These plaques may be found anywhere in the white matter of the brain and spinal cord, but they have a tendency to appear in places but not others, the most famous of which is the area around the cerebral ventricles (the ventricle is a cavity inside the brain), visual nerves, the brain stem, and the cervical part of the spinal cord And the cerebellum, and for this disease, like other autoimmune diseases, periods of activity are called relapse, followed by periods of calm called cumin (remission), and symptoms of diffuse sclerosis vary from one patient to another and from time to time, and among these symptoms are problems with the eyes Weakness or lack of control of eye movements Vision with pain in the eye, when moving, problems with speech, partial or complete weakness of any organ, a feeling of weakness and extreme fatigue. , Tremors in the hands, feeling dizzy, loss of control in urination or excretion, numbness and numbness in the limbs or face, loss of balance or ability to control movements, or heaviness in the limbs when walking. These early symptoms are often mild and disappear without treatment, but over time it may become more and more severe, and the main diagnosis of this disease may be made through its clinical (clinical) form only. Despite this, there is no specific set of symptoms of it. The disease has specific clinical patterns developed after studying the previous history of the disease to anticipate its future behavior and to determine its treatment methods because the disease often adheres to its own pattern. 1- Multiple sclerosis, relapsing-remitting M.S and constitutes 80-90% of cases, in which relapse occurs simultaneously with symptoms and is followed by a period of latency during which the progression of the disease stops and the body begins the repair phase in whole or in part. 2 – primary progressive multiple sclerosis: primary progressive M.S and constitutes 10-20% of cases, in which relapse occurs simultaneously with symptoms and is not followed by a period of calm, but the disease continues to progress gradually, and this type often comes to the person after the age of fifty. 3- Secondary progressive M.S. It begins with the disease as the first type and then turns into a condition similar to the second type and continues with progression, and this transformation is usually done after an average of 6-10 years of the disease. 4- Relapsing-progressive M.S, which is similar to the initial progressive type in that the symptoms develop gradually and continuously, but the difference in the presence of periods of relapse permeates the course of the disease where the symptoms increase significantly or new symptoms appear. There are two other types: benign MS: it is the lightest and least harmful pattern, as the disease does not leave any permanent symptoms, (fulminent MS): (less than 10%), in which the recurrence occurs and then the patient’s condition deteriorates in a way Fast, where the disease is very violent from the beginning, and in less than 5 years, the patient suffers from severe disability.
Now let’s review the different symptoms of the disease, such as: Visual problems: blurred vision (foggy), duplication of vision, optic neuritis, involuntary rapid eye movements, vision loss (very rare) Balance problems and movement symmetry: loss of balance, tremors (involuntary fibrillation), ataxia (irregularity) in walking, dizziness, asymmetry in movements (especially in the limbs), weakness: especially in the legs when walking, muscle cramps, changes in nature Muscle (loosening and contracting) and muscle stiffness can affect movement and walking, spasms Changes in nervous sensation: tingling sensation, paresthesia, burning sensation, possibly some pain related to multiple sclerosis such as facial pain (trigeminal neuralgia) and muscle pain Speech difficulties: slow pronunciation, stuttering and pronounced blurring (words and letters overlap with one another), difference in poise / frequency of speech, dysphagia Fatigue: General fatigue that weakens the body and is unpredictable and inappropriate for the activity the person has performed. Fatigue is one of the most common symptoms and one of the most disturbing to the patient. Urine and stool problems: Among the problems of urine: the need to urinate between short periods, the immediate need to urinate, not to empty the entire bladder, involuntary urination, of stool problems: constipation, involuntary discharge (rare) Sexual problems: impotence, loss of sensation, increased sensitivity to heat, and this symptom usually causes a temporary worsening of symptoms. Cognitive and emotional disorders: impairment of temporary memory, loss of ability to focus, right judgment or reasoning It is true that there is no completely cure for sclerosis until today, but this does not mean that there are no good measures to alleviate the disease and help the patient to his symptoms, especially in the last ten years after the availability of immunomodulators. The disease is diagnosed by clinical examination, visual field examination, measurement of electrical potential, laboratory confirmatory diagnosis, biopsy of the spinal cord, and use of MRI. But how can this disease be discovered in its early stages? Several years may pass from the first symptoms before a definite diagnosis, and for several reasons, including early symptoms of the disease may be mild as the patient does not notice them or consult a doctor because of them, and that other diseases of the nervous system are similar to the symptoms of diffuse sclerosis and may cause difficulty in the beginning to recognize or diagnose the disease And the absence of laboratory tests currently helps to detect the carrier of the disease with certainty, and there are two clinical characteristics to ensure the presence of diffuse sclerosis, the first of which are signs of a nervous system disorder, numbness paralysis, an unknown cause with clinical signs of infection in two or more places of the device The nervous system is discovered by the doctor upon examination, and the second is healing and relapse during periods of time that may be longer or shorter. The attending physician makes sure of the diagnosis by performing an MRI scan to examine the cerebrospinal fluid and planning the nerves, but the diagnosis of diffuse sclerosis does not have to be seen in a desperate way, although there are patients who suffer from recurrence of the disease, but few suffer from major complications of the disease, most patients live a life Active despite the relapse of the disease and adapt to the disease by adopting a positive style and a positive outlook in their lives.
Although the disease was discovered in 1870, the first drug to treat the disease was produced 120 years later, i.e. in 1990, which is “betaveron”, a drug produced by genetic engineering methods from natural interferon (and interferon is a natural protein found in the human body Helps overcome infections and diseases). Betaferon’s experience has shown that treatment helps reduce the number of relapses experienced by the patient, increase the time between relapses or attacks, reduce the intensity of attacks, and reduce the number of new infections that appear in the MRI scan. Treatment is divided into three types: attack treatment, disease treatment and complications Treating an attack: If the attack is light-weighted, and its symptoms are possible, then it may respond to rest for a day or two, while drinking sufficient cold fluids, cooling the atmosphere of the room, and many patients if they follow it at the beginning of the attack, their symptoms improve, and if the above does not work, Or the attack was very severe, and a cortisone was given, and the way to give it varies according to the attending physician, but most doctors give it for 3-5 days intravenously. The cortisone speeds up the recovery of the attack, and reduces its severity, giving cortisone does not cause any significant complications, such as those that may occur from abuse Chronic prolonged cortisone. Treatment of the disease: These are drugs called (immune rates), and they work to change the nature of the immune structure, thereby reducing the number of attacks, and reducing their severity, and may alleviate poor lesions in the brain’s magnetic images, and the severity of the disability that may occur from the disease In its advanced stages, one of these medications is always taken, all of which are closely related in effect, but some are taken intramuscularly once a week, and some are subcutaneously several times a week depending on the type of medication, and generally these medications do not have problems, but After injection, the patient may feel symptoms similar to the symptoms of the common cold from heat and fatigue, and this is usually treated with a medication such as a Pendulum before injection, given these drugs usually in the type paroxysmal (recurrent Pacific), and modified drugs are not given immunity during pregnancy and lactation. Medicines used to treat Rebif disease: (Betifron® = Interferon beta 1a) Avonex: Avonex® = Interferon beta 1a. Novantrone® = Mitoxantron. Taisabri: Tysabri® = Natalizumab. ). Other treatments: immunosuppressive drugs such as azathioprine and cyclophosphamide may be used, but some research has questioned whether they have any role in the treatment of multiple sclerosis, and the use of glatiramer acetate may be of benefit in Reducing the number of relapses, and using natalizumab But it must be emphasized that the patient must adopt healthy health habits such as balanced food, quit smoking and practicing light sports such as swimming and walking whenever possible. There is much that can be done to mitigate the effect of MS on patients to keep them highly vibrant, independent and comfortable. In this context, we must not forget the necessity of reminding the patient and his family that this disease varies in severity from one patient to another in a significant way. With almost complete disability, especially those who acquired the disease at an early age (after forty), and the resonance images showed many plaques hardening in the first 5 years of the disease. And one of the studies showed that the risk of suicide among patients with multiple sclerosis of nerve fibers is 5.7 times greater than the rest of society. In cases of untreated relapsing multiple sclerosis, the average time that elapses until a person needs a wheelchair is 20 years. And with the type of disease that develops quickly from the beginning, the average time required until the wheelchair is used is 6-7 years from the start of the diagnosis. Hope is pinned on recent developments in diagnostic methods and new treatments. Treatment has now become via daily oral tablets after all treatments were limited to injections, and the emergence of medical societies that care for patients with diffuse sclerosis have helped to raise awareness of the disease, its causes and how to live with it. Large companies pour huge sums into research based on this disease to compete in time to find the optimal treatment for each case and thus seek to the well-being of patients and improve their daily activity.