Once multiple sclerosis (MS) was considered a rare disease. However, as soon as they began to engage closely, it became clear that the disease is fairly common (in the world of these patients is approximately 2.5 million, in Russia, officially, about 200 thousand). Unfortunately, it’s hard invalidusername the disease most often affects young and, curiously, often talented people.
About the features of the disease, risk groups and treatment, we spoke with Alexei Nikolaevich Boyko, MD, Professor of neurology, neurosurgery and medical genetics, Russian national research medical University them. Pirogov, honored scientist of Russia, Director of the center for demyelinating diseases at yusupovskiy the hospital doctor of the highest category.
– Alexey, tell us about what multiple sclerosis is, why it should not be confused with the usual multiple sclerosis?
– This is a completely different disease. Multiple sclerosis (MS) is a disease of young people, which is associated with autoimmune and inflammatory lesions of the Central nervous system, i.e. brain and spinal cord. The basic mechanisms is the destruction of the sheath of nerve fibers – myelin and damage to nerve cells and their axons (neurodegeneration). If You mean memory impairments, they were more common in the elderly and are associated with quite different reasons. Although in MS there are also neuropsychological disorders.
– Who is at risk?
– Has a genetic predisposition to MS, ie family cases. But implementation of this predisposition, based on a combination of more than 200 genes, there must be an external factor that triggers chronic pathological process contributing to the breakdown of immunity to self antigens and development of autoimmune-inflammatory reactions. Among external factors the most significant are now considered to be viruses, especially the virus of Epstein-Barr and low vitamin D, Smoking, environmental pollution, i.e., environmental performance, changes in the intestinal microflora. The disease develops at a unique combination of factors of predisposition and external factors.
– Is it true that RS affects only talented, unusual people?
– There is an opinion that people have more “subtle” mentally, more vulnerable, often talented in something, the PC is more common. But this is not necessary. However among patients lots of artists, poets, professionals of mental labor.
– What is the basis of the PC?
– As I said – this is an autoimmune inflammatory reaction involving T and b cells of the immune system to self antigens in the brain. Already in the early stages in parallel, and neurodegenerative changes. Typically, the formation of foci in the white matter of the brain that disrupt the conduction system. But be sure to include the location and diffusion processes, which lead to the early development of atrophy of the brain tissue. Recently it was proved that the lesions are significantly smaller, but there are in the gray matter of the brain.
– At what age usually the disease manifests itself and what it involves?
– The disease develops usually between the ages of 18 to 45 years, although now more and more cases of PC diagnosed in children and adolescents. At the age of 40 years especially in the age of 20, RS significantly more often found in women. This is due to the hormonal level, which also is important in immune regulation.
– What symptoms should pay attention to?
– There may be disturbances of vision, sensation, movement (weakness and poor coordination), neuropsychological changes. But can not engage in self-diagnosis and self-treatment. It is important that the diagnosis of MS should only bet a neurologist. A lot of diseases which can be the same symptoms as MS, and even the same pattern on magnetic resonance imaging (MRI). Only experts will be able to rule out other causes such chronic multifocal lesions of the brain and spinal cord, in time to assign the correct pathogenetic and symptomatic treatment
– As a curable disease?
– The term “treatable” is not applied for chronic diseases. All of them are incurable. But to do so, that the disease practically does not disturbs a person, he or she maintains a normal quality of life, there is no clinical or MRI activity of the pathological process is now completely solved task.
– What new treatments exist today?
– Every year for patients in Russia are available new drugs for MS treatment. There are new mechanisms of action and dosing regimens of drugs, allowing to pass the courses of therapy, while repeated courses are conducted only when necessary, activation of the pathological process. There are currently 15 drugs for the pathogenetic treatment of relapsing-remitting MS course (alternating exacerbations and remissions). Their so-called – altering drugs for RS (PITRS). It is important early and accurately find the patient the drug, which in this type of course and activity of the RS will be the most effective and safe. Strong and harmless drugs do not happen. The more the drug interferes with the functioning of the organism, the greater the potential risks of unwanted side effects. Therefore, developed “risk management plans” for each drug, taking into account all indications and contraindications, the activity of RS and physical condition of the patient (i.e. other possible diseases) and so on. It is very delicate work, as diagnostic RS, so pick up these drugs only in specialist centres RS, where not only working professionals, neurologists with additional knowledge and experience with these patients, but there are multidisciplinary teams of doctors and nurses who provide a comprehensive treatment of this complex, but now completely curable disease.
HELP “MK” Multiple sclerosis (MS) is a chronic autoimmune disease that occurs in most cases in young and middle age (18-40 years) and ranks second among causes of neurological disability in young people after traumas. If not correctly matched to carry out pathogenetic treatment, the prognosis for PC is poor. About 50% of patients after 15 years from the onset of disease may have trouble walking, another 30% of patients may require a wheelchair or become bedridden.
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