Multiple sclerosis

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Multiple sclerosis epidemiology

The incidence of multiple sclerosis (MS) in Poland is estimated at 30-100 cases per 100,000 inhabitants. The incidence of MS is higher in developed countries. It is estimated that there are currently approximately 60,000 patients suffering from multiple sclerosis in Poland.

Multiple sclerosis causes

The cause of multiple sclerosis is not clearly defined, but many researchers point to the importance of the immune system in its formation.

The factors that trigger this disease were also identified, including:

1. intrinsic:
- genetic basis,
- impaired immune regulation (immune defect),
- physicochemical changes in myelin,
- disorders of myelin metabolism.
1.extrinsic:
-infection with a retrovirus or a common nonspecific virus (parainfluenza or measles virus, etc.),
-factors,
1.geographical,
2.environmental.
- climate.

Pathomechanism of multiple sclerosis development

Multiple sclerosis is a disease of the central nervous system. It is characterized by the occurrence of relapses and remissions, i.e. asymptomatic periods. The myelin surrounding the nerve fiber breaks down, scarring or scarring appears in its place, hence the name of the disease. The disease is characterized by multifocality. The available outbreaks can occur in different parts of the nervous system and illustrate widespread use involving the latter part of the term. Due to the diffuse nature of the disease

Varieties of multiple sclerosis

There are four types of multiple sclerosis:

- cerebrospinal,
- spinal (parapetic - with the predominance of paresis of the lower limbs),
- cerebellar,
- hemiparetic (in this variant, hemiparesis is mainly present

Multiple Sclerosis symptoms

The first symptoms of multiple sclerosis are: optic neuritis, cerebral ataxia, dizziness, numbness in the limbs, problems with urination .. Myelin damage causes conduction blockage and causes various symptoms.

Common disorders caused by MS include:

• spastic paresis, mostly of the lower limbs,
• ataxia (ataxia),
• abolition of abdominal reflexes,
• paresthesia,
• emotional lability,
• Charcot's triad (nystagmus, intentional tremor, chanted speech),
• disturbance

1. sphincter (vesico-rectal) activity,
2. logical thinking,

• affective

1. sexual (impotence).

• feeling tired / weary

In addition, the following disorders are accompanied by psychological symptoms:

-regarding the current state of health,
- for your and your immediate family's future (as anticipatory fears),
- concerns about finances,
- problems of a personal-intimate nature,
- fear of loneliness,

Multiple sclerosis treatment

Treatment of multiple sclerosis is based on therapy that reduces disease symptoms, reduces the duration of the relapse, its severity, and measures that influence the natural course of the disease. Interferon therapy is currently one of the most common and longest-used therapy in this disease. For years, the important role of vitamin D3 in modulating the clinical course of MS has been emphasized. In addition, the following are used: a special drug, which is Copolymerem, as well as Immunoglobulins and Immunosuppressive drugs. In the treatment of multiple sclerosis, it is important to assess the patient's health at each stage of the disease. The basic health recommendations for people with MS who leave hospital are a healthy lifestyle. In this case, the patient should exercise daily, eat healthy food, sleep 7-9 hours a day, rest, and effectively deal with stress. The patient should avoid rush. In the course of MS, regular sports should be practiced in order to improve muscle strength and maintain a full range of movements and normalize muscle tone.

Patients with MS are not advised to do any exercises in the acute period of multiple sclerosis, and after leaving the hospital, they should take a 10-day break for adaptation purposes. In the course of MS, a well-chosen diet containing 6-8 glasses of fluids a day, including apple juice, grape juice, orange juice, and chilled milk, is very important.

Rehabilitation in multiple sclerosis

An effective management strategy for treating MS must take into account the complexity of the disability caused by the disease, including the fact that treating one symptom may exacerbate another. In such a situation, comprehensive action is multidirectional and includes information provision, patient education, multidisciplinary treatment and pharmacotherapy. Finally, the diverse and variable nature of multiple sclerosis means that the needs of a particular patient will change over time, often suddenly, to encompass an ever wider spectrum of activities.

Rehabilitation, where the emphasis is on patient education and independence, is ideal for the complex and changing needs of MS patients. This is to increase the independence and quality of life of the patient by maximizing the opportunities and commitment of patients.

The World Health Organization has defined it as “an active process by which people with disabilities due to injury or disease achieve full recovery or, if full recovery is impossible, realize their physical, mental and social potential and are integrated into the appropriate environment.

The basic elements of rehabilitation in multiple sclerosis are:

- multidisciplinary assessment by a specialist,
- adopting a line of therapy aimed at achieving goals,
- assessment of the impact on the patient and the degree of achievement of goals.
This type of rehabilitation applies to all stages of the disease, from diagnosis to treatment of people with the most severe disabilities. In order to establish an action plan according to the needs of people with multiple sclerosis, it seems appropriate to detail the major stages of the disease. In this case, they are:

-diagnosis
- light disability
- moderate disability
- severe disability
At each of these steps, you should consider: access to up-to-date information, multi-disciplinary expertise, flexibility and accessibility, good communication, and empowerment of people with MS.

Source:

• W. Palasik, Leki biologiczne w leczeniu stwardnienia rozsianego. Przegląd aktualnych osiągnięć, Postępy Nauk Medycznych 10/2013, s. 715-719
• K. Adamczyk, Pielęgniarstwo neurologiczne, Wyd. Czelej, Lublin 2000, s. 60-67
• Ch. H. Polman, Przewodnik po lekach i leczeniu, Stwardnienie rozsiane, Polskie Towarzystwo stwardnienia rozsianego, Warszawa 2007, s. 33-49, s.59
• R. C. Kalb, Stwardnienie rozsiane, Polskie Towarzystwo stwardnienia rozsianego, Warszawa 2008, s. 1-16