The neuron – the building unit of the nervous system – consists of the cell body and axon, covering the axial end and enveloping a layer of myelin sheath and can be likened to the material covering the electrical wires, and the image shows the neuron and the cell axis and membrane Myelin. When the myelin layer is broken or damaged, the nerve signals that pass through the cell axis are slow or idle, especially when the damage encompasses the envelope and the axis it envelops.
MS is a patches or plaques from the crash or damage to myelin-scared myelin and the damage may also get axons that are covered by this And the spinal cord, and the picture shows the healthy cell to the left and next to an infected cell to the right. The cause of the disease is unknown, but there is evidence from scientists and researchers to suggest that the most likely cause is the attack of the immune system of tissues in the body autoimmune reaction.
The disease is characterized by the presence of periods in which the patient is relatively healthy and periods complain of the symptoms of the disease, any periods of latency and periods of activity. The patient complains of vision problems and abnormal sensations and motor movement where the movement is slow and heavy. Usually, doctors rely on the patient’s complaint symptoms, physical examination results and magnetic resonance imaging – MRI.
Treatment includes corticosteroids that help reduce the immune system’s attack on body tissues and other treatments to ease a patient’s complaint. In most cases, the progress of the disease is slow and causes some disability or disability in some cases, but it is not causing death, except in very severe cases.
Sclerosis means scars left by the breakdown of tissue that encapsulates the myelin sheath of the nervous system. This breakdown is called demyelination, and sometimes damage or damage occurs with the same nerve fibers that transmit nerve signals. Usually the disease arises in the age between 20 to 40 years, and most cases in women, where the proportion of up to 2 to 1.
In most cases, the periods of remissions are reciprocal with periods of activity of the disease flare-ups or relapses, and the activity of the disease may be simple or cause a state of weakness or weakness and the grace periods followed by improvement and healing, but incomplete and thus progress the disease slowly and over time.
Cause it
The cause is unknown, but scientists tend to interpret the disease as an immune reaction. They point out that young people are exposed to viral infections such as herpesvirus or retrovirus. They are also exposed to unknown substances. They say this exposure is triggered by triggering the attack. This immune reaction autoimmune reaction causes inflammation or damage and destruction of myelin sheath and nerve fibers enveloped in myelin sheath and the underlying nerve fiber.
Heredity seems to have a role. In about 5 percent of cases, a sibling has a brother or sister with the same disease. In 15 percent of cases, a relative complains about the same condition. Researchers have found certain human leukocyte antigens on the surface of cells. The body in people with this disease and these factors are determining the position of the immune system of the body tissues in the sense of whether it is considered strange Vijjmha or it does not attack.
The environment or the environment has a role in the emergence of the disease, as the environment surrounding the person in the first fifteen years of age has been observed to have an impact on the proportion of cases is up to 1 per 2000 in people who spend these years in a temperate climate temperate climate while reaching 1 per 10,000 in people who spend these years in a tropical climate and also almost does not occur in people living near the equator and scientists link these ratios and the influence of the sun on the level of vitamin D, which is affected by the level of exposure to the sun, scientists say People living away from the sun would be P level They have less D, so the incidence of this disease is higher, but how vitamin D protects the body from the occurrence of the disease, they stop there, and it is also worth noting that the climate in which they spend the last years of life has no effect on Incidence of disease. Smoking also has the effect of increasing the incidence of the disease.
Symptoms
Symptoms vary greatly from person to person and from time to time in the same person.This depends on the type of nerve fibers affected.When sensory nerves that transmit sensory signals are affected, the symptoms are defective in sensory symptoms, and when nerve fibers that transmit signals to muscles are symptoms of motor dysfunction. In most cases, the symptoms come and go and fluctuate and fluctuate the symptoms as a result of the damage and damage of the membrane around the nerve fibers, which is followed by repair or repair of this membrane and then more damage, more damage, and symptoms are greater in severity when people are exposed to high temperatures If it is represented in a very warm weather, a hot bath or shower, or fever, your symptoms may increase or decrease in an unpredictable manner. However, there are types and types of symptoms:
For the type in which periods of activity alternate
Symptoms worsen during periods of grace, which is a relative improvement and stability of the patient’s condition relapsing-remitting pattern, and periods of grace for months or years, and relapse and return of symptoms of the disease may occur automatically or after exposure to an infection such as influenza.
The type in which the disease progresses and symptoms progressively with no grace periods or noticeable relapses
This is in the presence of temporary periods of stability in which the stability and lack of progression of the disease or increase symptoms primary progressive pattern.
The type that begins with setbacks followed by interchange with grace periods
This is followed by increased disease and an increase in secondary progressive pattern
The type in which the disease gradually increases, but the progress of the disease breaks periods of sudden improvement
وهذا النمط نادر progressive relapsing patternSymptoms of demyelination may be vague, vague, or vague. Symptoms of demyelination may be long before the diagnosis, such as tingling, numbness, numbness, pain, burning, or itching in a limb, torso, or face. touch A person may lose the strength and skill of movement in one hand or foot.
A blurred vision may occur, or the vision becomes dim or dim, and may not see a person when he is looking straight forward central vision, but looking at the sides of the side vision is less affected, and in some people, the vision in one eye is weaker than the other, causing double vision. Partial blindness may occur in one eye and pain may occur when moving the eye and these symptoms occur as a result of optic neuritis and the patient may suffer from multiple sclerosis symptoms of optic neuritis only without complaining of any other symptoms, and the picture shows To the right is the natural vision and to me R vision into an infected
When the back of the spinal cord is affected by the neck, the forward curvature causes a tingling sensation, such as an electric shock, called the lower back, limbs, or one side of the body. This sign is known as the Lhermitte’s sign. This sensation occurs for a moment or then disappears when the neck returns from bending to the upright position with the rest of the body and the sensation of pain remains with the curvature of the neck forward, and with the progress of symptoms appear tremors of movement and irregularity may occur partial or complete motor paralysis of muscles in the body may occur muscle contractions Voluntary muscle weak Spasticity A muscle contraction may cause pain in these muscles, painful cramps, and affect muscle weakness and muscle spasm in movement and pronunciation that becomes sluggish and slurred and hesitant.
In late cases, mental disorder may occur and may be affected by nerves that control urination and bowel movement, causing intense desire and frequent urination or urinary retention or constipation.
Diagnosis
Due to the wide range of different symptoms, doctors may not recognize the disease in its early stages and doctors expect the disease to occur in women and young men when suddenly appear suddenly blurred vision or double vision or motor or sensory symptoms in different places and scattered or multiple and unconnected body, The symptoms fluctuate and there are periods of activity and latency periods in support of the diagnosis of the disease and when doctors suspect the presence of MS, they tend to examine the fundus and the optic nerve contact area of the optic disk, which appears pale and inflamed indicating optic neuritis, as Doctors have a magnetic resonance imaging (MRI) scan that shows the demyelination sites of the brain or spinal cord in the form of patches or plaques. There has been a long and prior examination of MRI images taken to the patient.
The diagnosis may become clear through symptoms and clinical medical examination and examination of the fundus and MRI, but if it is not clear we may need other tests to learn more and most important:
Spinal tap (lumbar puncture)
The percentage of CSF proteins and antibodies increases and identifying the specific pattern of antibodies helps to identify the diagnosis of the condition in approximately 90 percent of cases.
Test work to measure responses
By activating certain places in the brain and then monitoring the electrical activity in these places, through sensory stimulation, for example, uses optical flash to identify the injury of the optic nerve, which shows that the speed of signal delivery is slow due to the demyelination.
Tests help distinguish MS from similar conditions.
The severity of the disease
With regard to the impact of the disease as well as the speed of progression of the disease there are significant differences from person to person, the periods of grace may extend to months and years may reach more than 10 years. All cases, about 75 percent of the cases do not need a wheelchair and also 40 percent of the normal functions of the body is not affected by the disease As for the age of the patient, the disease has no effect except in very severe cases.
the cure
There is no standard treatment for all cases. Corticosteroids are usually used to inhibit the immune system and are given for a short period of time to alleviate the disease during its activity. Or extended due to its side effects.
Other drugs that reduce the immune system’s attack on the myelin membrane include:
Interferon-beta injections are given by injection to reduce relapses and disabilities.
Glatiramer acetate injections are also given to reduce relapses and disabilities in people with mild cases of the disease.
Mitoxantrone is given to reduce the progression of the disease in people who do not work with other treatments and is not given more than two years for its effect on the heart muscle.
Natalizumab, an antibody administered in a solution once in a month, is effective for other drugs to reduce the number of relapses and prevent further damage to brain tissue. Well-trained patients with follow-up are treated to detect signs of the disease.
Also, giving immune globulin proteins once a month intravenously helps the patient when other drugs are ineffective.
Other medications are used to treat muscle spasms, to control urinary incontinence, to relieve pain, tremors, fatigue or depression.
For people with this disease, they can enjoy an active life with exercise such as walking, swimming and stationary cycling. This helps maintain muscle, heart and mental health as well as reduce fatigue and muscle contraction.
High temperatures such as warm baths should be avoided.
Smokers must stop smoking.
For those with urinary retention, they should learn how to make a catheter so that they can get rid of their urine. Laxatives are also given regularly to people with constipation, and avoidance of bed sores in people with mobility.
When disability occurs, social and occupational therapists can assist in the rehabilitation of patients.