Multiple sclerosis (multiple sclerosis, sclerosis multiplex, MS) belongs to the most serious
neurological diseases. The prevalence of MS in Poland is estimated at about 150 cases per 100,000 inhabitants, which means that it is a disease that occurs frequently in Poland (60,000 patients in the whole country). The number of ill people depends mainly on geographical latitude (the farther north, towards the moderate climate, the number of cases is greater) and on the race (mainly white people suffer from MS).
Multiple sclerosis is a chronic demyelinating disease of the central nervous system (CNS).
Outbreaks of demyelination occur in the white matter of the cerebral hemispheres and the spinal cord. Depending on the location of the foci, various symptoms are observed in the CNS area. The first symptoms of the disease usually occur between 18 and 45 years of age. Common symptoms of young people with MS are movement disorders leading to increasing disability. Lower limb paresis is observed more often than the upper limbs and increased muscle tone, high reflexes, pathological symptoms are observed too. With the development of paresis, the ability of the patients to move and cope with normal life deteriorates, it is
necessary to use a wheelchair. Due to the involvement of the corticospinal tract with the disease process, sphincter disorders occur frequently in the form of pollakiuria, urinary incontinence, urgency, persistent constipation or, more rarely, stool incontinence.
Other typical manifestations of multiple sclerosis are cerebellar symptoms and brainstem
symptoms. There is cerebellar ataxia, nystagmus, intussional tremor and dia-logic speech. Double vision may occur due to eye nerve involvement and intranuclear paralysis. Sometimes V nerve neuralgia, peripheral nerve paralysis VII, dizziness and vomiting, swallowing disorders are observed.
Sensory disturbances may appear at a relatively early stage of the disease and proceed
in the form of numbness, tingling, burning of individual parts of the body. There may also be impaired sensory disturbances and sensory ataxia.
Patients with MS often complain of fatigue. Sometimes in the advanced form of MS, there are cerebral symptoms in the form of cognitive decline. Epileptic seizures, depression and manic states can appear.
MS may have different course and different symptoms in individual persons. There are
four forms of the disease:
• relapsing-remitting
• secondary progressive
• initially progressing
• initially progressive with exacerbations.
The course of throws and remissions, and thus periods, is typical for multiple sclerosis
exacerbation and regression of disease symptoms. In accordance with the adopted definition, the disease is affected by the occurrence of neurological symptoms persisting for at least 24 hours. Throws may vary in length, severity and remission. This type of the course of the disease occurs most often, and after about 7 years it goes into the phase of secondary chronic progressive. In this phase of the disease, the attacks are rare or absent but the disease is systematically progressing, leading to increasing disability.
About 15% of patients have a primary progressive form. It differs from that of the secondary
chronic progressive form, usually the later onset, less activity in nuclear magnetic resonance images (MRI), and other genetic predisposition. The course of the disease is progressing without remission from the onset of the disease.
The main feature of multiple sclerosis is the chronicity of this disease, which constantly
proceeds, leading to a significant reduction in mobility and other life activities.
At present, causative treatment of multiple sclerosis is unknown. The use of available drugs
can alleviate symptoms and slow down the development of the disease. However, this does not change the fact that MS will constantly progress and lead to a significant reduction in mobility and serious problems with other life functions.
Currently available therapies for multiple sclerosis are based on the use of drugs such as
interferon, mitoxantrone, glatiramer acetate and humanized monoclonal antibody (natalizumamb). Patients undergoing MS treatment are exposed to dangerous side effects of the above-mentioned medications (mitoxantrone - cytostatics, interferon - paragetic symptoms) and complications of disease, including encephalitis induced by the opportunistic JVC virus (natalizumamb). The current pharmacological treatment of MS does not guarantee cure, but only delays the progression of the disease and prolongs the remission time (the period without relapses) and reducing the deficits associated with MS.
