Multiple sclerosis

Multiple sclerosis (synonym multiple sclerosis (MS) is a chronic progressive disease characterized by symptoms of diffuse lesions of the Central and peripheral nervous system, mainly motor, less sensitive pathways. The cause of the disease is not clear.
The majority of authors considers multiple sclerosis infectious viral disease. In the brain, spinal cord contains a large amount of different size and form grey and greyish-pink foci (plaques); they are more common in the side and rear pillars of the spinal cord, in the course of the pyramid, cerebellar and sensitive ways, and also in the brain stem and cerebellum. Microscopically lesions of the nervous tissue is expressed mainly in the foci of microcross and demyelination (damage to the myelin sheaths of nerve fibers pathways, and in later stages and their axial cylinders).
Disseminated sclerosis usually starts at a young age (18-35 years old), rarely up to 18 (12 - 16 years) and after 40 years. Most often, multiple sclerosis starts with movement disorders - fatigue and weakness of the legs that sometimes occurs after a long walk, during pregnancy, after birth, after transferring infections and injuries. Weakness occurs first one leg, then another, gradually growing, in later periods joins the weakness of arms. In this period tendon reflexes in the limbs and tone muscles is increased, marked pathological reflexes, no abdominal reflexes, disturbed deep sensitivity. Less often the first symptoms are parestesia (feeling numbness, crawling pins and needles, legs become as "wooden", as prostheses, a sense of constriction in the area of the body, pain in the hands, feet, spine, headache, disorders of surface sensitivity.
Sometimes the disease begins with unsteadiness of gait. Very frequent optic nerve injury in the form of transient blindness, vision loss, scotomas (see); it is sometimes transient double vision (diplopia). In some cases the disease begins with dizziness, nystagmus (see), vomiting.
In the further course of the disease all initial symptoms can increase or, on the contrary, disappear and reappear. In the course of multiple sclerosis characterized by periods of relative and absolute wellbeing, which can last 2-4 years. However, with every aggravation grow paresis, and in later stages appear paralysis of the arms and legs. Often there are disorders of functions of pelvic organs (delay or incontinence of urine, persistent constipation). Perhaps a slight increase of pressure of the cerebrospinal fluid with increasing amounts of protein (0,4-0,6% respectively), positive globulin reactions and small limfotsitoz (15-20 cells in 1 mm3).
Clinical forms of multiple sclerosis varied; generally describe the form of cerebral, spinal and more cerebrospinal. Death occurs from acceding diseases - pneumonia, typhoid, of urosepsis, sepsis, due to the extensive bedsores and other
The diagnosis of MS in the early period of the disease is difficult and frequently wrong diagnosis - rheumatism, sciatica etc For correct diagnosis is often necessary long-term monitoring; is set to diffuse nature of the brain and spinal cord with multifocal symptoms, beginning at a young age, often sudden (blindness, double vision, weakness of the limbs), remitting and progressive course. Should differentiate with ataxia (see Ataxia), with encephalomyelitis (see), tumors of the cerebellopontine angle (see the brain) and tumors of the spinal cord (see).
Treatment of multiple sclerosis is conducted by a physician. In severe forms, and new outbreaks recommended to assign anti-inflammatory drugs (40% solution of hexamethylenetetramine 5 ml of 40% glucose solution 10 ml intravenously, rate of 15 injections); the daily vitamins: B1 (5% solution thiamine-chloride 2 ml intramuscularly), B12 (cyanocobalamin 200-500 mcg im), B6 (5% solution of pyridoxine 1 ml intramuscularly); adenosine triphosphate (1 % solution of 1 ml intramuscularly); steroid hormone preparations for example, prednisolone 0,005 g 2 times a day during a month (hormone therapy should be combined with drugs potassium - potassium chloride); antiallergic means (diphenhydramine 0,025-0,05 g 2 times a day for 1 month). The motor disorders and pelvic disorders without increasing muscle tone recommended galantamine 1% solution of 0.5 ml subcutaneously 2 times a day; neostigmine in 0,0075 g 3 times daily inside for a period of 2-4 weeks. Physiotherapy, massage. Stay on the air. Not recommended electrotherapy and Spa treatment. Avoid injuries, fatigue, cooling.

Multiple sclerosis (sclerosis disseminata; synonym: multiple sclerosis, sclerosis multiplex, sclerose en plaques disseminees, encephalomyelitis periaxialis scleroticans) is a chronic progressive disease with scattered lesions in the Central and peripheral nervous system, proceeding with exacerbations and remissions.
Geographical distribution. Many authors have noted the relationship of climatic and geographical conditions of the prevalence of multiple sclerosis. Statistical study of multiple sclerosis in the United States for 1949-1951 showed that in the Southern States the incidence of breast cancer is less, than in the North and Canada. The incidence of multiple sclerosis is higher in Scandinavian countries, the UK, Canada, is very low in Japan, China, India. In the USSR it occurs more often in the Urals, in the Baltic States, Belarus and rarely in the Tajik SSR, Transcaucasia.
Among the points that predispose to the disease, Berend (R. C. Behrend) puts a cold climate. Some authors tend to associate the frequency of multiple sclerosis in European countries and the USA with the spread of shots, leading to allergies [Pete (I.e. Pette)]. Others point to the nutritional value (excess fats and carbohydrates in food) and biogeochemical factors (shortage or surplus in the soil of copper, cobalt, zinc).
The etiology of multiple sclerosis is not clear. Sharko (J. M. Charcot) believed multiple sclerosis a symptom of various etiology, mainly infectious. Marie (Marie P.) expressed the opinion about the infectious nature of the disease. Strumpel (A. G. G. Strumpel) the cause of multiple sclerosis saw in congenital predisposition glioznogo tissue to sclerotic changes, but the presence of acute cases of P. S. speaks against this theory. Russell and the brain (J. S. R. Rassell, J. C. Brain) consider the obvious presence of a family of diseases, however, most authors denies hereditary R. S., although sometimes describes the disease two members of the family (a mother and daughter, brother and sister).
Toxic theory of multiple sclerosis is based on the fact that some toxic substances, organic and inorganic origin can cause diffuse the centers of demyelination in the Central nervous system. However, toxic diseases do not have the relapsing nature. Disseminated sclerosis usually develops in people not exposed to the toxic effects. Thus, there are sufficient grounds to assert about the toxic nature of occurrence of P. S.
The Putnam (I. J. Putnam), Hoefer and gray (P. Hoefer, M. Gray) advanced vascular theory R. C. After intravenous animal oils and other blood clotting substances, the authors found they encephalitis and sclerotic plaques and believed that the cause of changes in the nervous tissue in R. S. is the vein thrombosis. The Dow and Bergland (S. Dow, G. Bergland) believe that venous thrombosis are not the cause of R. c., and a blood clot in the veins are formed due to local absorption tromboplasticheskoy substances in the area sclerotic plaques.
No morphological evidence pathogenetic role of circulatory disorders in education sclerotic plaques.


Experimental studies on rabbits (introduction to the sciatic nerve in the spinal fluid of patients with multiple sclerosis) gave the grounds to Bullock (W. E. Bullock) to consider, that in the cerebrospinal fluid of patients R. S. contains filterable virus or soluble in the liquid toxin.
Steiner and kun (G. Steiner, P. Kuhn, 1914 and 1917) was administered to rabbits and Guinea pigs intraperitoneally, vnutriarterialno and in front of the camera eye cerebrospinal fluid and blood of patients R. S., after which he found in animals in the blood (life after death), and in the vessels of the liver spirochaete that was not, however, confirmed by other authors.
In 1957-1958 Simone Arena and (H. S. R. Simons, S. C. Ahrens) found the spirochete in the cerebrospinal fluid in patients with multiple sclerosis. Steiner adds the data as evidence of a role in the etiology R. S. described them "demielinizirutaya" spirochetes.
In 1942-1943 M. S. Margulis, B. D. Solov'ev and A. K. Shubladze from the blood of two patients with acute disseminated encephalomyelitis and from the brain dead patient has identified the virus, infecting which experimental animals, reproduced have acute disseminated encephalomyelitis. The large animals pathomorphological picture was identical with acute disseminated encephalomyelitis man, R. S. and "model" Fox encephalomyelitis.
A. K. Shubladze, and S. Ya, Russian indicated similarity of the virus acute disseminated encephalomyelitis with the rabies virus, but did not identify them.
In 1958 dick, poppy-Kyung, Wilson (G. W. Dick, F. McKeown, D. G. Wilson), exploring the virus strain of acute disseminated encephalomyelitis man, came to the conclusion that this virus is identical to the rabies virus, because the virus infected encephalomyelitis mice in the cytoplasm of nerve cells they were found bullock Negri. Not having received the neutralization of the virus in the serum of patients with MS, the authors denied the relationship virus acute disseminated encephalomyelitis with multiple sclerosis. In their experiments on monkeys and other animals with the virus of acute disseminated encephalomyelitis person Pete and Kersting (G. Kersting) found no Taurus Negri, but considered that these data do not give osnovami to establish a link between the virus acute disseminated encephalomyelitis and R. S.
Cabecera, Vanko, the Xinca and Tukhto (N. Tschabitscher, So Wanko, N. Schinko, W. Tucht) failed to detect M. tuberculosis in the cerebrospinal fluid of patients R. S., which allowed the authors to assume the role of mycobacteria in the etiology R. C. Some authors suggest that toxoplasmosis and rheumatism are significant in the development of multiple sclerosis.
Recently it has been suggested that multiple sclerosis is a disease politologicheskogo. Although the causative agent R. C. not yet open, most researchers believed multiple sclerosis neyrovirushnykh disease. Many authors talk about R. C. how about infectious and allergic disease.