Multiple sclerosis: causes, stages, symptoms, diagnosis and treatment

Multiple sclerosis has a long latent period and the loss of nerve fibers before the manifestation of pathology can be 10 - 20%. The initial stage of the disease in most cases occurs without symptoms and without timely detection of the disease. Correct diagnosis, selection of medication and therapy at an early stage of the disease restrains its further acceleration and relieves disability.

What increases the risk of multiple sclerosis in women?

The female body, more than the male body, is susceptible to autoimmune diseases, which include multiple sclerosis. Why is the disease so selective and prefers the fair sex?

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There is no explanation for this fact other than gender. Hormonal and immune changes in the body: phases of the menstrual cycle, pregnancy, childbirth, viruses that break the immunity of women, genetic features combined with other causes of the disease more often trigger the disease.

Women's bodies are predisposed to a “jump” in the permeability of the blood-brain barrier

. Periodic use of hormonal contraceptives and menopausal changes (estradiol production stops) lead to the entry of unwanted particles into the brain.

Any viral infection under these conditions is aimed at destroying cells of the nervous system.

It is well known that gender determines differences in the brain of the nervous system, from genetic to cellular. The emergence and development of MS occurs under the influence of sex hormones

, this nuance distinguishes and facilitates the course of the disease in women, unlike men.

Auditory or visual hallucinations may indicate a severe course of illness or be a consequence of stress, substance use, or alcoholic beverages. Read more in the article: “how to get rid of auditory hallucinations.”

Forecast

At the moment, it is difficult to give a prognosis about the future fate of the patient, since brain activity and the brain itself have not yet been fully studied. There is no need to even talk about the prevention and prevention of multiple sclerosis. Throughout the course of the disease, there is a constant increase in exacerbations. What can be said about treatment methods is that it consists of stopping the progression of pathological developments.

Therefore, in case of multiple sclerosis, properly selected individual relief of exacerbations can stop the development of the disease, but not cure it. After stable remission is achieved, physiotherapeutic measures begin to restore the body’s lost abilities.

Therefore, a very important role in treatment is given to caring for victims of this disease. Such complex measures, at home, are possible only with stable remission of multiple sclerosis.

What are the characteristics of multiple sclerosis in women?

The specifics of the disease are:

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• in single or multiple damage to the myelin sheath of nerve tracts in different parts of the central nervous system;
• in violation of the conduction of nerve impulses;
• in the occurrence of severe autoimmune conditions.

Symptoms in women at the initial stage of multiple sclerosis indicate the presence of injured nerve endings in areas of the brain or spinal cord.

Retrobulbar neuritis, dizziness, and muscle weakness are caused by the involution of various functions of the nervous system that determine psycho-emotional and physical health.

The focus of the disease is formed by multiple sclerosis plaques in areas of myelin destruction. Plaques up to 2–3 cm in diameter are observed

, sometimes the MRI picture looks like “everything is like snow” in these plaques; spots of fiber damage can “stick together” into larger ones as the disease progresses.

During the examination, the patient has plaques of different levels of activity: old ones are present and new ones have appeared. Most likely, the answer to such a wide variety of symptoms of the disease lies in the ongoing atrophy of nerve fibers.

Hypothyroidism and hyperthyroidism are diseases that occur against the background of hypofunction and hyperfunction of the thyroid gland. With hypothyroidism, the thyroid gland produces insufficient hormones, and all internal processes slow down. Read more in the article: “hyperfunction of the thyroid gland, symptoms in women.”

Some notes on the course of the disease in women

Primary signs of multiple sclerosis in women are most often not detected, even when the patient has already developed MS plaques in the brain; the onset may go unnoticed, or it may immediately cause enormous damage to health; the disease can manifest itself in different forms.

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Approximate options for recognizing the onset of the disease:

1. due to weakened vision, sensory impairment;
2. the pathology did not manifest itself in any way, but by chance an MRI study showed focal brain damage.

The mechanism of pathology development includes the process of compensation by intact nerve fibers for damage to a small amount of nervous tissue. Until the damage is 40 - 50%, focal neurological signs do not manifest themselves.

The typical course of the disease in women occurs with alternating moments of exacerbation and remission, in men there is a relentless intensification of the disease

. It is believed that female hormones block the dynamics of the development of astrogliosis and the nerve cell membrane is able to recover.

There is no classification of specific signs of multiple sclerosis for different patients. They are individual for each patient. The disease can reveal itself by one or a group of signs depending on the location of the foci of demyelination

.

Causes of MS in adults

Signs of multiple sclerosis usually appear between ages 20 and 40. And this is precisely the main category of patients. The likelihood of the disease is much higher in those who have a family history of the disease, but we are not talking about the fact that it will definitely develop. Eliminating factors that can lead to the development of the disease will allow you to avoid even genetic predisposition. Precipitating factors for MS in adults include:

• Chronic stress

It is worth noting that there is no reliable scientific evidence that stress provokes the development of multiple sclerosis, however, practice shows that severe emotional shock can cause the disease, and almost all patients report stress in their history of the disease.

• Geography

It has been found that the diagnosis is more often made to patients who live far from the equator. The reason is a small amount of sunlight and, therefore, a deficiency of vitamin D. By the way, studies show that about 60% of the world's population lives with a chronic deficiency of the sun vitamin.

• Smoking and poisoning

The effect of carcinogens contained in tobacco smoke and poisoning by toxic substances are possible and obvious causes of MS.

• Viral infections

The herpes virus, rubella, and rotaviruses, although they are not a clear and direct cause of MS, do affect the immune system, and therefore can provoke its impairment and the development of the disease.

Causes of illness in the elderly and children

The likelihood of developing MS in older patients is much lower compared to younger ones. However, the same provoking factors apply. They are layered with acquired chronic diseases and age-related changes. The mechanism of development of the disease in children is associated with the production of antimyelin autoantibodies. The process itself can be triggered by external factors. It is known that in childhood the influence of unfavorable environmental factors is dangerous, which leads to intoxication.

Symptoms of multiple sclerosis depending on the form

The clinical picture of MS depends on which area of ​​the brain or spinal cord is affected.
In accordance with this, several forms of the disease are distinguished. Early signs of multiple sclerosis differ; for example, in one form they are bright, in another they are faded. “Pure” forms of MS are extremely rare; usually the symptoms refer to several at once, and doctors diagnose mixed pathologies.

What causes can trigger multiple sclerosis in women?

The etiology of multiple sclerosis considers the disease as multifactorial

. But the leading role is given to autoimmune processes, considering them as the primary cause of the disease. List of other reasons that may influence the appearance of this pathology:

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• viral and bacterial infections;
• effects of toxic factors on the body;
• increased level of environmental radiation;
• negative effects of ultraviolet radiation on the skin;

  

• geography of permanent residence (cold climate);
• injuries and surgery;
• disturbance of psycho-emotional state;
• infectious and allergic diseases;
• vascular diseases;
• hereditary predisposition.

Symptoms of the initial stage of multiple sclerosis

• Visual impairment
  . A response to the impact of the disease on the optic nerve, causing pain and double vision, the appearance of dry eye syndrome, a black spot in the center, nystagmus.
• Reduced skin sensitivity
  . The onset of the disease is indicated by: numbness in the arms and legs, tingling in the fingers, restless legs syndrome, spasms in the muscles of the limbs.
• Hand tremors
  . The disease at the initial stage is illustrated by trembling of the hands. The patient may find that it is difficult to fasten buttons and tie shoelaces.
• Impaired coordination of movements
  . Lesions on the spinal nerve can cause the following symptoms: dizziness, unsteadiness of gait, loss of balance.

  

• Sudden influxes of heat or cold
  . Damaged nerve fibers “signal” to the brain with soft impulses, and the patient is besieged by unpredictable waves of heat or cold. The manifestation of this symptom has no connection with the temperature of the environment.
• Disorders of the pelvic organs
  . Unexpected constipation, urination is disrupted, and a moment comes when the patient loses control over the processes of bowel movements and bladder.
• Weakened memory and decreased intelligence
  . Decreased memory and mental performance is the most convincing symptom of multiple sclerosis.
• Changes in the length of the menstrual cycle
  . Damage to nerve fibers causes dysfunction of the reproductive system and hormonal levels.
• Increased fatigue
  . The state of overwork and weakness immediately after a night's sleep is the body's response to multiple sclerosis.

Manifestations of sclerosis in women

The symptoms of multiple sclerosis in women, and the causes of their occurrence, are varied and depend on which part of the spinal cord or brain is affected. In addition, symptoms may appear or disappear, which complicates the diagnosis of the organism. Frequent signs of the development of early multiple sclerosis are:

• severe weakness in the limbs;
• constant fatigue of the body with minor loads;
• a sharp deterioration in a person’s visual functions with rapid recovery;
• numbness of the limbs;
• headache;
• dizziness;

  

• severe incoordination of movement;
• men may develop impotence;
• epilepsy appears.

If left untreated, these symptoms intensify, leading to:

• vision;
• speech patterns;
• swallowing problems appear;
• dry mouth;
• lack of sleep and desire to eat;

  

• severe decrease in mental abilities;
• urinary and fecal incontinence;
• dementia develops.

Only timely treatment and early diagnosis of this pathology can save a person from rapid disability and delay its onset. The manifestations of the clinical form of the pathology are directly related to damage to certain areas of the human brain and spinal cord. All of them are expressed by a sharp decrease in the muscle capacity of the victim, which requires outside help in some cases of the disease. If the disease is severe, paralysis of the limbs may occur. In such a situation, an integrated approach to treatment is required,

Consequences of multiple sclerosis

Multiple sclerosis in women brings severe consequences for the body. Multiple sclerosis in itself is not fatal to a person, but its consequences increase the mortality rate significantly. The development of the disease is difficult to predict and predict. The disease has consequences for the body:

• human organs and limbs stop receiving impulse commands from the brain;
• motor skills of smooth movements are impaired;
• unclear speech occurs;
• loss of sensitivity of the skin appears;
• A person's intellectual abilities are greatly reduced.

How the disease progresses largely depends on the immune system and the body's ability to defend itself against multiple sclerosis.

Symptoms of the initial stage

The disease manifests itself in different ways. It all depends on the location of the progressive lesions. Damaged neuron processes (the upper layer of axons) form connective tissue (“sclerotic”) in the form of scars. These dead areas do not conduct nerve impulses from the central nervous system (or spinal cord) to the organs and peripheral areas of the body.

As a result, the nerve cells gradually die. This process is not reversible. Symptoms of multiple sclerosis in women at the initial stage:

• Loss of coordination of movements
  . Accompanied by dizziness and loss of balance when walking.
• Decreased sensitivity
  . It is expressed by burning, tingling in the extremities or a feeling of tight skin.
• Vision problems
  . The patient suddenly begins to have difficulty seeing in one eye. The image becomes cloudy and colors become distorted. This is one of the most common symptoms of multiple sclerosis in women.

  

• Disruption of the genitourinary system
  . Urination becomes frequent or delayed. At the same time, urinary incontinence is observed, as well as disruption of the menstrual cycle.
• Emotional disorders
  . Frequent depression or sudden mood swings are accompanied by either tears or hysterical laughter.

The first manifestations of MS in young girls are associated with visual and hearing impairment. Constant weakness, severe fatigue, frequent headaches and abdominal discomfort are warning signs that cannot be ignored. As the disease progresses, paralysis of the limbs occurs, spreading to the entire body.

How to understand that you are sick?

The initial stage of multiple sclerosis is characterized by alternating relapses (attacks, exacerbations) and remissions. MS in most cases (75-85%) begins in a remitting form. Common symptoms of early-stage multiple sclerosis do not differ between women and men and include:

• sensitivity disorders;
• movement coordination disorder;
• ocular movement disorders (nystagmus);
• sexual and sphincter dysfunctions;
• inflammation of the optic nerve is often present.

In most cases, early stage symptoms subside within 6-8 weeks, but can sometimes leave a permanent abnormal neurological finding or some degree of disability. The ability to reverse the effects of multiple sclerosis in women usually decreases as the disease progresses. The periods of alternating attacks and remission last about 5-15 years. Inflammatory activity on MRI at this stage is the highest.

• MS is a complex disease. It takes about 7 years from the onset of the first symptoms in women in the early stages to the diagnosis of multiple sclerosis. So what should you focus on? What signs are a reason to see a doctor? Changes in sensation in the limbs: tingling, trembling, numbness in the legs;

  

• sensations resembling an electric shock, moving along the spine or radiating to the limbs.

Dizziness in MS has an uncharacteristic course and is often accompanied by loss of limbs and pins and needles throughout the body. What is multiple sclerosis like and how to live with it, how the first symptoms appear - a woman’s view of the problem from the inside:

What is remission of multiple sclerosis?

Remission is a clear decrease or disappearance of neurological symptoms lasting at least 24 hours [3].

If the duration of remission is more than 30 days, then it can be defined as persistent . When a new symptom appears or a clear worsening of previously observed symptoms within 30 days inclusive, the condition is regarded as an ongoing exacerbation [3].

• Going into remission does not mean that the symptoms have disappeared completely. Some people return to their previous state before the exacerbation began, while for others the symptoms persist, but remain less severe than during the exacerbation period.
• The longer the period of exacerbation and the shorter the period of remission, the faster the neurological deficit accumulates and the patient’s condition worsens.

The period of remission of multiple sclerosis, depending on the type of course and activity of the process, can last from several months to several years. The absence of new symptoms and the patient’s stable condition, as a rule, is not a reason to discontinue DMT therapy. Drugs that modify the course of multiple sclerosis must be taken according to the prescribed regimen for a long time and treatment should be discontinued or adjusted only in consultation with the attending physician [7].

It should be remembered that the main condition for maintaining remission of multiple sclerosis is the timely use of prescribed drugs [7]. More detailed rules and recommendations for the use of DMT can be found on the page “Rules for the treatment of multiple sclerosis.”

About 90% of patients have a relapsing-remitting form of the disease. This form is characterized by alternating relapses and exacerbations. Over time, symptoms during exacerbations accumulate and the patient's condition worsens. Therapy allows you to limit the number and depth of exacerbations and slows down the disability of patients [8, 9].

The main objectives of treatment at the early stage of the disease

At an early stage, the disease is asymptomatic or with a range of symptoms.

, confusing the picture of the disease.
Periods of serious condition alternate with moments of relative well-being. After the diagnosis is made, immunomodulatory therapy is immediately prescribed, pathogenetic agents and immunosuppressants are selected. Delayed administration of treatment reduces its effectiveness. It is advisable to quickly solve the following problems:
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1. stop the exacerbation of the disease;
2. provide assistance to foci of autoimmune inflammation;
3. prevent or temporarily delay the appearance of new exacerbations;

   

4. reduce symptoms that make it impossible to work;
5. plan activities to alleviate the illness.

Important information. In the center Pirogov tested the latest method of treating multiple sclerosis through stem cell transplantation and chemotherapy. The patient's immune system was completely removed and later restored using stem cells previously isolated from her own blood.

All about multiple sclerosis of the spinal column

Sclerosis of the spinal column is a chronic pathology, its course is progressive, and the prognosis cannot be called favorable. This disease is considered demyelinating because it affects the myelin sheaths of nerve fibers in the central and peripheral nervous systems. In this case, the soft tissues surrounding the spine are replaced by connective tissue. The protective myelin sheath becomes inflamed and destroyed, causing impaired coordination of motor acts, back pain, impaired urination and defecation in the form of incontinence, as well as some other clinical manifestations.

What can be attributed to the main causes of this pathology?

Medical science these days does not stand still, it is constantly progressing, but all the reasons leading to the development of sclerosis have not been fully studied. The main causative factors are:

• infectious processes caused by viruses or bacteria;
• hereditary predisposition;
• negative effects of toxic products, as well as ionizing radiation;
• geologically undesirable place of residence for a sick person;
• traumatic injuries of the spinal column;
• chronic stressful situations, depressive states;
• dietary violations;
• the presence of various autoimmune pathologies;
• long-term use of various hormonal drugs belonging to a number of contraceptives.

Smokers and people infected with the Epstein–Barr virus are also at significant risk of developing multiple sclerosis. It should be noted that finding out the cause of the disease even after its development can be very, very difficult.

Clinical manifestations of the pathological condition

As already mentioned, in the early stages the disease may not manifest itself at all or may imitate the clinical picture of other diseases. The first symptoms that patients with multiple sclerosis complain about are a decrease in skin pain and temperature sensitivity, numbness in certain areas of the body, and a feeling of goosebumps running across the skin. Often, patients note a decrease in muscle strength in the limbs, the appearance of tremors, and unsteadiness while walking. Very characteristic of this disease is pain in the spinal column of varying degrees of intensity, which intensifies during physical activity, and can also radiate to other parts of the sick person’s body.

In addition, there may be a constant feeling of fatigue that does not go away even after a full night’s sleep, limbs often become stiff, and there is double vision in everything around you. Deterioration in the quality of vision, nystagmus of the eyeballs, and manifestations of epileptic seizures are also often noted.

Males often experience a decrease in the quality and strength of potency and a decrease in sexual desire. Also, patients in advanced stages may experience disturbances in the act of urination and defecation (a variant of incontinence), memory impairment, up to complete amnesia.

Diagnostic and therapeutic measures for multiple sclerosis

If you suspect this pathological process, you should immediately contact a specialist, who in this case is a neurologist. He will thoroughly question and examine you, after which he will prescribe all the necessary diagnostic methods, which include both laboratory tests and modern instrumental research methods.

For this pathology, blood is taken for clinical testing, as well as to identify specific antibodies, cerebrospinal fluid is collected and analyzed, and MRI and evoked potentials are performed.

For treatment, corticosteroids, anti-inflammatory painkillers, medications that protect the structure of joint cartilage, as well as various vitamin complexes are prescribed.
Author: K.M.N., Academician of the Russian Academy of Medical Sciences M.A. Bobyr

Prevention of sclerosis

Prevention of multiple sclerosis includes:

1. Cigarettes and alcohol accelerate the destruction of neurons and can cause damage to the immune system.
2. Monitoring your weight, avoiding strict diets and overeating.
3. Avoidance of hormonal medications (if possible) and contraceptives.

   

4. Refusal of large amounts of fatty foods;
5. Avoid overheating. Alzheimer's disease - what it is, symptoms and signs, causes, treatment, stages.

Multiple sclerosis is an incurable disease that can lead to disability, but this is not a death sentence. It is important to diagnose the disease in time and follow all doctor’s instructions. Then a person has a chance to live to an old age and maintain good spirits. Primary prevention (directly aimed at preventing the disease) does not exist. You can protect yourself a little from multiple sclerosis or its relapses if you exclude any infections, stress, injuries, surgeries, and smoking.

Therapy for multiple sclerosis at the Vesna boarding house

For many people, being diagnosed with multiple sclerosis sounds like a death sentence. The reasons for its development have not yet been fully elucidated. It can occur at any age, and does not depend on status and standard of living. This diagnosis is also a strong blow for the patient’s relatives. Is it possible to help a loved one with this pathology?

Today, treatment for multiple sclerosis has three types and methods:

1. Treatment of disease progression and exacerbations.
2. Preventive therapy through drug treatment.
3. Relief of disease symptoms.

In addition to the listed methods, the first option is the main and most important. The effectiveness of sclerosis treatment depends on many factors, including proper patient care, timely use of medications, and correct performance of physical procedures. Only by implementing these treatment methods will a patient with this diagnosis be able to live his life according to the biological time allotted to him.

For relapsing-remitting multiple sclerosis, during exacerbations, our specialists use pulse therapy with hormonal agents:

1. Corticosteroids, which relieve the inflammatory process in the human central nervous system and restore impaired functions of the body and nervous system. After the exacerbation is relieved, medications are selected, strictly on an individual basis, which stop the development of foci of inflammation and stop the possibility of recurrence of attacks.
2. For progressive secondary sclerosis, our specialists use high-dose immunomodulators, as well as immunosuppressive drugs that suppress the increased activity of the human immune system.
3. Progressive primary multiple sclerosis is the least treatable and requires combating the symptoms of the disease and high-quality patient care, which our boarding house provides at the highest level.
4. Progressive-remitting multiple sclerosis is treated using the same methods as for relapsing-remitting sclerosis.

All these methods must be monitored using diagnostics, which makes it possible to completely begin to control the condition of the affected person. Each treatment has its own individual approach to the patient and his condition, which significantly improves his condition.