Multiple Sclerosis

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Multiple Sclerosis
Body Parts: Head
Medical Subjects: Nervous System
Overview

What Is Multiple Sclerosis?

Multiple sclerosis refers to the central nervous system being attacked by one's own immune system, leading to demyelination of nerve cells (myelination is like the insulating skin outside the wire, and demyelination is the loss of this cortex), which causes limb weakness and paresthesia , Visual impairment, unstable walking, dizziness, eye movement disorders, dysphonia and other manifestations.

If a patient with this disease undergoes a pathological biopsy, it can be seen that the area of neuropathy is plaque-like. Medically, this manifestation is called "sclerosis."

Multiple sclerosis is characterized by a large number of attacks and multiple locations. Each episode may have different symptoms because of the involvement of different parts of the central nervous system. In medicine, this phenomenon is called "time-prone and space-prone". Because patients are prone to relapse, severe limb dysfunction can be left behind. Therefore, long-term medication is generally required to reduce recurrence and delay disease progression.

Are there many patients with multiple sclerosis?

Not many. About 1 out of more than 100,000 people is sick.

Cause

What Causes Multiple Sclerosis?

At present, the cause of multiple sclerosis (MS abbreviated in English) is still unclear, and may be related to the following factors:

  • Genetic factors: Studies have shown that multiple sclerosis is closely related to genes. If one of the identical twins has the disease, the probability of the other is 30%, and the probability of the fraternal twins is 3% to 5%. The incidence of the patient’s parents or siblings The rate is 15 to 35 times that of the general population.
  • Viral infection: It is related to the autoimmune response induced by virus infection, such as measles virus, Epstein-Barr virus, human herpes virus type 6 and so on.
  • Environmental factors: The prevalence of this disease increases with the geographical latitude, the prevalence is smaller in tropical areas, and the number of patients in temperate and frigid zones increases significantly. More light causes an increase in vitamin D in the body, which may reduce the occurrence of multiple sclerosis.
  • Autoimmune response: It is related to the abnormal antibodies in the patient's body attacking its own tissues.

Who are multiple sclerosis common in?

Young women are prone to multiple sclerosis. Female patients are two to three times as common as men, and the average age of onset of women is several years earlier than men.

Is multiple sclerosis contagious?

The key factor that causes multiple sclerosis is the disorder of autoimmune regulation, so the disease cannot be transmitted.

Can multiple sclerosis be inherited?

Multiple sclerosis is not inherited, but people with immediate family members suffering from multiple sclerosis are more likely to develop multiple sclerosis than ordinary people.

Symptom

What Are The Symptoms Of Multiple Sclerosis?

  • At the beginning, it will manifest as fatigue, numbness, unclear vision, unsteady walking, dizziness, eye movement disorders, and unclear speech.
  • The above symptoms can appear singly or in different combinations, and often reach a peak within a day, leading to severe paralysis, sensory disturbances, and even blindness.
  • Patients with medulla oblongata or high cervical spinal cord involvement may have symptoms such as dyspnea and chest tightness.
  • To the late stage of the disease, memory loss and mental disorders can occur.

In addition to the clinical manifestations of the disease itself, what are the harms of multiple sclerosis?

Patients with complete paralysis are prone to deep venous thrombosis in both lower limbs. The thrombus is easy to fall off. With blood flow into the lungs, pulmonary embolism occurs. In mild cases, it only manifests as chest tightness. In severe cases, it can cause breathing difficulties, pulmonary edema, and even life-threatening.

Patients who stay in bed for a long time or who have difficulty swallowing are more likely to have lung infections.

Can multiple sclerosis become cancerous?

Multiple sclerosis is a demyelinating disease, not a proliferative disease like malignant tumors, and therefore does not become cancerous.

Detect

What Tests Are Needed To Diagnose Multiple Sclerosis?

Head and spinal cord magnetic resonance: 

The internal structure of the head or spinal cord is displayed like a slice, and plaque-like lesions in the brain and spinal cord can be seen, and the lesions appear to be different from old to new. Note: A professional neurologist or imaging doctor is required to determine the nature of the lesion.

Lumbar puncture:

Take the cerebrospinal fluid in the lumbar spinal canal for examination. It plays an important role in clarifying the nature of the lesion, and excluding infections such as bacteria and parasites, helping doctors diagnose and treat them, and avoid serious consequences of the opposite treatment.

What should I pay attention to when doing the above check for multiple sclerosis?

When performing head and spinal cord magnetic resonance examination, pay attention to:

  • Patients who have undergone heart or internal jugular vein stent implantation or have undergone orthopedic surgery to release steel plates or other implants, before undergoing a magnetic resonance examination, be sure to determine whether the implants on their body can be resonance check or not. It can be clarified by consulting the doctor who performed the operation on oneself.
  • Do not carry magnetic objects, such as mobile phones, on your body during the magnetic resonance examination.
  • Do not move randomly during the MRI examination, and keep the corresponding posture according to the requirements of the examiner.

When doing lumbar puncture, pay attention to:

  • Before the puncture operation: you should keep lying on your side, with your legs flexed, your head lowered, and your back protruding back. A posture like a "cooked shrimp" will help increase the success rate of puncture.
  • Do not move around during the puncture process, otherwise the needle may break.
  • After the puncture, you should lie down for 6 hours to prevent headaches. If a patient with low intracranial pressure is found during the examination, the doctor will advise the patient to drink more water to reduce the probability of headache.

Which diseases are easily confused with multiple sclerosis?

  • Neuromyelitis optica: In general, the symptoms are heavier than multiple sclerosis.
  • Cerebral infarction: It is more common in older patients, with sudden onset, limb weakness, even paralysis, slurred speech, and disturbance of consciousness in severe cases. It is recommended to go to the emergency department as soon as possible after the onset of the disease, and patients who meet the conditions can receive thrombolytic therapy.
  • Tumors of the central nervous system: multiple lesions of the spinal cord and brain may also occur.
Prevention

How To Prevent Multiple Sclerosis?

The current cause of multiple sclerosis is not clear, so there is no clear preventive measure.

Patients with multiple sclerosis should do the following to reduce the aggravation or recurrence of the disease:

  • Reduce the hot water shower, because it is easy to aggravate the illness.
  • Follow the doctor's advice and insist on medication, and can't stop medication by yourself.
Treatment

How Is Multiple Sclerosis Treated?

Does multiple sclerosis need to be hospitalized?

It depends on the severity of the illness. For more serious cases, such as paralysis of one limb and unclear eyesight, hospitalization is required.

Can multiple sclerosis be completely cured without recurrence?

Multiple sclerosis is characterized by repeated attacks. Moreover, due to multiple attacks, each attack can leave some residual symptoms, which leads to the disease becoming more and more serious.

Therefore, timely consultation and standardized treatment are essential for patients.

If multiple sclerosis is not treated, what are the serious consequences?

  • Severe functional disability: such as limb paralysis, blurred vision and even blindness.
  • If patients who have improved do not take preventive treatment, they are prone to recurrent attacks, which will lead to serious disability.

What are the treatments for multiple sclerosis?

The main treatment for patients with multiple sclerosis is drug therapy, without surgery.

Drugs include treatment in acute stage and treatment in remission stage.

What is the treatment of multiple sclerosis in acute stage?

The purpose of treatment in acute stage is to improve symptoms, shorten the duration of disease onset, and prevent serious complications and sequelae.

Commonly used treatment is intravenous injection or oral administration of glucocorticoid, such as methylprednisolone. Because the severity of different patients is different, combined with the experience of clinicians, the dosage and scheme of hormone use often vary from person to person.

Plasma exchange therapy and/or high-dose intravenous human immunoglobulins (commonly known as "globules") may be attempted if hormonal therapy is unsatisfactory or if the patient is unable to tolerate its adverse effects.

What is the treatment of multiple sclerosis in remission stage?

The main purpose of treatment in remission is to reduce the recurrence of multiple sclerosis, delay the progression of the disease, and improve the quality of life of patients.

At present, there are more than ten kinds of drugs in the world to reduce the recurrence of multiple sclerosis and delay the progression of the disease. Including: dimethyl fumarate, teriflunomide, fingolimod, sinimod, cladribine, beta-interferon, glatiramer acetate, natalizumab, orrelizumab, Alemtuzumab.

Although rituximab is a "super-indication drug" in the treatment of multiple sclerosis, there are few high-quality studies in this area, but it has been widely used for multiple sclerosis for more than ten years. Can be used as an alternative.

Patients should receive regular medication as soon as possible to avoid delaying the disease.

What should multiple sclerosis patients pay attention to during hospitalization?

The following situations should be notified to the doctor:

  • Exacerbation: the original symptoms are aggravated or new symptoms appear.
  • Adverse reactions such as allergy, nausea and vomiting occurred during drug treatment.

Do patients with multiple sclerosis need frequent reexamination?

Yes, for the following reasons:

  • The disease is easy to recur, and the medication plan should be adjusted according to the actual situation.
  • Long-term use of glucocorticoids or β -interferon may cause liver and kidney dysfunction, electrolyte disturbance and other side effects, so the corresponding indicators should be re-examined according to the requirements.

Will there be sequelae after multiple sclerosis is cured?

Yes, multiple sclerosis occurs repeatedly, and it is easy to leave sequelae, such as weakness of legs and feet, decreased vision of eyes, dysuria or defecation, numbness of one limb, etc.

How to judge whether multiple sclerosis is cured?

Generally, it should be reexamined within one month after the onset of the disease. If the disease has not recurred for a long time or the condition has not deteriorated significantly, it can be reexamined once every six months.

There are two bases for judging whether the disease has improved or not:

  • Whether the original symptoms are improved or alleviated. For example, whether the muscle strength of patients with myasthenia has improved, and whether the sensory symptoms of patients with numbness of limbs have returned to normal.
  • Whether the lesions in the head are reduced.
Life

What Should Multiple Sclerosis Patients Pay Attention To In Their Lives?

Patients need to adhere to medication, check regularly, keep proper exercise, enhance their immunity, and avoid fatigue, stress, smoking and drinking.

What should we pay attention to in diet?

Patients undergoing hormone therapy are encouraged to eat foods that are high in protein, low in fat, easy to digest, and rich in potassium and calcium. And intake enough water, avoid eating spicy, too cold, too hot, too hard and other irritating foods. Do not drink strong tea, coffee and other stimulating beverages.

How should multiple sclerosis patients exercise?

Rehabilitation exercises for limbs with corresponding dysfunctions are recommended to go to a professional rehabilitation center.

What should we pay attention to during the treatment and medication of multiple sclerosis patients at home?

Need to pay attention to the following:

  • Adverse drug reactions (such as osteoporosis, hormone-related ulcer, obesity, etc. caused by long-term use of glucocorticoids) should be treated promptly, and doctors will adjust the dosage of drugs or modify the treatment plan as appropriate.
  • Some drugs may have liver and kidney function damage, which should be monitored regularly according to doctor's advice.

Does multiple sclerosis affect fertility?

If the lesion involves the spinal cord, it may affect sexual function and thus affect fertility.

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