Early and late symptoms of multiple sclerosis. Symptomatic therapy for multiple sclerosis Multiple sclerosis dizziness how and how to relieve it

There are five forms of the disease:

1. Recurrent – ​​the most common, when after deterioration comes improvement.
2. Recurrent-progressive – partial restoration of neurological functionality after each period of deterioration. Moreover, in the pauses between stages of remission, the symptoms of the disease become more pronounced.
3. Primary progressive – the onset of the disease is slow and the symptoms practically do not bother the patient.
4. Secondary progressive - a recurrent and relapsing-progressive disease several years after the first exacerbation appeared. There is a gradual, irreversible development of neurological disorders.
5. Clinically isolated – when the disease first appeared.

Symptoms of multiple sclerosis at different stages

Let's look at the classic symptoms at different stages.

Among the atypical forms:

1. The disease was detected in a child under sixteen years of age.
2. Manifestation of clinical signs after 45 years.
3. Persistent neurological crisis in the shortest possible time.
4. Maintaining full functionality for a long period of time.

First signs

Multiple sclerosis can be recognized by the appearance of:

• headaches;
• nausea;
• dizziness;
• tremor;
• states of apathy and depression;
• loss of appetite;
• disorders in the gastrointestinal tract;
• insomnia;
• limited movement and impaired coordination.

EDSS scale

The scale analysis provides results on how the seven systems and organs work. The operation of such systems is analyzed:

1. visual.
2. Pyramid.
3. Cerebellar.
4. Thoughtful.

In addition, they examine:

1. Brain structure.
2. Pelvic organs.
3. Brain tissue sensors.

When the diagnosis is completed, the doctor assigns points that determine the severity of the disease and the treatment plan.

Interpretation results

Here is a breakdown of the values ​​in the table:

The relationship between scores and disability

The values ​​obtained on the scale are needed not only by the doctor and the patient. The points determine which disability group will be assigned to a person diagnosed with multiple sclerosis:

• 3-4.5 – third;
• 5-7 – second.
• From 7.5 – first.

The group, in turn, depends on financial and social assistance. The patient can count on some free medicines, sanatorium treatment, and the provision of means to facilitate movement: canes, wheelchairs, crutches. A social worker may also be provided to a disabled patient.

Photo

And this is what patients with this type of sclerosis look like in the photo.

How to determine using diagnostics?

Typically, diagnosis begins with a conversation between the doctor and the patient, examination and collection of tests. The diagnosis of multiple sclerosis is made based on the results of an MRI and a biopsy - analysis of a sample nerve tissue, and not on obvious signs of pathology. In order to reveal it early stages, magnetic resonance imaging of the spinal cord and brain is used.

This procedure reveals the “plaque”, which is the source of inflammation. Today, a new development is used, called polar contrast. The method determines the activity of nerve impulses. Diagnostic methods cannot clearly identify pathology. There is also no universal method of basic therapy. The cerebrospinal fluid is analyzed and immunological and infectious markers are identified.

Important: If you notice symptoms of multiple sclerosis, consult your doctor. Do not start treatment without first consulting a specialist and do not resort to questionable methods.

Treatment

Multiple sclerosis cannot be cured, but the right treatment can help slow its progression. The use of corticosteroids relieves symptoms of the disease. Modifying therapy drugs are also used. They slow down the work of the central nervous system and make receptors less sensitive to the action of the stimulus.

To avoid the onset of illness, you need to eat right, maintain physical activity, maintain a sleep schedule and avoid stress. If you have been diagnosed with multiple sclerosis, do not self-medicate and strictly follow your doctor's instructions.

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Multiple sclerosis (MS) is a disease immune system, which affects the central nervous system. In MS, inflammation damages myelin, the protective covering around nerve cells. The resulting injury or scar tissue interferes with the transmission of nerve signals.

Symptoms of MS can include vision problems, numbness in the limbs and balance problems. Dizziness and dizziness are common symptoms of MS, although most people do not have them as their first symptoms. Read on to learn more about these symptoms and what to do about them.

Symptoms of Dizziness and Dizziness in MS

Many people with MS experience episodes of dizziness, which can make you feel light-headed or out of balance. Some also have episodes of dizziness. Vertigo is the false sensation of you or the world around you swirling or spinning. One report suggests that about 20% of people with MS experience dizziness.

Dizziness and dizziness contribute to the balance problems that are common in people with MS. Constant dizziness and dizziness can interfere with daily tasks, increase the risk of falls, and even cause you to lose consciousness.

Dizziness is an intense sensation of spinning, even when you are not moving. It's similar to what you feel in a spinning amusement park. The first time you experience dizziness can be very unsettling, even frightening.

Dizziness may be accompanied by nausea and vomiting. It can last for several hours or even days. Sometimes dizziness and vertigo are accompanied by vision problems, tinnitus or hearing loss, or difficulty standing or walking.

CausesBasics of dizziness and dizziness in MS

The damage that occurs due to MS makes it difficult for the nerves in the central nervous system to send messages to the rest of the body. This causes MS symptoms that vary depending on the location of the lesions. A lesion or damage to the brain stem or cerebellum, the area of ​​the brain that controls balance, can cause dizziness.

Dizziness can also be a symptom of a problem with inner ear. Other possible reasons dizziness or dizziness include certain medications, diseases blood vessels, migraine or stroke. Your doctor can help you rule out other possible causes of dizziness.

Self-helpServer measures

When dizziness occurs, the following steps will help you stay safe and more comfortable:

• Sit until it passes.
• Avoid moving your head or body.
• Turn away the bright lights and don't try to read.
• Avoid stairs and do not try to move until you are sure the dizziness has passed.
• Start moving very slowly as you feel better.

If you feel dizzy at night, sit up straight, turn on soft lighting, and remain still until you feel better. The dizziness may return when you turn off the lights and lie down. A comfortable chair can help.

Treatment Treatment for dizziness and vertigo

Over-the-counter (over-the-counter) anti-wrinkle medications may be all you need. They are available as oral tablets or skin patches. If dizziness or dizziness becomes chronic (long-lasting), your doctor may prescribe stronger anti-aging or anti-nausea medications.

In cases of severe dizziness, your doctor may suggest a short course of corticosteroids. In addition, physical therapy can be helpful to improve balance and coordination.

RisksRumors about dizziness and dizziness

Balance problems caused by dizziness and dizziness increase the risk of injury due to a fall. This is especially true for people whose symptoms of MS already include problems walking, weakness and fatigue. Several safety measures around the home can help reduce this risk:

• Clear your home of trigger hazards, especially throw rugs.
• Use a cane or walker.
• Install handrails and grips.
• Use a shower chair.

Most importantly, remember to sit down when you feel dizzy or spinning.

Contact your doctor

Tell your doctor if you have MS and frequent attacks of dizziness or dizziness. They can test you and rule out other problems to determine if MS is causing the problem. Regardless of the cause, your doctor may recommend a course of treatment to help you feel better.

Clinical manifestations multiple sclerosis (MS) are diverse. This is explained by the dispersion of lesions of the central nervous system (CNS), whichlocated in various parts of the brain and spinal cord.

Depending on their predominant localization, cerebral, spinal and cerebrospinal forms of MS are distinguished.

Due to the variety of symptoms, MS is often called the disease of 1000 faces.

In most cases, there is a relapsing-remitting type of disease.
Periods of remission, in this case, alternate with periods of exacerbation. The stable state can last for various periods of time.

In some, a more severe, steadily progressive course is noted (progredient primary and progressive secondary).
A distinctive feature of MS is (especially in its early stages) the fragmented appearance of various symptoms.

At the beginning of the disease, in places where myelin is destroyed, a recovery process is still possible.
This is the basis for the positive dynamics of the disease (remission). Subsequently, demyelination becomes more persistent and widespread.
At the sites of myelin destruction, compacted areas form connective tissue. (see Pathogenesis of MS)

The first signs of the disease often occur after illness, injury, prolonged physical activity, pregnancy, childbirth.
Usually, these are transient (reversible) motor and sensory disorders - weakness in the legs, or, less often, in one arm and leg on the right or left (according to the hemitype), coordination disorders (lack of coordination of gait, awkwardness, trembling when performing purposeful movements, paresthesia, visual impairment , speeches.
Nystagmus, intentional tremor and strident speech were described in patients with MS in 1865. J Charcot (French neurologist). The combination of these three symptoms is called Charcot's triad.
Visual impairment occurs due to damage to the optic nerves.

Visual acuity decreases (transient amaurosis and amblyopia), blurred vision, diplopia, and narrowing of visual fields occur.
Scotomas and changes in the fundus appear in the form of partial or complete atrophy of the temporal halves of the optic nerve discs.
With isolated visual disorders, retrobulbar neuritis is usually diagnosed. The relationship between these two diseases has been established.

In addition to the visual ones, MS affects the facial, abducens, and oculomotor cranial nerves. Vestibular disorders occur - dizziness, loss of coordination, nystagmus.
At the onset of the disease, both individual symptoms and their various combinations are observed.
Movement disorders throughout the course of the disease are leading - these are paresis, in advanced stages - paralysis, coordination disorders.
Paresis is more pronounced in the proximal limbs. Lower paraparesis is more often observed, triparesis and tetraparesis are less common.
Clinical examination reveals signs of pyramidal insufficiency, in varying degrees of severity, signs of damage to the cranial nerves, cerebellar deficiency, intellectual-mnestic, emotional-volitional disorders.
Weakness in the limbs is combined with increased tendon reflexes and expansion of their reflexogenic zones.Sometimes, clonus of the feet is noted, less often - of the kneecaps.
But, if cerebellar disorders predominate, damage to the roots, anterior horns and posterior columns of the spinal cord, a decrease, and, in rare cases, loss of tendon reflexes is possible.

The most common pathological symptoms are Babinsky and Rossolimo. It is detected in most patients even at the earliest stages of the disease.
Absence, exhaustion or decreased superficial abdominal reflexes - also common signs MS in the initial period.
In approximately a third of patients, reflexes of oral automaticity can be detected.

Coordination disorders are also a typical sign of MS. An atactic gait, instability in the Romberg position, and intentional trembling almost always accompany this disease. Often, ataxia of the arms and legs, changes in handwriting, and dysdiadochokinesis are observed.
Disturbances in the sensitive area are manifested by subjective sensations in the form of paresthesia and pain of various localizations.
Objectively, disturbances in the vibration and muscle-articular spheres are detected.
Superficial types suffer less frequently and are of the radicular rather than conductive type.
After taking a hot bath, shower, bath, sauna, prolonged exposure to the sun and even after eating hot foodthere is an increase in existing symptoms. Elevated temperature worsens conduction along demyelinated fibers and worsens the patient's condition.
With a long course of MS, a disorder is often detected in the intellectual, mnestic and emotional volitional spheres varying degrees expressiveness. Sometimes generalized seizures occur.
Remission of the disease, in duration, can be from several months to several years and even decades.
The first remission is usually more complete and longer than subsequent ones.

During the course of the disease, the duration of the stable period decreases, and the severity of neurological symptoms increases.
The relapsing-remitting type of the disease predominates when it begins at a young age. In the later stage, a progressive primary and progressive secondary course are more often observed.
Complications include pneumonia, chronic cystitis, and chronic pyelonephritis.

Course of multiple sclerosis and prognosis. Diagnosis of multiple sclerosis is based largely on clinical data that indicate a relapsing course of the disease. It is characteristic of multiple sclerosis that the neurological symptoms of the central nervous system “flicker”, that is, they are disseminated over time. For example, with one of the exacerbations an episode of dizziness develops, with a subsequent exacerbation - neuritis optic nerve. Clinical diagnosis is confirmed by MRI findings. Multiple sclerosis tends to progress with the appearance of new neurological symptoms and complaints. The prognosis depends on the degree of involvement of the nervous system in the pathological process.

Prevention of multiple sclerosis. Currently, no specific measures have been developed to prevent multiple sclerosis, but the severity and severity of each individual exacerbation can be reduced by using special treatment.

Therapeutic approach for multiple sclerosis. Treatment of multiple sclerosis includes treatment of exacerbations with intravenous methylprednisolone, as well as long-term treatment with preventive drugs that reduce the frequency of subsequent exacerbations and progression. Treatment of multiple sclerosis is discussed in detail in our article.

Expected treatment results and prognosis for multiple sclerosis. It is believed that certain treatments can reduce the severity and severity of individual episodes of exacerbation of multiple sclerosis and its progression. Treatments are described in our article.

Specialist consultations. Patients with probable or confirmed multiple sclerosis are observed and treated by a neurologist.

Arnold-Chiari malformation

- Course of Arnold-Chiari malformation and prognosis. Arnold-Chiari malformation in adults consists of descent of the cerebellum or brain stem below the level of the foramen magnum. The condition usually presents with unsteadiness or dizziness, which is accompanied by nystagmus, often directed when looking to the side. Oscillopsia often creates the impression of dizziness when the patient looks to the side. Symptoms tend to progress over time. It is possible that, over time, the appearance of a headache when coughing against the background of progressive compression of the brain stem.

- Prevention of Arnold-Chiari malformation. Preventive actions treatments aimed at preventing disease progression have not yet been developed.

- Therapeutic approach for Arnold-Chiari malformation. After verification of the diagnosis, it is recommended to carry out surgery decompression of the posterior cranial fossa.

- Expected results of treatment of Arnold-Chiari malformation and prognosis. Surgical intervention in most cases it helps to stop the progression of stem symptoms and sometimes leads to regression of existing symptoms.

- Consultations with specialists for Arnold-Chiari malformation. After confirming the diagnosis of Arnold-Chiari malformation with MRI data, the patient is referred to a neurologist, who decides on treatment and referral for neurosurgical treatment. III. Dizziness on exposure medications and for systemic diseases

Dizziness with postural hypotension.

Course of postural hypotension and prognosis. Symptoms of postural (orthostatic) hypotension are usually described by patients as a feeling of instability, rather than rotation of objects. Often there are no attacks systemic dizziness occur when changing body position, for example, when getting up from a lying position, but sometimes they can develop after a few minutes. They may be accompanied by “blackout” in the eyes or even fainting. The course of the disease and prognosis depend on the pathology underlying postural hypotension. This may be autonomic neuropathy, including diabetes mellitus, as well as taking certain medications. Diabetic neuropathy tends to progress over time. If postural hypotension is the result of taking antihypertensive drugs, then improvement can be achieved by changing the dosage regimen or discontinuing the drug.

Prevention of postural hypotension. Currently, no means of preventing autonomic neuropathy have been developed. Careful control of blood pressure helps prevent postural hypotension caused by antihypertensive agents.

Therapeutic approach for postural hypotension. Treatment of postural hypotension in autonomic neuropathy is challenging. Some episodes can be stopped by wearing special elastic stockings and tights. Sodium-sparing corticosteroids such as fludrocortisone (Florinef, Cortineff) can have a significant effect, but they should be used with caution, given the possibility of developing heart failure.

Expected treatment results and prognosis for postural hypotension. The prognosis depends on the pathology underlying postural hypotension. The most favorable prognosis is for hypotension caused by the use of antihypertensive drugs.

Consultations with specialists for postural hypotension. Patients with postural hypotension due to pathology of the autonomic nervous system are usually referred to a neurologist who specializes in diseases of the autonomic nervous system.

Transcript

1 Dizziness in the multiple sclerosis clinic Dudov T.R. 1, Shevchenko P.P. 2 1.Student, Stavropol State medical University; 2. Candidate of Medical Sciences, Assistant of the Department of Neurology, Stavropol State Medical University Abstract The article discusses the etiopathogenesis and features of the nature of dizziness in multiple sclerosis, which play a certain diagnostic role; as well as basic methods for correcting dizziness. Dizziness is often observed in patients with demyelinating diseases, primarily multiple sclerosis. The characteristic relapsing course of the disease, multifocal lesions, the examination results make it possible to recognize the nature of pathological process. Diagnostic difficulties may arise if dizziness occurs at the onset of the disease, in the absence or moderate severity of other symptoms of damage to the brain stem and cerebellum. Dizziness in patients with multiple sclerosis can be of a mixed nature and is characterized by a persistent course. Key words: multiple sclerosis, dizziness. Signs of dizziness in case of multiple sclerosis Dudov T.R. 1, Shevchenko P.P. 2 Stavropol, Russia 1.The student of Stavropol Statement Medical University, 2.Candidate of Medical Sciences, the assistant of the Neurology Department of Stavropol statement Medical University. Annotation This article concerns aetiopathogenesis and those peculiarities of nature of in case of multiple sclerotic dizziness which play a certain diagnostic part. Dizziness is often observed among people suffering from demyelinizing diseases, mainly from multiple sclerosis. Typical remissive clinical course, multinidal affection, survey results enable to identify the nature of pathological process. Diagnostic complications may arise if dizziness occurs with the invasion, in the absence or moderate intensity of other symptoms of the affection of the brainstem, of the cerebellum. Dizziness among those suffering from multiple sclerosis may have mixed nature, it is characterized as intense.

2 Key words: multiple sclerosis, dizziness. Relevance: the need to study multiple sclerosis is due to its significant prevalence among diseases of the nervous system. Multiple sclerosis is a chronic, progressive disease characterized by multiple foci of demyelination in the white matter of the central nervous system and, to a lesser extent, the peripheral nervous system. This disease affects people mainly aged and leads to severe disability, which emphasizes the importance of the problem not only medically, but also in socioeconomic terms. Despite the use of the most modern diagnostic methods, pathognomonic signs of the disease have not yet been identified that allow a confident diagnosis of multiple sclerosis. One of these signs is dizziness, which can vary in nature with multiple sclerosis. Purpose: to analyze the etiopathogenesis and nature of dizziness in multiple sclerosis, the main methods for correcting dizziness, and their results. Results: The human balance system is based on messages from the visual, vestibular and musculo-articular systems. External information coming from various sense organs is compared and integrated at the level of the brain stem, cerebellum and parietal lobes of the cerebral cortex. Disturbances that occur at various stages of impulse transmission lead to dizziness. Dizziness is a symptom of many diseases, not only of neurological origin. Multiple sclerosis is no exception. Dizziness is the leading symptom in approximately 10% of patients with multiple sclerosis. During various periods of the disease, up to 20% of patients with multiple sclerosis experience this extremely unpleasant sensation. However, the feeling of dizziness in some cases is not constant symptom, and often the reasons for its appearance are not a direct consequence of the processes of demyelination or inflammation. It should be noted that dizziness in idiopathic vestibulopathy is usually much more pronounced than in cases where it is a manifestation of multiple sclerosis. In the advanced stage of multiple sclerosis, dizziness is a fairly common symptom. Dizziness in multiple sclerosis can be non-systemic (manifested by a feeling of instability, unsteadiness of gait, difficulty maintaining a certain

3 poses) and central systemic (true, vertigo), but more often mixed and characterized by a persistent course. The first type indicates the predominant localization of foci of demyelination in the central part of the vestibular analyzer and the preservation of the vestibular nuclei and pathways when the latter are irritated, since with complete morphological destruction of the vestibular nuclei and pathways, complete loss is observed vestibular function. True dizziness in multiple sclerosis can be caused by foci of demyelination in the brain stem (pons), cerebellum, and damage to the VIII pair of cranial nerves. Systemic dizziness can be described as a sensation of imaginary rotation or translational movement of the patient in various planes, less often, an illusory displacement of a stationary environment in any plane. Most often, there is a paroxysmal nature of dizziness. Attacks of dizziness may be accompanied by autonomic reactions (nausea, vomiting, weakness, sweating, paleness skin), or neurological symptoms (severe headache, numbness in various parts of the body, muscle weakness). Provoking factors for the occurrence of dizziness are sudden changes in body position, turning the head, stress, and for some, the provoking factor is completely absent. Dizziness is most acute in cases where a person also has disturbances in vision, touch and proprioception (sensations that help determine the position of one’s body). Impaired functions of the eye muscles (implying damage to the III, IV and VI pairs of cranial nerves) are also often associated with multiple sclerosis and with the appearance of a feeling of dizziness. It is now possible to treat dizziness in multiple sclerosis. The main goal of dizziness correction is to eliminate it as completely as possible. discomfort and concomitant neurological and otiatric disorders, which ensures independence in Everyday life and minimizing the risk of falls as a potential source of injury. Treatment for dizziness in multiple sclerosis is mainly symptomatic. This correction involves the use of vestibulolytics. They are widely used to relieve and prevent attacks of systemic dizziness. synthetic analogues histamine (betahistine), but for non-systemic dizziness their use as the main drug is inappropriate. With predominant damage vestibular analyzer apply antihistamines. Widely used combination drugs vestibulolytic and sedative effects, helping to reduce the severity of both dizziness itself and accompanying vegetative

4 manifestations. A rather difficult problem is the management of patients with a predominantly non-systemic nature of dizziness. In this case, drugs from pharmacological groups antidepressants, anxiolytics, anticonvulsants, antipsychotics, the dosages of which must be set absolutely precisely to prevent side effects these groups of drugs. Non-drug therapy for dizziness is of a certain importance, consisting in the patient performing a set of exercises that are adaptive in nature and allow to control dizziness. It is important to teach the patient skills to overcome imbalances. These methods of treating dizziness have enough wide application, as they lead to relief of the patient’s condition and prevent the risk of various injuries resulting from dizziness. Conclusion: thus, the causes and pathogenetic mechanisms of dizziness in multiple sclerosis were considered, with the resulting nature of dizziness in the clinic of multiple sclerosis and the main methods of its correction. Literature 1. Clinical and neurological characteristics of patients with multiple sclerosis, taking into account the severity of the condition. Pazhigova Z.B., Karpov S.M., Shevchenko P.P., Kashirin A.I. Basic Research, pp Multiple sclerosis: etiopathogenesis from the perspective modern science. Shevchenko P.P., Karpov S.M., Rzaeva O.A., Yanushkevich V.E., Koneva A.V. Success modern natural science C Prevalence of multiple sclerosis in the world (review article). Pazhigova Z. B., Karpov S. M., Shevchenko P. P., Burnusus N. I. International Journal experimental education. 2014; c Symptoms of multiple sclerosis. 5. Dizziness with multiple sclerosis. 6. Dizziness is a symptom multiple sclerosis. 7.National guide "Neurology". Gusev E.I., Konovalov A.N. page 909.

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