DISEASES OF THE NERVOUS SYSTEM : THE MULTIPLE SCLEROSIS (MULTIPLE SCLEROSIS, SCLEROSIS IN PLAQUES) (SCLEROSIS DISSEMINATA) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
An infectious disease. The causative agent belongs to the group of filterable viruses. Pets hematogenous and lymphogenous spread of the pathogen. At postmortem examination find scattered throughout the Central nervous system plaques, representing the first foci of demyelination; they are of various sizes, grayish-pink color, and in advanced cases consist primarily of glioznogo tissue. Plaques are most often observed in the optic nerves, the walls of the lateral ventricles, intermediate brain, spinal cord, rarely in the cortex.
Soviet authors Margulis, Soloviev and Shubladze include acute forms of multiple sclerosis to the group of so-called demyelinating of encephalomyelitis, for kotoryjvy consider a typical necrobiotic process micronecrosis and demyelination, considering the latter as a result of nonspecific reactions of the nervous tissue to penetrate the virus.
Symptoms. Painting is a polymorphic disease. An early symptom is subjective discomfort in the form of paresthesia and dysesthesia - feeling the cold, heat, electric current. Later marked and objective disorders of sensation: vibration, deep; most frequent musculoskeletal lesions in the form of paresis and paralysis. The emergence of paresis may be preceded by a feeling of fatigue in the hands and feet. Paresis and paralysis are spastic: increased tendon reflexes, there clonus and pathological reflexes (symptom Rossolimo, symptom Babinski). Disappear abdominal reflexes, sphincter rarely upset. Ataxic disorders are very frequent, especially intentsionnogo tremor. Often marvel at II, III, VI, VII pair of cranial nerves, frequent symptom is atrophy of the temporal halves of the optic nerve. It is staccato; nystagmus intentsionnogo tremor and staccato speech known as Charcot triad. Marked changes in cerebrospinal fluid: lymphocytosis up to 20 - 30 cells in 1 mm3, protein 0,3 - 0,45%0. Typical paralytic curve in the study by Lange with chloride of gold: in the first tubes marked discoloration. Very frequent mental changes: neurotic reactions, euphoria, and in advanced cases damentasche.
For. The disease is chronic or acute. Often begins retro-bulbar neuritis, transient paresis. Marked remission lasting up to several years. The disease can last many decades.
It is necessary to exclude syphilis disease (cerebrospinal syphilis, spinal "dryness"), under which there have been positive serological reaction, symptom Ar Gilles-Robertson, no nystagmus and intentsionnogo tremor; the tumor, which typically is steadily progressive course and protein-cell dissociation in the cerebrospinal fluid that surrounds the pain.
In acute or acute outbreaks - infusion 40% solution + 5 ml 1 to 2 days, only 10 - 12 injections. With success, especially in the early stages, used x-ray treatments. The favorable effect of early, non-running instances obtained from vaccine therapy. The vaccine is a 15% suspension from the brain of infected animals. Conducted three cycles of vaccination on 4 injections in each. Dose: 3 ml, 4 ml, 5 ml, 5 ml after 3 to 4 days. The intervals between cycles 2 - 3 weeks. Treatment lacquer blood: intravenous patient's blood, diluted castilliano water. Simultaneously restorative treatment.