can be provoked by:
- past inflammatory diseases;
- circulatory disorders;
- age-related changes.
It should be noted that sclerosis is a disease that can affect almost any human organ and tissue: brain vessels, lungs, heart, kidneys and others.
Risk factors
Research has shown that sclerotic lesions can be caused by a number of factors, which are both modifiable and uncontrollable.
Unmodified risk factors for the development of sclerosis that cannot be controlled include:
1. Genetic, inherited from our parents. For example, the specific structure of proteins and enzymes, metabolic features.
2. Belonging to one or another ethnic group.
3. Age-related changes. It has been established that sclerotic manifestations occur much more often in postmenopausal women and in men over 45 years of age.
The factors we can modify or control are:
1. Lifestyle.
2. Some bad habits.
3. Increased cholesterol levels.
4. Diseases caused by metabolic disorders.
5. Blood clotting disorders.
6. High blood pressure.
7. Physical inactivity.
Classification of the disease
Sclerosis is classified depending on how much the disease has damaged the nervous system and which organs are affected:
- Multiple sclerosis is an autoimmune disease in which the protective myelin sheath of nerve fibers is destroyed under attack from one’s own blood cells and their conductivity is disrupted. The following clinical forms of this disease are distinguished:
Stem;
Cerebrospinal;
Optical;
Spinal;
Cerebellar.
- Arteriosclerosis (atherosclerosis) is a chronic disease that occurs as a result of the deposition of cholesterol plaques on the walls of blood vessels, impeding blood supply, which can subsequently lead to the development of ischemia.
- Amyotrophic lateral sclerosis is a progressive disease that results in the death of motor neurons in the brain and lateral columns of the spinal column, which leads to muscle atrophy and the development of muscle paralysis.
- Cardiosclerosis develops on the valves and muscles of the heart and triggers the development of scar tissue in them, which significantly reduces the ability of the heart muscle to contract.
- Nephrosclerosis occurs as a result of various lesions and injuries to the kidneys and vessels that supply them with blood. Normal tissue is replaced by scar tissue, which leads to dysfunction of this organ.
- Sclerosis of cerebral vessels is caused by cholesterol plaques that impair blood circulation, thereby creating a deficiency of nutrients and oxygen in brain cells and their subsequent death. In place of dead cells, cysts of scar tissue form.
- Cirrhosis (sclerosis) of the liver can be caused by prolonged intoxication of various substances, and also develop as a consequence of viral hepatitis.
- Pneumosclerosis is a disease that causes the growth of scar tissue in the lungs, leading to a decrease in the elasticity of damaged areas and disruption of gas exchange functions.
- Systemic scleroderma causes inflammation of small vessels throughout the body, which leads to sclerotic lesions of internal organs, skin and the musculoskeletal system.
- Subchondral sclerosis is a disease that affects the joints.
Having listed the main types of this serious disease, let us consider in more detail the most common forms.
This is a chronic autoimmune disease that affects the nervous system. Today it is incurable; there are only a number of methods that stop the development of this disease, as well as reduce the frequency and number of exacerbations. Despite many studies being conducted, scientists have still not been able to establish the exact cause of its occurrence. Today, doctors consider multiple sclerosis as a polyetiological disease, that is, having several causes that cause it. Thus, the disease mechanism is triggered only in a certain combination.
Symptoms
This disease manifests itself in a very diverse manner, so much so that doctors had to identify 50 different signs of this disease that can manifest themselves in one case or another. When diagnosing multiple sclerosis, the most common symptoms considered are:
- feeling of constant fatigue;
- depression;
- dizziness;
- visual impairment;
- tingling and numbness in the hands and feet;
- tremor of the limbs;
- bowel and bladder dysfunction.
However, similar symptoms in one or another combination may indicate other diseases. That is why various laboratory tests are carried out to confirm the diagnosis.
Motor Neurone Disease
This is also called amyotrophic lateral sclerosis. It selectively affects peripheral and central motor neurons, which manifests itself:
- in increasing weakness of the pelvic and shoulder girdle, abdominal and torso muscles;
- damage to the bulbar muscles of the tongue, pharynx, larynx and palate paresis;
- in decreased or increased reflexes;
- in spontaneous and irregular contractions of muscle fiber bundles of individual muscles or their groups;
- speech disorder.
Lateral sclerosis in most cases develops in patients after 50 years of age, although this disease can affect a person of any age. Experts distinguish the following types:
Lumbosacral;
Bulbar;
Cervicothoracic.
How is it treated?
Current therapies cannot cure this disease. Patients with a similar diagnosis should be regularly monitored by doctors of several specialties. To maintain the vital functions of patients with a disease such as lateral sclerosis, treatment consists of taking many different drugs, including anabolic hormones. The disease lasts from 2 to 10 years and always, with the exception of the case of Stephen Hawking, has a poor prognosis. Patients die from exhaustion, concomitant infections or paralysis of the respiratory center.
Atherosclerosis
This is another name under which cerebral vascular sclerosis is hidden, a fairly common and often diagnosed disease. Its first symptoms may appear after the age of 25, but usually this disease is diagnosed in people over 50 years of age. During the development of this disease, narrowing and deformation of brain vessels occurs under the influence of cholesterol deposits on their inner surface. As a result, there is a slowly increasing deficiency in the supply of nutrients and oxygen to the organ supplied by the affected vessel.
Atherosclerosis has different symptoms, and their manifestation depends on the location of the disease and the spread of the process. Diagnosis is made by identifying lesions of individual vessels.
Causes
The development of this disease can be triggered by the following factors:
1. Heredity.
2. Staying in constant psycho-emotional tension.
3. Diseases of the endocrine system.
4. High blood pressure.
5. Bad habits, such as smoking.
6. Low physical activity.
During the treatment process, special attention is paid to regular physical activity, which promotes the development of alternative blood flow pathways, as well as proper nutrition.
Subchondral sclerosis
During the development of this disease, degradation of the articular cartilage occurs, which subsequently leads to changes in the surface of the joint. This type of sclerosis is divided into primary and secondary forms. In the first case, healthy cartilage is damaged under the influence of strong overloads of the spine. The secondary form occurs on cartilage that has been injured in some way. Thus, subchondral sclerosis is a disease that can occur both under the influence of injuries and diseases, and due to improper organization of physical activity.
These types of sclerosis are classified:
- atherosclerosis;
- scleroderma;
- amyotrophic lateral sclerosis;
- otosclerosis;
- melorheostosis;
- cirrhosis;
- idiopathic fibrosing alveolitis;
- tuberous form of sclerosis;
- Pick's syndrome, etc.
In colloquial speech, sclerosis is called age-related memory dysfunction.
Most likely, this interpretation comes from the term “atherosclerosis of cerebral vessels,” which is relevant for older people, as a consequence of age-related changes.
Causes of sclerosis and risk factors:
Also note such moments:
- Geographical factor.
- Excessive stress.
- Use of tobacco products.
- Age-related changes in the body.
- Vaccination against hepatitis group B.
- Disorders of carbohydrate and fat metabolism.
- Increased uric acid content.
How does it manifest?
Signs of multiple sclerosis in 50% of cases of the disease are disturbances in the functions of the musculoskeletal system (muscle weakness, impaired coordination of movements). Changes in the sensitivity of the limbs (numbness, ossification). Sometimes there are visual disturbances, difficulty walking, accidental urination, fatigue, and sexual dysfunction. In the later stages of the disease, a decrease in intelligence is observed.
Signs of the course of sclerosis depend on the location of the focus of demyelination. Therefore, symptoms vary from patient to patient and are often unpredictable. The first signs of the disease are the result of demyelination, which causes disruption of the passage of electrical impulses through nerve synapses.
In children
In men and women
In older people
All of the above symptoms are complemented by:
- dementia;
- Alzheimer's disease;
- memory loss.
At first, memory loss is short-term, in small segments, but over time these segments increase.
What types of disease are there?
Absent-minded
Multiple sclerosis is a pathology of a neurological nature, which is characterized by a progressive course with many lesions in the central nervous system and with fewer lesions in the local nervous system. In neurology, we can distinguish the terms:
- "multiple sclerosis";
- "spotted sclerosis";
- "plaque sclerosis";
- "multiple sclerosing encephalomyelitis".
They are all names for the same disease.
The course of the pathology is chaotic, the nature is chronic. Women are most often affected, although about 30% of cases of sclerosis occur in men.
Amyotrophic lateral (ALS)
Subchondral (endplates)
Kidney
Stroma
Nodular
Nodular sclerosis is the most common type of Hodgkin lymphoma, predominant in women and usually affecting the lower cervical, supraclavicular and mediastinal endocrine nodes. The disease affects young people and has a positive prognosis(especially at stages I or II).
In the overwhelming majority of cases, in the affected node, the lymphoid tissue in the form of isolated nodes is divided into ring-shaped layers. In addition to lymphocytes, this structure may contain eosinophils and histiocytes in varying concentrations.
Hippocampus
Hippocampal sclerosis is a form of epilepsy caused by pathology of the limbic system of the brain. The main generator of epileptic activity is considered to be gliosis in combination with atrophy of the cortical plate of the underlying white matter.
To diagnose the disease, neurologists at the Yusupov Hospital use modern instrumental research methods, perform laboratory tests and minimally invasive diagnostic procedures.
Multiple
A situation where nerve fibers are destroyed by the immune system. They will either recover or be replaced by “scars” - areas of dense tissue. In medical practice, these “scarred” areas of manifestation of the disease are called “plaques of multiple (multiple) sclerosis.”
As a rule, during the course of the disease they form in many places and are distributed throughout the patient’s nervous system. An illustrative example: You are cutting the insulation of a wire that carries current. The body does the same with fibers.
What varieties are distinguished according to the nature of the flow?
Remitting
The relapsing-remitting type of multiple sclerosis is the “kindest” or “benign” type. It occurs in 90% of cases in young patients, at the age of 20 years. Characteristic of this type is periodic exacerbation, during which new lesions of the nervous system form or old lesions worsen.
Primary progressive
Primary progressive multiple sclerosis - a course characterized by a noticeable impairment of neurological functions due to the resulting symptoms, without relapses or remissions
Secondary
SPMS does not appear immediately at this stage, unlike PPMS.
Before this course can be identified, the patient must be diagnosed with symptoms of RRMS. In this course, exacerbations and relapses continue, as in the relapsing-remitting course, due to the formation of new foci. The nature of the disease smoothly transitions from demyelinating to neurodegenerative, which is characterized by damage to nerve fibers and tissues.
Mixed chaotic
A progressive-remitting type of disease that is difficult to diagnose.
Forms
Cerebral
The cerebral form is characterized by a disorder of nervous activity(aphasia, apraxia, etc.), epileptic seizures.
Spinal
It is distinguished by lower spastic paraparesis, a mildly expressed disturbance of sensitivity and function of the pelvic organs.
Cerbrospinal
A systemic lesion that combines the previous two types.
Stages
The severity of multiple sclerosis is determined by the EDSS scale, which shows the strength of neurological symptoms. The minimum indicator of this scale (0) corresponds to a neurologically conditionally healthy person. With an EDSS value of 1.0 to 4.5, patients with multiple sclerosis have the ability to self-care, and with an EDSS value of 7 or more, complete loss of motor ability occurs.
Which doctor should I contact? Doctors who treat sclerosis are called neurologists; these specialists have in-depth knowledge in the field of diagnosing and treating pathologies and processes affecting the central and peripheral nervous system.
Treatment method
They resort to both therapy and medication.
In the initial stages
At the beginning stage of the disease, physiotherapy methods are used (electrophoresis, shock and ultrasound therapy). Their essence comes down to the effect of waves on plaques and accumulations in the vessels, which leads to their destruction and gradual removal from the vessels. The sooner the patient goes to the hospital, the greater the chance of recovery without surgery.
If the goal is to restore the functioning of nerve cells, facilitate recovery between seizures, protect the brain and spinal cord from attacks by lymphocytes and support the normal functioning of the immune system. These drugs are used to support the immune system:
- Azathioprine;
- Cyclosporine A;
- Mitoxantrone;
- Methotrexate;
- Interferon beta;
- Immunoglobulins.
In some situations, surgical treatment is required. To stop an immune attack, the thymus gland and spleen may be removed, and a bone marrow transplant may also be performed. In recent years, research has been conducted on the effectiveness of introducing stem cells that replace brain neurons damaged by the disease.
Exercise therapy
This method is a therapeutic exercise that includes special exercises. Physical activity is very important for patients with multiple sclerosis. Swimming and walking are also an excellent effective way to keep fit.
Giving up bad habits also helps to alleviate the condition, since alcohol and alcoholic beverages thicken the blood, no less than sclerosis itself.
Proper nutrition is a must. It is necessary to reduce the amount of sweet foods and carbohydrates in the diet, focusing on protein foods, vegetables, healthy fats (seeds, flaxseed oil, poppy seeds, cheeses).
Conclusion
Use the knowledge and advice provided in this article, then even such a terrible disease as sclerosis will come as late as possible or will bypass you altogether. We remind you that it is easier to prevent any disease than to treat it. Start reviewing your lifestyle right now. Eat healthy food and exercise, then diseases simply won’t have a chance.
Sclerosis is an autoimmune disease with damage to the myelin of nerve fibers, accompanied by neurological symptoms. Clinical symptoms depend on the severity and area of the lesion.
Improper functioning of the immune system leads to the destruction of nerve fiber sheaths by monoclonal antibodies. The process is chronic in nature, in which the defective areas are covered with non-functional scar tissue. The connective tissue covers the affected areas and scars form. Rough fabric cannot be restored.
It is necessary to distinguish between multiple sclerosis and its analogue, which occurs in the elderly. In pathology, the lesions are distributed throughout several parts of the brain and spinal cord. The name is formed based on the presence of many scattered foci.
The concept of “sclerosis” describes the nature of the disorders. Inflammatory areas become sclerosed and become overgrown with coarse connective tissue. The sizes of pathological foci are variable and spread over a wide area. The size of the lesions ranges from a few millimeters to a couple of centimeters.
According to the age limit, multiple sclerosis occurs mainly in young people after 40 years of age. There are cases of the disease occurring in young children - ages 2 and up. After 50 years of age, getting multiple sclerosis is more problematic.
Common and multiple sclerosis - what is it?
Multiple sclerosis is a disease that affects young people. The difference between the pathology and other neurological diseases of the elderly is that it occurs with periods of remission and exacerbation. A gradual increase in various symptoms arising due to disturbances in nerve impulses.
Features of the disease:
- Age 15-40 years;
- Significant reduction in the incidence of the disease after 50 years.
The disease is common. It ranks second in terms of disability among young people. On average, 20-30 cases of the disease are diagnosed per 100 thousand population.
Statistical information indicates the spread of the disease among residents of regions far from the equator. In the northern regions people are more common. The prevalence of the pathology is 70 cases per 100 thousand population. Scientists attribute this prevalence to a lack of vitamin D. The substance is produced under the influence of sunlight, which is insufficient in northern latitudes. This condition leads to disruption of the functioning of nerve fibers and increased permeability of the blood-brain barrier. Antibody damage to the myelin of nerve sheaths.
Sometimes we meet people suffering from this disease on the street or in other places while they can still walk. Anyone who, for some reason, has encountered multiple sclerosis (MS or, as neurologists write, SD - Sclerosis Disseminata) recognizes it immediately.
In the literature you can find information that multiple sclerosis is a chronic process that leads to disability, but it is unlikely that the patient can count on a long life. Of course, this depends on the form, not all of them progress equally, but the longest life span for multiple sclerosis is still short, just 25-30 years with a remitting form and constant treatment. Unfortunately, this is practically the maximum period, which is not meted out to everyone.
Age, gender, shape, prognosis...
Life expectancy - 40 years or more - is an extremely rare phenomenon, because in order to establish this fact, you need to find people who got sick back in the 70s of the 20th century. And in order to determine the prospects of modern technologies, you need to wait 40 years. Laboratory mice are one thing, humans are another. Difficult. With a malignant course of MS, some die after 5-6 years, while the sluggish process allows a person to remain in an active working state for quite a long time.
MS usually debuts at a young age, for example, between the ages of 15 and 40., less often at 50, although cases of the disease are known in childhood and on average, for example, after 50. However, despite the fact that multiple sclerosis is by no means a rare disease, expanding age boundaries does not happen so often, so the occurrence of multiple sclerosis in children is considered the exception rather than the rule. In addition to age, MS prefers the female gender, as do all autoimmune processes.
Patients often die from infections (urosepsis, pneumonia), called intercurrent infections. In other cases, the cause of death is bulbar disorders, in which swallowing, chewing, and the function of the respiratory or cardiovascular system are affected, and pseudobulbar disorders, which are also accompanied by impaired swallowing, facial expressions, speech, and intellect, but cardiac activity and breathing are not affected. There are several theories about why this disease occurs, but its etiology has not been fully elucidated.
Forms and pathomorphological changes of the nervous system
The symptoms of multiple sclerosis are very dependent on the area in which the pathological process occurs. They are caused by three forms, located in different stages of the disease:
- Cerebrospinal, which is rightfully considered the most common, because its incidence reaches 85%. With this form, multiple ones appear already at the very early stages of the disease, which lead to damage to the white matter of both the spinal cord and the brain;
- Cerebral, including the cerebellar, ocular, stem, cortical varieties, occurring with damage to the white matter of the brain. With a progressive course with the appearance of pronounced tremors, another form is distinguished from the cerebral form: hyperkinetic;
- Spinal, which is characterized by spinal lesions, where, however, the thoracic region is most often affected;
Pathomorphological changes in multiple sclerosis are associated with the formation of multiple dense red-gray plaques, forming foci of demyelination (destruction of myelin) of the pyramidal, cerebellar tracts and other parts of the central nervous system (central nervous system) or peripheral nervous system. The plaques sometimes merge with each other and reach quite impressive sizes (several centimeters in diameter).
In the affected areas (the focus of multiple sclerosis), mainly T-helpers accumulate (with a drop in the content of T-suppressors in the peripheral blood), immunoglobulins, mainly IgG, while the presence of Ia antigen is characteristic of the center of the focus of multiple sclerosis. The exacerbation period is characterized by a decrease in the activity of the complement system, namely its components C2, C3. To determine the level of these indicators, specific laboratory tests are used to help establish the diagnosis of MS.
Clinical manifestations, or rather their absence, the duration and severity of remission of Sclerosis Disseminata are determined by what occurs during intensive treatment and the corresponding reaction of the body - remyelination.
It should be noted that MS has no relation to other forms of sclerosis, although it is called sclerosis. Many people, explaining their forgetfulness, which is characteristic of old age, refer to sclerosis, but in the case of multiple sclerosis, although a person’s intellectual abilities suffer, this has a completely different (autoimmune) mechanism and occurs for completely different reasons. The nature of plaques in MS is also different; if sclerotic vascular lesions (!) are caused by the deposition of cholesterol (low-density lipoproteins - LDL), then in this situation foci of demyelination arise as a result of the replacement of normal nerve fibers with connective tissue. The lesions disperse randomly in different areas of the brain and spinal cord. Of course, the function of this area is significantly impaired. Plaques can be detected by myelo- or.
What can cause multiple sclerosis?
Discussions defending one point of view or another regarding the etiology of multiple sclerosis continue to this day. The main role, however, belongs to autoimmune processes, which are considered the main cause of the development of MS. A disturbance in the immune system, or rather, an inadequate response to some viral and bacterial infections, is also not discounted by many authors. In addition, the prerequisites contributing to the development of this pathological condition include:
- Impact of toxins on the human body;
- Increased background radiation levels;
- The influence of ultraviolet radiation (in white-skinned lovers of the annual “chocolate” tan obtained in southern latitudes);
- Geographical location of the area of permanent residence (cold climatic conditions);
- Permanent psycho-emotional stress;
- Surgical interventions and injuries;
- Allergic reactions;
- No apparent reason;
- There is a genetic factor that I would like to especially focus on.
SD does not relate to hereditary pathology, therefore it is not at all necessary that a sick mother (or father) will give birth to a known sick child, however, it has been reliably proven that the HLA system (histocompatibility system) has a certain significance in the development of the disease, in particular, antigens of the A locus (HLA-A3), locus B (HLA-B7), which are detected almost 2 times more often when studying the phenotype of a patient with multiple sclerosis, and D-region – DR2 antigen, detected in patients up to 70% of cases (versus 30-33% in healthy population).
Thus, we can say that these antigens carry genetic information about the degree of resistance (sensitivity) of a particular organism to various etiological factors. Reduced levels of suppressor T cells, which suppress unnecessary immunological reactions, natural killer cells (NK cells), involved in cellular immunity, and interferon, which ensures the normal functioning of the immune system, characteristic of multiple sclerosis, may be due to the presence of certain histocompatibility antigens, since the HLA system genetically controls the production of these components.
From the onset of clinical manifestations to the progressive course of multiple sclerosis
main symptoms of MS
Symptoms of multiple sclerosis do not always correspond to the stage of the pathological process, exacerbations can be repeated at different intervals: even after a few years, even after a few weeks. And a relapse can last only a few hours, or can last up to several weeks, but each new exacerbation is more severe than the previous one, which is due to the accumulation of plaques and the formation of confluent plaques that cover more and more new areas. This means that Sclerosis Disseminata is characterized by a remitting course. Most likely, because of this inconstancy, neurologists have come up with another name for multiple sclerosis - chameleon.
The initial stage is also not very specific; the disease can develop gradually, but in rare cases it can give a rather acute onset. In addition, in the early stage, the first signs of the disease may not be noticed, since the course of this period is often asymptomatic, even if plaques already exist. This phenomenon is explained by the fact that with a few foci of demyelination, healthy nervous tissue takes over the functions of the affected areas and thus compensates for them.
In some cases A single symptom may appear, such as blurred vision in one or both eyes in the cerebral form (ocular variety) SD. Patients in such a situation may not go anywhere at all or limit themselves to a visit to an ophthalmologist, who is not always able to attribute these symptoms to the first signs of a serious neurological disease, which is multiple sclerosis, since the optic nerve discs (ON) may not have changed their color yet (in the future in MS, the temporal halves of the optic nerve will become pale). In addition, it is this form that gives long-term remissions, so patients can forget about the disease and consider themselves completely healthy.
The basis of neurological diagnosis is the clinical picture of the disease
The diagnosis of Sclerosis Disseminata is made by a neurologist based on a variety of neurological symptoms, manifested by:
- Tremors of the hands, legs or the whole body, changes in handwriting, it is difficult to hold an object in the hands, and it becomes problematic to bring a spoon to the mouth;
- Impaired coordination of movements, which is very noticeable in the gait, at first patients walk with a stick, and subsequently transfer to a wheelchair. Although some still stubbornly try to do without it, since they themselves are not able to sit in it, so they try to move with the help of special walking devices, leaning on both hands, and in other cases they use a chair or stool for this purpose. Interestingly, for some time (sometimes for quite a long time) they succeed in this;
- Nystagmus - rapid eye movements that the patient, watching the movement of the neurological hammer to the left and right, up and down alternately, cannot control;
- Weakening or disappearance of some reflexes, abdominal ones in particular;
- Due to a change in taste, a person does not react to once-favorite foods and does not enjoy eating, so he noticeably loses weight;
- Numbness, tingling (paresthesia) in the arms and legs, weakness in the limbs, patients cease to feel a hard surface, lose their shoes;
- Vegetative-vascular disorders (dizziness), why at first multiple sclerosis is differentiated from;
- Paresis of the facial and trigeminal nerve, which is manifested by distortion of the face, mouth, and non-closure of the eyelids;
- Menstrual irregularities in women and sexual weakness in men;
- A disorder of the urinary function, which is manifested by frequent urges in the initial stage and urinary retention (by the way, stool too) as the process progresses;
- A transient decrease in visual acuity in one eye or both, double vision, loss of visual fields, and subsequently retrobulbar neuritis (optic neuritis), which can result in complete blindness;
- Scanned (slow, divided into syllables and words) speech;
- Impaired motor skills;
- Mental disorders (in many cases), accompanied by a decrease in intellectual abilities, criticism and self-criticism (depressive states or, conversely, euphoria). These disorders are most characteristic of the cortical variety of the cerebral form of MS;
- Epileptic seizures.
Neurologists use a combination of certain signs to diagnose MS. In such cases, complexes of symptoms characteristic of SD are used: Charcot's triad (tremor, nystagmus, speech) and Marburg's pentad (tremor, nystagmus, speech, disappearance of abdominal reflexes, pallor of the optic discs)
How to understand the variety of signs?
Of course, not all signs of multiple sclerosis can be present simultaneously, although the cerebrospinal form is particularly diverse, that is, it depends on the form, stage and degree of progression of the pathological process.
Typically, the classic course of MS is characterized by an increase in the severity of clinical manifestations, which lasts 2-3 years to produce detailed symptoms in the form of:
- Paresis (loss of function) of the lower extremities;
- Registration of pathological foot reflexes (positive Babinsky sign, Rossolimo);
- Noticeable unsteadiness of gait. Subsequently, patients generally lose the ability to move independently, however, there are cases when patients cope well with a bicycle, the main thing is to hold on to the fence, sit on it, and then ride normally (it is difficult to explain this phenomenon);
- Increasing severity of trembling (the patient is unable to perform a finger-to-nose test - to reach the tip of the nose with the index finger, and a knee-heel test);
- Reduction and disappearance of abdominal reflexes.
Of course, the diagnosis of multiple sclerosis is primarily based on neurological symptoms, and Laboratory tests help in establishing diagnoses:
Currently answering questions: A. Olesya Valerievna, Ph.D., teacher at a medical university
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