Multiple sclerosis (MS) symptomsSymptoms of multiple sclerosis in a different
between patients may vary greatly. Completely different symptoms depending
plaque or damage parts of the central nervous system . For example, parts of the
optic nerve damage can cause optic nerve disorder , damage nerves in the spinal
cord can lead to weakness and upper extremity , lower extremity sensory loss
.Sensory disturbancesForeign
data show that one-third of patients with multiple sclerosis is the first
symptom of sensory dysfunction , which is some strange feeling , such as
numbness , tingling , or an area of the body to lose feeling. These symptoms are often
asymmetric : they may appear in a hand or a leg , or the trunk showing the
distribution star ."Mobility feel" or a major joints
obstacles and torso straps feeling is common symptoms. In some other cases has been reported in
patients under the current will pass from the back feeling. This phenomenon is called the phenomenon of L
Hatch
Visually impairedMultiple sclerosis is one of the most common symptoms
of visual impairment . Symptoms include
blurred vision , which can be extended to the side of the eye loses vision (
mainly as a transient single-blind ) , and even the eyes are involved on both
sides ( double-blind ) .Can not be
corrected by glasses vision loss can occur .If the nerve demyelination around
the eyes , can cause double vision , which is one of the symptoms of multiple
sclerosis -related vision .When
nystagmus, visual disturbances sometimes cause dizziness .If you squint , then the eye will occur
unconsciously fast reverse movement.
Vertigo
and coordinationDizzinessVertigo ( dizziness ) accompanied by
weakness, or endure a kind of dizzy or shaky feeling. Vertigo is because the imbalance and damage.Coordination DisorderCerebellar coordination
disorder usually because of nerve fibers have been damaged : Located above the
cerebellum part of the brain stem that control movement balance and
coordination. Coordination disorder may lead to
some specific sport does not work , for example, can not be completed
successfully lift the cup action . In some cases, will be accompanied by
convulsions , so that more action could not be completed toast .Some patients may sit, stand, walk were
difficult , medically known as ataxia . Voice disorders that of dysarthria,
which speak not continuous, or slow , pronounced hesitation , sometimes occur
aphonia .
DyskinesiaDyskinesiaOne symptom along with the
development of multiple sclerosis , will gradually become the main symptom , it
is not at liberty to move the limbs . This is the
performance of movement disorders . Movement disorders has led to loss of muscle strength
and tone . Medically known as spasticity
.Secondary symptoms
may include walking problems ; walking for a long time , the legs become heavy ,
as if nailed to the floor ; games will be slow ; stair will become very
difficult.Legs will gradually become
stiff and weak, which is the main symptom , one leg may appear drag on bumpy
ground, were difficult to maintain balance. Premature muscle fatigue . Limb weakness and stiffness ( spasticity ) may be
aggravated .SpasmSpasm was under pressure and pain affect climate .
As complex
spasms , rhythmic , involuntary twitching and trembling usually do a very simple
action, such as heels , you may occur.Most patients experienced several episodes , the
rhythmic twitching stops . Despite sporadic convulsions still
occur , but you can transform the position of body parts to improve these
convulsions. For example , you can step on
the feet firmly on the ground .However, in the evening, some patients
still occur painful leg muscle spasms or cramps.Bladder dysfunction
The frequency of occurrence of bladder
dysfunction and disease at different stages of development , but also on the
degree and obstacles .The most frequently heard complaints
are: patients need repeated compulsive urination, urgency, dysuria and urinary
flow interruption .As the disease
increased, may lose control of bladder function caused by urinary incontinence
or bladder emptying weakened cause urinary retention , urinary tract
inflammation caused by infection.
Sex
lifePatients suffering from
multiple sclerosis may experience some sexual problems in life . These problems include impotence, decreased
pleasure during intercourse , or inadvertently muscle tension.Mood changesPatients with multiple
sclerosis in a bad mood , there will be changes, including depression, lack of
self-esteem, is the most common clinical depression . Once the diagnosis of multiple
sclerosis , the patient will have a depressive reaction , or one of the symptoms
of multiple sclerosis .FatigueMultiple sclerosis fatigue caused by a rapid
onset of fatigue unique . 70% of multiple sclerosis
patients in the disease process more or less will experience fatigue, fatigue in
body and spirit would have been apparent over- tired .The progress of multiple sclerosisAn unpredictable diseaseMultiple sclerosis is an
unpredictable disease, and progression of the disease is not an identical model.
Course
of the disease , the type and severity of disease , dysfunction occurs in the
order may be different for each patient , so the diagnosis of multiple sclerosis
, it is impossible to predict the disease 's progress.Because of the
unpredictability of the disease , so to predict to what stage the disease will
develop , or whether the disease is very difficult to maintain stability
.Meanwhile, patients and between
patients with disease manifestations are also very different .Most multiple sclerosis has a normal and near
normal life expectancy.Drugs,
such as changing the course of a number of drugs (DMD drugs) , can help patients
have a complete vibrant life , alleviate symptoms of the disease most important
, the slow progression of the disease .There are four types of multiple
sclerosis : relapsing - remitting , renewal progressive , primary progressive
and benign . Four
types of multiple sclerosis may reach the level of progress of disability not
the same , the following will be explained in detail .Typical characteristics of multiple sclerosisMultiple sclerosis is one
of the biggest characteristics of recurrence , a new symptoms appear or existing
symptoms worse , and lasted 24 hours. In general, the symptoms
develop will last a few days , and then the next 3-4 weeks remained relatively
stable , about a month after symptoms.Need to know about each of the different
types of multiple sclerosis characteristics , you can click the following
link.The following information
is included for each stage of development of the disease the general
summary.Relapse - remitting multiple
sclerosis
Relapse - remitting
multiple sclerosis (RRMS) is the most common one multiple sclerosis type (
accounting for almost all cases of multiple sclerosis for 40% ) . Relapse - remitting multiple
sclerosis patients are unable to predict when the onset of the disease , or when
it will be what kind of new symptoms. But in the two attacks can be fully restored
to " normal" ( so-called remission ) . During remission , onset of symptoms occurred
period more or less improved.If
relapse - remitting multiple sclerosis patients had deteriorated condition after
each attack , but recurrence between the two conditions remain stable , then it
is called the " worsening relapsing - remitting multiple sclerosis
."Relapse
- remitting multiple sclerosis disease process is in progress , and foreign data
show ,10- 15 years later, almost 75% of remission - relapsing multiple sclerosis
will progress to renew - progressive multiple sclerosis (SPMS).References1.
Weinshenker et al., 1989, Weinshenker BG, Bass B, Ricce GPA et al. The natural
history of Multiple Sclerosis: a geographically based study. 1. Clinical course
and disability. Brain 1989; 112: 133-46.Renewal
- progressive MSThe case
without treatment , about 50% of relapse - remitting multiple sclerosis (MS)
will be in 10 years the development of secondary - progressive MS, formally
known as chronic progressive MS.Some secondary - progressive MS can have
seizures, but many people may not have seizures. At this time , the patient's symptoms and
disability is going through a process of gradually increased .15 years later, was
diagnosed with secondary - progressive MS patients , some people need to use a
cane to walk , while others may need to use a wheelchair .Primary progressive MSPrimary progressive
multiple sclerosis (MS) patients' symptoms begin self-diagnosis , the symptoms
gradually began to deteriorate , however, no significant ground attack.
In later months or years, will
stabilize or continue to deteriorate.Primary progressive MS is a form of disease
progression , relapse and remission is not clear . Such
patients suffering from multiple sclerosis with age more often than other types
of multiple sclerosis patients to be large ; 40 -year-old primary progressive MS
is a good age ( young people rarely suffer from this type multiple sclerosis ) .Unlike other types of multiple
sclerosis, primary progressive MS pathogenesis of male to female ratio is almost
the same. The initial
symptoms of this disease is usually gradual deterioration of spastic gait ,
followed by a decline in walking ability . Primary progressive MS prognosis than
other types of multiple sclerosis usually poor condition deteriorated quickly.
The exact diagnosis of primary progressive
MS is difficult.Because
the typical primary progressive multiple sclerosis, spinal cord lesions occur in
parts of brain magnetic resonance imaging (MRI) images may not show any damage
typical of multiple sclerosis , therefore, in order to accurately diagnose
primary progressive multiple
sclerosis, spinal cord MRI scans are necessary checks.
Benign MSBenign multiple sclerosis (MS) has a
relatively mild symptoms uncommon paresthesia, can be completely recovered.
After a once or twice after
the attack , may be accompanied by a complete recovery with no disability
occurred .This type of multiple
sclerosis will not deteriorate over time , it will not appear permanent
disability , disease would not be progress . However, some benign
multiple sclerosis patients will eventually have disease progression ; 10-15
years starting from the onset of multiple sclerosis will evolve into advanced
stage .Benign MS is the
most rare type , only 10% of the patients were diagnosed as benign
MS.Benign MS does not occur
when the onset of the symptoms of vision loss , without any symptoms of movement
disorders , such as diplopia, coordination difficulties , or
tremors.Benign
multiple sclerosis only after the onset of 10-15 years have had minimal
disability in order to be properly diagnosed .Prognostic factorsAlthough there
is no standard model of multiple sclerosis , but the long-term development in
the disease process, and outcome of the disease there are still some very
positive factors affecting the prognosis of the disease .n If within 5 years
after the onset of slight damage, 2/3 of patients with multiple sclerosis in 15
years time will remain relatively stable ;n If you have a disability in the
rapid onset occurs, then after 15 years will occur in significant
disability.
The following signs
indicate the disease will have a benign course :l The initial symptom is a feeling or vision disorders
;l between disease onset complete
remission ;l 5 years without disabilities
occurred ;The following signs appear
presages course of evolution is not optimistic:n diseases when there is paralysis symptoms
;The initial stage of the disease ,
there n sustained loss of function ;n older
when the disease ;n disease process
have frequent attacks.Other features on the
multiple sclerosisn Multiple sclerosis is not a
fatal disease , only a small number of people will die from complications caused
by advanced multiple sclerosis ;n patients with multiple sclerosis life
expectancy of people with and without suffering from this disease is similar
;n About half of the
course of disease is relatively benign, and there is no occurrence of severe
functional limitations .
Diagnosis of
multiple sclerosis
In the
implementation of the multiple sclerosis treatment , you must confirm the
diagnosis.Only the
exclusion and MS have the same symptoms of other diseases can be diagnosed after
MS.
Complete medical examination is very
important
Currently, there is not a very clear
means of checking the exact diagnosis can someone suffering from multiple
sclerosis.Multiple
sclerosis is difficult to diagnose because the symptoms of patients with diverse
, cross each other combination of these symptoms , making the clinical
manifestations of MS patients is more complex unorganized , patients, and
patients with symptoms of the difference between very large .Because early
symptoms may appear on a variety of other neurological diseases , therefore,
requires accurate diagnosis of multiple sclerosis neurologist has a very
extensive clinical experience . Requirements
neurology experts to conduct a comprehensive patient history taking as well as
some specific examinations, including neurological examination , and correct
assessment of test results, draw the right conclusions .Multiple sclerosis is only in the exclusion
of all other possible diseases before the correct
diagnosis.
How to diagnose multiple
sclerosis ?
The
first symptoms of the disease law , or often just arms for short leg discomfort
, but no other significant changes . Patients and doctors can not I which the diagnosis
of multiple sclerosis . May be
in a few months or even years later , be possible to accurately diagnose
multiple sclerosis.
Diagnosis
should be based on clinical manifestations and laboratory basis.The importance of clinical diagnosis
depends on medical history , or past history, and clinical neurological
examination.Subclinical diagnosis
is based on the results from the laboratory tests , such as magnetic resonance
(MRI), evoked potential (VEP), cerebrospinal fluid (CSF).Once a
diagnosis of multiple sclerosis, the results are often people feel very
depressed , it may cause the patient intense disappointment , pain, shock , fear
and grief , these are normal reactions.In fact, in the
diagnosis of multiple sclerosis , you should try to find a neurologist or nurse
talking to seek how to deal with and the best way to treat multiple sclerosis
and support . Can and
have been suffering from multiple sclerosis patients through patient will
respond or forum for the exchange of experience in MS disease
.
What is MS relapse ?The logo is a diagnosis of multiple sclerosis
disease recurrence and the original symptoms intensified.MS relapse is defined
as: In the absence of signs or omens like the case of the emergence of a new
symptom or symptoms of recurrence old and lasted for more than 24
hours.Recurrence and
worsening the duration and course of the disease process associated with little
or can be predicted in advance . Recurrence can develop several days and
lasts 3-4 weeks and then a month later , the slow recovery.Neurological examination is how is it ?Neurological examination is the function of the
nervous system for inspection and testing.Cranial
nerve examinationBrain
examination is to check the efficiency of facial movement and visual ( eye
movement ) . We are
more familiar with the ophthalmoscopy , can be used to observe the fundus
painless , fundus is part of the optic nerve enters the eye .ReflexReflection is the
nervous system to external stimuli involuntary reaction . Reflex is to use a rubber hammer to tap the inspection
site . For
example, the knee-jerk reflex is in the muscle tissue relaxed state , below the
knee with a rubber hammer tapping parts of the lower limbs caused by involuntary
bounce .One side of the body
becomes weak reflection , deletion, enhanced or abnormal reflexes. Graze the skin leads to abnormal abdominal reflex .
Doctors foot grazed outer
circumferential force , leads to an abnormal reflection , known as " Babinski
reflex ." These are important to
determine the diagnosis of multiple sclerosis considerations .Muscle strength ( strength ) checkMuscle strength and muscle interaction checking
important step motor .Sensory
testing is to assess the main touch, pain, temperature sensation , swing and
positioning sleep.Autonomic nervous
system automatically adjusts the respiratory and digestive
functions.Your doctor
can thoroughly examine the bladder, intestinal function , respiratory and
circulatory systems to detect autonomic nervous system .
In the diagnosis of
multiple sclerosis , perception, orientation , concentration , attention and
emotional identification integrally psychology is also very popular means of
checking .Diagnosis of MS
techniques
Some can be used
for the diagnosis of multiple sclerosis laboratory methodsNuclear magnetic resonance (MRI) imaging
scansFavorite
neurologist to diagnose multiple sclerosis using MRI , MRI is the ( nuclear )
magnetic resonance acronym in English .MRI is a painless
screening tool, brain imaging can clearly see the white spots on the brain (
injury ) , these are precisely the characteristics of multiple sclerosis
.
Others are used to exact
diagnosis of multiple sclerosis is an electrophysiological examination .
Medically known as " evoked potentials
."There are many
types of evoked potentials , all of these checks to test a part or several parts
of the body reaction .
Evoked potentials ,
including :l vision : visual evoked
potentials or "VER"l Hearing
: hearing or auditory brainstem evoked potentials or "AEBR"l cognitive function : somatosensory induced
reaction or "SSER" andNuclear magnetic
resonance (MRI) imagingMagnetic Resonance Imaging
(MRI) is also known as magnetic resonance tomography , can provide high
-resolution images of the human body imaging . The following are explanations brainstem ,
periventricular typical of MS on MRI imaging features
MRI has a superior ability to distinguish
soft tissues , such as brain and spinal cord on a clear identification.
MRI does not use X- rays, is in a
strong magnetic field in the distinguished organizations . Distinguish the image data to be entered into the
computer , and then converted to images. This method can be observed in
parts of the central nervous system plaques , plaque and display position and
size.Nuclear Magnetic Resonance (MRI)
scans are what ?Nuclear
Magnetic Resonance (MRI) scan , patients were asked to lie on a special bed,
then , this bed into a narrow examination channel, this channel is actually a
huge magnetic field . Inspection process,
although the machine will emit some noise , and asked to be checked by lying
does not move more than a half hour , but the whole process is painless .
Inspection process , the operator
could be checked , and the microphone and headphone communication. If that is checked for fear of confined
space , you can take anti-anxiety medication in advance .
AngiographyThis
method can be found in the new , active infection sclerosis lesions and obsolete
sclerosis lesions. In the
intravenous injection of contrast agents, such as gadolinium , identification of
new and old lesions can seem easier.
Late in the disease , the
extent of nerve fiber damage increasing , this time, the brain and spinal cord
begins to shrink , magnetic resonance (MRI) can also be observedTo the case of brain atrophy . By MRI examination revealed brain atrophy early in
the disease has occurred.
MRI usually, but not always able to find and
hardening of the corresponding clinical lesions. In turn, the disease
process can be found in the MRI examination also showed no clinically
symptomatic sclerosis lesions, namely, " occult pathology ." Conversely , the obvious lesions on
MRI , it is impossible without their corresponding clinical symptoms
.
The sensitivity
of MRI examination revealed lesions tend to be higher than the clinical
observation , the former is the latter 10 times .Head and spinal cord can not be
simultaneously scanned at the same time , it is necessary to determine in
advance the most important part of the scan .Because the magnetic field causes the metal
object can not be brought into the examination room or tomography machine.
These include metal implants
, such as: artificial hip joints, heart pacemakers, metal clip postoperative
.
Two different forms of magnetic
resonance (MRI) scansTwo basic forms
of magnetic resonance (MRI) scansn T1 -weighted scans : You can display the
new active lesions and infections locationn T2 -weighted scans :
both can display active lesions , lesions and can also display still the total
volume of the lesion , also known as " damage load ." T2-weighted scans can display the result of
the involvement of multiple sclerosis and brain tissue volume . Ideally, the application of common T1
and T2-weighted scans can more fully understand the changes in the disease
.MRI examination is only a means of
multiple sclerosisDefinitive
diagnosis of multiple sclerosis MRI is the most important means of laboratory
tests . Meanwhile , MRI
provides a neurologist early and accurate diagnosis of MS means , however, is
impossible and can not rely solely on MRI in the diagnosis of multiple sclerosis
.Other
diseases can also cause on MRI changes in the central nervous system , multiple
sclerosis, and these changes and the performance is very consistent with the MRI
.Assess the progress of multiple
sclerosisIn addition to
helping diagnose MS, MRI in assessing the progress of MS also has great value.
MRI lesion was found in the
number and scope of disease activity are closely related. In addition to clinical
observation, repeated MRI examination can be long-term tracking the disease
process , to help doctors decide on the best and most appropriate
treatment.Computed tomography
(CT)Computed tomography (CT)
scan of the brain specialized X-ray scan. Once the computer image processing
technology, normal brain tissue and brain any changes can be observed .
Radioactive and other X-ray
examinations such as chest X- checking almost unanimously . For doctors,
computerized tomography (CT) is not on the exclusion of other diseases and
symptoms of MS and MS are similar, but not the MS disease is very
useful.Evoked potentialsEvoked response ( human
impact on the external stimuli ) can reflect the impaired nerve conduction
information in the nervous system that occur during delays and interruptions .
Myelin
provides a nerve fiber insulation function and nerve conduction jump
physiological basis , in multiple sclerosis , the myelin damage can cause nerve
impulse conduction block.The following lists some
typical evoked response test, these tests are placed around the head of the
local magnetic field coil manufacturing inspection .Evoked response to help diagnose and assess the
progress of multiple sclerosisEvoked response ( evoked potentials ) does
not occur independently , but in the external stimulation occurs
.Evoked response in the
diagnosis and assessment of the progress of multiple sclerosis has an important
clinical significance. When the disease has not caused
significant changes in symptoms and functional impairment , the evoked
potentials may have discovered the disease changes. Even in remission , or
occurred years before the symptoms can also be evoked potential examination
revealed pathological changes in neural pathways .
Can
be detected in the skin to the nerve and muscle cells produced by
electrophysiological responses ( potential) is not the same , for example:
electrocardiography nystagmus , brain cells that produce the electrical activity
can be recorded diagnostic method .
Evoked potential difference between various points are as
follows :
Visual
evoked potentials (VER / VEP) testing via the optic nerve pathway nerve impulse
conduction. Each electrode tab pass
brain stimulation for the visual response . Healthy Eyes 100-120 ms after stimulation which
produce reactions. If this
delayed reaction , it indicates the possibility of the existence of multiple
sclerosis .Auditory evoked
potentials or listen (AER / AEP) helps neurologists found to have hearing or
feeling on the auditory nerve pathway disorders, as well as the cerebellum and
the path to the heart of the disorder .A ticking sound through headphones
communicated to the ears of those tested in the occipital region corresponding
potential can be measured . This approach has been clinically
determined for previously no brain dysfunction is particularly important for
patients .Somatosensory
evoked potentials (SSER / SSEP) through specific parts of the body , most cases
are the hands and feet touch detection, including those tactile impulses to the
brain condition is detected. Often with a mild
electrical impulses to stimulate the tibial nerve at the ankle on the path or
the median nerve or ulnar nerve pathways on the inside of the wrist to check the
corresponding area of the brain .Magnetic evoked potentials different from the
previously discussed several evoked potential screening method.Superficial electrodes used to
evaluate the upper arm and leg muscles react in different parts of the brain
corresponding to the arm and leg muscle function . Brain and muscle cells are stimulated
to react with a time difference between , the measured time difference can be
obtained. Stimulation or
spinal cord can also be located in the region to distinguish impulse conduction
through the brain or spinal cord .Lumbar
punctureIn order to obtain
cerebrospinal fluid, doctors often perform a lumbar puncture .Although puncture technique
has very advanced , but , lumbar puncture often makes people feel fear, in fact
, the idea is biased .As shown in the
figure , the puncture process is very short.Under local anesthesia ,
the iliac spine height , with a hollow needle between the spinal vertebrae
protruding portion ( through the intervertebral space ) into the needle, into
the central canal . Needle at least
6-10 cm , to avoid damage to the spinal cord .If the brain and spinal cord are infected ,
then CSF biochemical changes occur . In
the laboratory testing of cerebrospinal fluid composition and compared to
standard values. Help doctors
determine whether the central nervous system disorders of the immune response
occurs . Cerebrospinal fluid of
patients with multiple sclerosis will increase the number of infected cells
.Blood testsRoutine blood tests , such as blood
count, liver and kidney function tests for the diagnosis of multiple sclerosis
is not meaningful . The detection value
of multiple sclerosis patients are often in the normal range . However, the specificity of the immune system of
the blood test is valuable . These checks are used to
identify and symptoms similar to the symptoms of multiple sclerosis and other
diseases , such as infectious diseases or immune system disorders diseases.
Among them, a human
leukocyte antigen detecting leukocytes method can sometimes provide the basis
for diagnosis of multiple sclerosis .Other
testsEye movement examinationAnother laboratory technique , known as
" nystagmus electric plethysmography ," also known as " ENG ."Multiple sclerosis patients , because
the brain stem and cerebellum demyelination , normal eye movements can lead to
damage . Therefore, the
stimulation of abnormal visual response can make the neurologist found visual
problems .Blink reflex examinationBlink reflex examination can reflect the brainstem
neuronal damage. Stem cells in multiple
sclerosis patients are often involved. In the eyelid counter electrode , the
eyebrows given with electric pulses , reflections can be induced and measured ,
too. Typical symptoms of
multiple sclerosis patients is absent blink reaction or the reaction delay
.
