Neurologist Abroskina called the first symptoms of multiple sclerosis

Until now, many people confuse senile sclerosis with multiple sclerosis, while these two diseases have nothing in common. If in the first case we are talking about age-related memory impairments, then in the second case we are talking about a severe, disabling disease that affects mainly young people. According to various estimates, from 70 to 200 thousand people suffer from it in Russia, and if earlier it took an average of 3-5 years to make a diagnosis, today the situation has changed. Maria Abroskina, chief neurologist of Krasnoyarsk, spoke about this in an interview with MK.

— Maria Vasilievna, who is at risk for multiple sclerosis?

— The risk group includes people mostly of young working age. For example, we have the highest incidence in the Krasnoyarsk Territory – at the age of 25 to 38 years. Women get sick more often.

– It is believed that multiple sclerosis is a disease of creative natures (artists, musicians). How true is this?

– Of course, among our patients there are famous personalities, actors, artists, but to say that creative specialties tend to get sick more – no, this is not so. Anyone can get sick, and predisposing factors are hereditary predisposition, lifestyle, vitamin D deficiency, dietary habits, frequent head injuries, frequent infections, especially herpetic ones, such as the Epstein-Barr virus.

– What symptoms should alert you in the first place and who should immediately go to be examined?

– If a healthy person develops an acute (within one or two days) visual impairment in one or both eyes, especially complete blindness, then this is one of such alarming factors. This person should go to the doctor at the place of attachment to be examined. In addition to visual impairment, symptoms can include a significant impairment of sensitivity (for example, a person loses sensation in half of the body or limbs), impaired movement, significant weakness in half of the body or in several limbs, and impaired coordination (a person shuffles when walking). In a word, diffuse neurological symptoms. However, in no case should people look for symptoms of multiple sclerosis in themselves, there is no need to engage in self-diagnosis and self-treatment. The manifestations of multiple sclerosis are very bright, have a pronounced degree, develop very suddenly against the background of relative well-being. And any person who is attentive to himself will not be able to miss them in most cases. If vision gradually decreases over the course of life, then you do not need to suspect multiple sclerosis. In the same way, if a person is tired after a hard day’s work, he has a headache on the background of stress, then also do not attribute multiple sclerosis to yourself.

What methods of early diagnosis of the disease exist?

— Now the situation in the diagnosis of multiple sclerosis has changed a lot. And this is due to the increasing availability of magnetic resonance imaging of the brain. All early diagnosis is based on the fact that, firstly, doctors have learned to detect multiple sclerosis itself at an earlier stage and monitor its symptoms more closely. In addition, patients became more alert and, at the first significant symptoms, they began to turn to doctors, and doctors began to prescribe MRI scans of the brain and spinal cord. In addition, laboratory diagnostic methods have appeared. In general, the diagnosis of multiple sclerosis is made by a neurologist based on the clinical manifestations (symptoms) and how the disease progresses, as well as on the basis of MRI, on which we can see the damage to the spinal cord and brain. At the same time, other diseases that are similar to multiple sclerosis must be excluded. Most often, the diagnosis is made either in specialized multiple sclerosis centers or in multiple sclerosis rooms by trained physicians who are qualified and experienced in managing such patients.

— What modern methods of multiple sclerosis treatment are available in Russia?

— Treatment is carried out in different directions. In a sudden acute condition (for example, when the patient is blind in one eye), the person is prescribed therapy aimed at eliminating symptoms (so that vision is either fully restored or partially restored). Such treatment is generally available throughout the entire country. The patient is admitted to the hospital and treated according to treatment protocols. The second direction is pathogenetic therapy with drugs that slow down the progression of the disease, reduce the number of exacerbations and maintain the quality of life. All patients in Russia who are diagnosed with this disease receive such drugs at the expense of the federal state program “14 high-cost nosologies”. More than 12 drugs have already been registered in the country, many of them are included in the program, and patients receive them free of charge. There are experimental drugs that are not registered on the territory of the Russian Federation, and they are offered in various clinical trials in research centers. We also have such centers in Krasnoyarsk.

The third direction is symptomatic therapy. For example, the patient has high muscle tone and the muscles need to be relaxed. Special preparations are prescribed.

In recent years, medicine has made great strides in the development of drugs for the treatment of multiple sclerosis. For example, in the early 2000s there were only 2 groups of drugs (interferon and glatiramer acetate), and now a group of monoclonal antibodies has appeared, this is immune reconstitution therapy. And such drugs are also included in the federal program and are provided to patients free of charge.

– Is there a chance that the disease will be completely defeated or there will be drugs that can stop its progression?

– Previously, the diagnosis of multiple sclerosis was a sentence, but now it is a disease with which you can lead a normal life. Pathogenetic drugs have been developed and are available for all forms of the course of the disease. Of course, modern medicine has room to develop. The therapy that currently exists is mainly aimed at preventing negative dynamics on MRI, exacerbations. It is impossible to completely recover from multiple sclerosis, like from the flu or a cold, because it is a chronic progressive disease. We can only slow down its course and preserve the quality of life as much as possible for a long time. But the earlier the diagnosis is established, the earlier therapy is started, the better the prognosis for the patient.

HELP “MK”

Multiple sclerosis is a chronic autoimmune disease that damages the myelin sheath of nerve fibers in the brain and spinal cord. Damage to the nerve fiber gives rise to a number of neurological symptoms: muscle weakness, fatigue, vision problems. The prospects for such patients are progressive disability, a significant decrease in quality and a reduction in life expectancy. The onset of the disease usually occurs between the ages of 20 and 40. In the absence of pathogenetic therapy, after 10 years, about 50% of patients cannot work and do housework, after 15 years they cannot move independently, after 25 years they cannot walk even with support.

Published in the newspaper “Moskovsky Komsomolets” No. 29063 dated July 5, 2023

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