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Publié par happy-diet vendredi 11 décembre 2009

MS Multiple Sclerosis - MS



Introduction

Consists neuron - a building unit of the nervous system - from the cell body cell body and by the central axon, and covers the central party and clouded by a layer of myelin sheets (myelin myelin sheath) and could be likened to article covering electrical wiring, and the image shows the nerve cell and the axis of the cell membrane myelin. And when you crash or damage the myelin layer, the nerve signals that pass through the center of the cell to be slow or disabled, especially when it involves damage to the cover and the pivot on which clouded.

And MS is a patches patches or plaques of the crash or membrane damage myelin - myelin - scared myelin may get the crash as well as axes nerve axons, which, because of this membrane patches of damage in myelin and underlying nerve fibres and these spots are the optical nerve of the eye and brain and spinal cord, and the image shows the cell to the left and right beside infected cell to the right. The reason for this disease is not known, but there is evidence among scientists and researchers indicate that the most likely cause is the immune system to attack the tissues of the body's autoimmune reaction.





The disease is characterized by the existence of periods during which the patient enjoyed relatively good health and periods in which he complained of any symptoms of the disease latency periods and periods of activity. And a patient complains of problems Balibesar vision problems and sensory disorder and abnormal sensations, where the activist movement is slow and heavy. Typically, doctors rely on a complaint by the patient's diagnosis of symptoms and the results of clinical examination and physical examination results of MRI scanning to magnetic resonance imaging - MRI.

Therapy includes corticosteroids corticosteroid compounds that help to reduce the immune system to attack the body's tissues and other therapies to alleviate the patient's complaint. In most cases, the disease progresses slowly and causing some disability or disability for some cases, but not be cause of death only in severe cases.

The word sclerosis means hardening of the scars left by the crash of the tissue that encases nerve fibers myelin sheath in the nervous system and this crash, so-called disarmament myelin demyelination and sometimes corruption occurs, the crash of the same nerve fibers and axons that carry nerve signals. Usually, the disease arises in between the ages of 20 to 40 years, and are often in women, where this ratio is 2 to 1.

In most cases, the grace periods mutual remissions of disease activity with periods of flare-ups or relapses, and disease activity may be simple or causing a state of weakness or vulnerability and the grace periods, followed by improvement and healing but not completely, and so the disease progresses slowly over time.

Cause
Cause was not known, but scientists tend to explain the disease and immune Ktefaal remember that people in the prime of life are exposed to viral infections such as herpes virus and rotavirus herpesvirus or retrovirus and subjected to unknown substances unknown substance, and say that this exposure serve as a trigger and the trigger that starts after the beginning of the move to attack the device immune tissues of the body and this interaction immune inflammatory autoimmune reaction occurs inflammation or damage and destruction crash myelin membrane and nerve fibers which, because of myelin sheath and the underlying nerve fibre.

It appears that genetic factors play a role heredity, at approximately 5 percent of the injuries, the injured brother or sister suffering from the disease in 15 percent of cases there is a close relative who suffers from the same situation that researchers have found genetic factors and certain human leukocyte antigens on the surface of cells the body in patients with this disease and these factors are determined by the position of the immune system of the body's tissues is considered a strange sense Vihagmeha or it is not attacked.

The environment or the ocean environment have a role in the disease, as the environment surrounding the person in the first fifteen years of age were noted to have an impact on the proportion of cases it is up to 1 Overall 2000 in persons who spend these years in a temperate climate temperate climate, while up to 1 per 10000 persons serving in these years in a tropical climate and tropical climate, it also almost does not occur in people living near the equator near the equator and links between scientists and the impact of these ratios the sun on the level of vitamin D that is affected by the level and impact of exposure to the sun, scientists say that people who live far from the sun is lower level of vitamin D in their bodies, and therefore the incidence of this disease have more, but how vitamin D protects the body from the occurrence of this disease, they stop at this point and it is also worth noting that the climate in which spent by the late years of age has no impact on the incidence of the disease. Also, the smoking effect in increasing the incidence of the disease.

Symptoms

Symptoms vary greatly from person to person and from time to time in the same person, depending on the type of affected nerve fibers, sensory nerves get When that transmits signals to the sensory symptoms are a bug in the sense of sensory symptoms, and when they get the nerve fibers that transmits signals to the muscles of the symptoms of a defective motor motor symptoms, and in most cases, symptoms come and go, the fluctuation and volatility of symptoms as a result the crash damage, and damage to the membrane around the nerve fibers, which followed the repair or restoration of repair of this membrane and then followed by more damage more damage, and symptoms are more intense when you expose people to high heat high temperatures, whether by the representatives in hot weather very warm weather or a warm bath, a hot bath or shower or high body temperature may increase fever symptoms or less like you can not predict, however, there are models and types of symptoms, namely:

* For the type of which alternate periods of activity where
And worsening symptoms with which the grace periods, and where the relative improvement and stability of the patient's relapsing-remitting pattern, and the grace periods for months or years, and the setback and the return of symptoms may occur spontaneously or after exposure to infection such as influenza.
* The kind of growing progress of the disease and the symptoms gradually with no grace periods or setbacks Note
This with a temporary periods of stability where the stability and the lack of progress of the disease symptoms or increase the primary progressive pattern.
* Type, which starts setbacks followed by exchange with periods of grace
This is followed by increased disease symptoms and increase the secondary progressive pattern
* The kind of increased disease gradually but interrupt progression of the disease sudden periods of improvement
This pattern is a rare progressive relapsing pattern

The symptoms of myelin on vague and unclear or vague vague symptoms of demyelination and precede the diagnosis of the disease, such as long duration of tingling sensations tingling or numbness or tingling numbness, pain or burning or itching, burning itching in one of the parties or the trunk or face, and the least sense of touch sense of touch the person may lose strength and skill of movement in one of the hands or feet.

He spoke for an eye blurred vision blurred vision or become dark or dim dim person may not see when looking straight ahead central vision, but look at the aspects of the side vision is affected less, and some people have vision in one eye is weaker than the other, causing double vision double vision when eye move from side to side, may cause partial blindness partial blindness one eye pain may occur when you move your eye These symptoms occur as a result optic neuritis optic neuritis The patient suffers from multiple sclerosis neurological symptoms of inflammation of the optic nerve only, without complaint from any other symptoms, and photo identification to the right vision, natural vision and to the left into infected.

And when you hit the back of the neck spinal cord the back part of the spinal cord, the curvature of the neck to cause the feeling of pain or tingling sensation Kalokhoz Kalsdmp electrical electrical shock, which is called the lower back or limbs or one side of the body and the brand known for the tired sign Lhermitte's sign, This occurs sense of sight or a moment and then disappears when you return the neck of the bend to put integrity with the rest of the body and the pain remains with the curvature of the neck forward, As the symptoms appear tremor and irregular motion may occur activist partial paralysis of the muscles or the entire body muscle contractions may occur non - involuntary muscle spasticity may occur weak muscle contraction cause pain in these muscles painful cramps, muscle weakness affects the muscles and spasticity in the movement and speech, which becomes slow and slurred and clear hesitant hesitant.

In cases in arrears may occur as a mental disorder may be affected by nerves that control urination and bowel movement, causing the intensity of desire and many times urination or urine retention or constipation
Diagnosis
Given the broad range of different symptoms, doctors may not recognize the disease in its early stages, some doctors and disease incidence in women and young men when they suddenly appear suddenly blurred vision or double vision or motor or sensory symptoms in different locations and different or multiple and unrelated to the body, and be fluctuation of symptoms and the presence of periods of activity and latency periods of the symptoms supporting the diagnosis of the disease when doctors suspected in the presence of MS, they tend to examine the bottom of the eye and the contact of the optic nerve retina and optic disk pale pale and inflamed, referring to the inflammation of the optic nerve, and is heading for the work of doctors-ray examination MRI magnetic resonance imaging - MRI and places in which they appear on myelin demyelination in the brain or spinal cord in the form of patches patches or plaques, were injected material Gadolenem gadolinium prior to this examination, which helps to distinguish between hot spots and newly demilitarized myelin stains that have occurred since a long time and a precedent when examining the MRI images taken of the patient, and the image shown to the left is a normal brain MRI and to the right image of the brain injured.


Diagnosis may become clear from the symptoms and medical examination and clinical examination of the bottom of the eye and the MRI, but if it was not clear, we may need other tests to find out more, including:

* Examination of cerebrospinal fluid (Spinal tap (lumbar puncture:
And that's where increases cerebrospinal fluid proteins as well as antibodies and help identify the distinctive form of antibody specific pattern of antibodies in identifying the diagnosis in nearly 90 percent of the cases.
* Work to test responses Evoked responses:
And by stimulating certain brain areas and to monitor the electrical activity of these sites, through the alarm sensory For example uses the flash light in the identification of an optic nerve, which shows that the connection speed is slow because of the reference on myelin.

The tests help to distinguish between MS and similar situations.


Seriousness of the disease
For the impact of the disease and the pace of progress of the disease there are significant differences from one person to another, allowing Vfterat may extend to months or years can amount to more than 10 years, however, some people, particularly men who develop in middle age, they suffer recurrent attacks accelerate injury disabilities in all cases, about 75 percent of the cases do not need a wheelchair, as well as the 40 percent of the natural functions of the body does not incur the disease As for the age of the patient The disease has no effect except in severe cases.

Treatment
There is no standardized treatment for all cases. Fmrkpat corticosteroid corticosteroids are usually used to inhibit the immune system is offered for a short period to mitigate the disease during the activity, and despite the fact that these compounds reduce the disease activity and slow down the offer but it does not prevent disease progression also gives formulas and stop as needed and given to long periods of time or extended in order to side effects.


There are other drugs reduce the immune system from attacking the myelin membrane, including:

* Interferon beta Interferon-beta injections and given an injection is given in order to reduce the setbacks and disabilities.
* Jlatyramir glatiramer acetate injections and is also given to reduce relapses and disability in people with injury at the beginning of mild disease.
* Mitutxantron mitoxantrone and is given in order to reduce the progression of the disease in people who do not work with other treatments are not given more than two years of its impact on the heart muscle.
* Ntalivomab natalizumab is an antibody is given in intravenous solution once a month, is as effective as other drugs in reducing the number of relapses and to prevent more damage to the fabric of the brain, however, cause infection, a rare and fatal brain and spinal cord, progressive multifocal leukoencephalopathy and must therefore be used by well-trained doctors with follow-up of patients who treated him for signs of this disease.
* Also, the immune proteins to give immune globulin infusion once a month to help the patient when other drugs are ineffective.
* Also used other drugs for the treatment of muscle contraction of the muscle spasms and lack of control over urination and urinary incontinence to relieve pain and chills, tremors, feeling tired, fatigue or depression depression.
* And for those with the disease, they can enjoy a life with active exercise such as walking, swimming or cycling fixed, it can help to maintain healthy muscles, heart and mental health as well as in reducing fatigue and muscle contraction.

Should also avoid high temperatures such as warm baths.

We must stop smokers from smoking.
And for those who suffer from urine retention must learn how to work a catheter so they can rid themselves of urine were also being given laxatives regularly for people who suffer from constipation, and taking into account the injury to avoid bed sores in people who lose the ability to move.

At the time of disability because of this illness, the specialists in the field of social and occupational therapy can provide assistance for the rehabilitation of patients.

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