What to expect before dying with multiple sclerosis. Multiple sclerosis, prognosis: course of the disease, factors of favorable and less favorable prognosis

The problem of multiple sclerosis - what is it and how long do people live with it? This question is asked by anyone who has encountered a pathology of the nervous structure, which was formed as a result of damage to the nerve membranes of tissues and their scarring. This disease develops in the tissues of the central nervous system. Although the development of this disease is not considered hereditary, the risk of multiple sclerosis still increases in a family where there are people with this diagnosis.

The disease belongs to the group of chronic diseases and occurs in several alternating periods: exacerbations and remissions. In the initial stages, remission can occur without medication, simply by itself. But you should not rely on chance, but immediately consult a doctor for support. Because there are a number of examples when the disease proceeded steadily quickly, developing a malignant pathological process.

There are a number of factors that include the early development of the disease:

• age limits. These are mainly people over 20 and under 40;
• women are more susceptible to the disease;
• hereditary history, i.e. genetic predisposition to sclerosis;
• the presence of endocrine pathologies;
• presence of the Epstein-Barr virus in the body.

Reasons

There are quite a few versions of the origin of the disease. However, common causes of multiple sclerosis are autoimmune processes and weakness of the immune system.

Prerequisites for the development of irreversible pathology of the central nervous system:

• genetics;
• consequences of unsuccessful surgical interventions;
• poisoning with toxic substances, radiation;
• spinal or head injuries;
• mental disorders, stress, emotional outbursts;
• overstrain: physical, mental, emotional;
• UV exposure;
• lack of vitamin D;
• allergic reactions;
• consequence of vaccination.

Signs

When a person starts to get sick, his body sends signals. These are the signs of the disease, by which we can accurately say that the development of multiple sclerosis is beginning. The characteristic symptoms for this disease are:

1. Impaired coordination of movements, its subsequent loss. After some time, a person cannot move without outside help.
2. Complete absence of any reflexes or their weakening.
3. The limbs lose sensitivity and flexibility, and a burning or tingling sensation is felt.
4. Tremor of arms and legs. This symptom manifests itself well when writing; you can observe a change in handwriting.
5. Malfunction of taste buds, complete lack of taste and pleasure from eating.
6. Weakness and dizziness.
7. Lack of sexual desire.
8. Nerve paresis and, as a result, blurred vision, distortion of the face, and incomplete closure of the eyelids.
9. Frequent urination, possible incontinence.
10. Many mental disorders, decreased mental potential, development of depressive and suicidal tendencies.

Consequences of multiple sclerosis

The disease takes a very long time to respond to treatment, which is only a temporary weakening of the symptoms, which will return after a while. In the later stages, the signs of the disease are more pronounced and more persistent, and the period of remission occurs less and less often. Life with multiple sclerosis becomes a seesaw from relapse to remission and vice versa. Most often, the disease gains momentum and steadily progresses, moving from a mild form to a more severe one. New symptoms appear.

The absence of therapeutic measures taken to alleviate the disease is fraught with more serious disorders for patients, up to complete muscle atrophy and the inability to move independently, eat, and do simple things. Such a patient becomes completely dependent on the people around him.

Living with multiple sclerosis can become disabling within a few years or decades. Statistics have figures from 3 to 30 years.

Death from multiple sclerosis ends in cases where the disease causes severe complications in various organs that the body is unable to cope with. This could be pneumonia, sepsis, cirrhosis, etc.

With multiple sclerosis, life expectancy is significantly reduced, especially dangerous is damage to the spinal nerves, which acutely progresses with this disease and can cause death.

Life expectancy with multiple sclerosis

The predicted life expectancy of people with this pathology is from 5 years to 30 or more. Within 5 years, every 10 people die. Half of the sick patients remain able to work, 70% of the total mass do not suffer from impaired motor skills and move independently. During remissions, most of them lead normal lives.

Possible complications

In patients with multiple sclerosis, life expectancy is shortened, but in addition, various disorders throughout the body may occur. Such complications can arise after the onset of the disease as early as 5 years. The most common complications are:

1. Infectious disease of inflammatory pathways;
2. Urinary incontinence or retention;
3. Rapid loss of total body weight;
4. Infectious foci in the genitourinary system;
5. Hypotension;
6. Split personality and other psychological disorders;
7. Poor health, replaced by cheerfulness;
8. Rapid wear of joints;
9. Bedsores;
10. Disorientation in time and space.

Diagnosis of pathology

A diagnostic search for information is necessary to fully present the clinical picture of the disease, to confirm symptoms and prescribe effective treatment, so that the patient knows how to live further and cope with this problem.

To confirm this diagnosis, it is necessary to undergo a complete examination:

• MRI (tomography of the brain and spinal cord);
• blood screening for antibodies;
• electromyography;
• examination of the patient's vision, somatosensory potential and auditory examination.

After diagnosing multiple sclerosis, your doctor will give a prognosis. He explains how to relieve symptoms and how to live and behave during exacerbations.

How to prolong the life of patients

Today it is impossible to say exactly how long people live with multiple sclerosis, but you can live a year, two or more if you follow a few instructions. It is possible to change the disappointing prognosis for multiple sclerosis with the help of supportive therapy, which will make life fulfilling.

To prevent the disease from progressing, drug treatment is prescribed:

• immunomodulatory drugs to improve general condition and strengthen the whole body;
• means that help fight viruses;
• diuretics;
• drugs for the treatment of malignant cells;
• nootropics;
• antihistamines;
• medications to improve vascular tone;
• means for blood microcirculation;
• means for improving metabolic processes in the body;
• muscle relaxants;
• drugs that regenerate nerve tissue.

The treatment regimen is selected purely individually, because symptoms and complications differ in each individual case.

Every year, patients suffering from multiple sclerosis must undergo a complete medical examination. Mandatory methods are MRI, electromyography and immunogram. It is necessary to visit an ophthalmologist and a genitourinary system specialist more often - 2-3 times a year.

In addition to the examination, you need to monitor your lifestyle: perform small exercises or play sports with minimal stress, attend massage courses, reflexology. Once every six months, undergo sanatorium-resort treatment. Reconsider your views on nutrition, take more vitamins.

Prevention

To date, there are no specific ways to prevent multiple sclerosis. The main associated factors are a healthy lifestyle, avoiding negative situations, stress, controlling body weight, and keeping the body fit. You need to try to avoid overheating and hypothermia, as well as take preventive measures to protect against viral diseases and infections.

One of the main characteristics of multiple sclerosis is its unpredictability.

Symptoms of the disease not only can vary significantly between different people with MS, but they can also vary over short periods of time within the same person.

However, despite all the variability and unpredictability of the disease, from time to time, every patient with multiple sclerosis has questions about the prognosis.

The prognosis for multiple sclerosis is a topic rarely discussed with doctors, and various sources on the Internet and discussions on forums practically do not touch on this topic. Perhaps this is partly due to the fact that doctors, accustomed to operating with proven facts, unfortunately do not currently have clear prognostic criteria for MS, and many people living with a diagnosis of multiple sclerosis try not to think about the uncertain future .

Indeed, as research results show, as confirmed by the experience of practicing doctors, the possible outcome of the disease depends to a certain extent on the relationship of certain factors, but it is rather premature to talk about them with a high degree of confidence. A disease that has been in a mild form for a long period of time can suddenly begin to progress, and vice versa, a severe form of the disease can stabilize.

The factors listed below, which may indicate a favorable or, on the contrary, less desirable prognosis, are based on statistics, but statistics should be taken with healthy skepticism. Data from such statistics are undoubtedly not parametric and multidimensional, and often contain errors. In this regard, it is important to mention that the results of some prognostic studies were slightly inconsistent with the results of other studies, and only a few prognostic criteria were common across all studies.

In addition, the variable nature of multiple sclerosis does not allow us to say with certainty that even under the influence of negative factors, multiple sclerosis will necessarily go into a malignant stage. For example, in many men the disease occurs in a mild form. Although, according to statistics, being male in itself is one of the factors contributing to the relatively rapid development of the disease. It should also be remembered that 75% of people with multiple sclerosis do not need a wheelchair and in the vast majority of cases, MS is not the cause of death.

It is important to note that most studies aimed at identifying prognostic criteria were conducted before the widespread use of disease-modifying drugs (DMDs) for multiple sclerosis (MDTs) in clinical practice. Moreover, today, a significant number of clinical studies of new drugs for the treatment of MS are being conducted, the use of which is likely to lead to more optimistic prognoses. No matter how controversial it may sound, hearing a diagnosis of “multiple sclerosis” today is a more favorable time in terms of prognosis than 10-20 years ago.

Factors indicating a more favorable prognosis

It is believed that factors that suggest a more favorable prognosis are:

1. the first symptoms of MS are associated with sensory disturbances or damage to the optic nerve;
2. symptoms of the onset of the disease indicate disturbances in only one functional system (monosymptomatic onset);
3. complete remission after the first clinical relapse (CIS);
4. long time interval between the first two relapses;
5. low relapse rate in the first five years;
6. onset of illness before age 25;
7. few lesions on MRI;
8. 5 years after the onset of the disease, minimal disturbances are observed;
9. female

Factors that determine a less favorable prognosis

According to experts, factors that indicate a less favorable prognosis are:

1. involvement of several functional systems in the pathological process at the onset of the disease (polysymptomatic onset);
2. multiple focal lesions on MRI;
3. disorders indicating involvement of the cerebellum (for example, ataxia, tremor), brain stem (for example, dysarthria) in the pathological process;
4. incomplete recovery after the first relapse of the disease;
5. the interval between the first two relapses is less than a year;
6. high relapse rate in the first five years;
7. active progressive course of the disease in the initial stage;
8. onset of the disease after 40 years of age;
9. disorders of the musculoskeletal system;
10. male gender

It should be noted that in the majority of patients with multiple sclerosis, both signs that suggest a more favorable prognosis and a less favorable prognosis of the disease “coexist”. Many experts tend to give the first, cautious forecasts after the first five years of the disease: if up to this point the disease has not actively progressed, then most likely in the future it will develop just as slowly.

However, the manifestation of multiple sclerosis and the prognosis for future life are individual, because in each patient the disease behaves differently, the pathology progresses at different rates.

Individual prognosis for multiple sclerosis

The prognosis for multiple sclerosis largely depends on the form of the disease. Depending on the clinical course (presence and frequency of relapses) of the disease, doctors distinguish multiple sclerosis:

1. Remittent. An undulating course with alternating periods of exacerbation and remission is most common. The pathological process characteristic of multiple sclerosis continues even when there are no clinical manifestations.
2. Primary progressive. Without clear exacerbations from the manifestation of the disease. With this type, neurological disorders steadily increase over time; there are no periods of remission. This course is more malignant than remitting ─ according to research, patients with this clinical form begin to feel the need for help with self-care and daily activities earlier than others.
3. Primary progressive with exacerbations. A rather rare variant of the disease, which is characterized by a continuous course, against the background of which exacerbations occur.
4. Secondary progressive. With this type of pathology, symptoms increase slowly, exacerbations are rare, and there are periods of stabilization of the disease. Relapsing-remitting multiple sclerosis transforms into a secondary progressive form (within 25 years, the transition is expected in almost all patients). The effectiveness of therapy at this stage is low, the prognosis is worse than with other types.

Exacerbation is usually understood as the appearance of new clinical signs or the intensification of existing ones.

Destruction of the myelin sheath of nerve fibers in MS

What promotes illness?

Factors that first contribute to the onset of multiple sclerosis and then to its progression:

• young age;
• genetic predisposition to the disease (presence of sick relatives);
• frequent bacterial and viral infections, history of neuroinfections;
• physical and nervous overload;
• prolonged exposure to the sun, overheating;
• harmful effects at home (household chemicals) and at work (toxic substances, etc.);
• pregnancy can cause an exacerbation of the pathology.

Increasing symptoms

As the disease progresses, a person becomes increasingly concerned about the following manifestations of multiple sclerosis:

1. Movement disorders. They include weakening of muscle strength, paralysis of the lower, and less commonly, upper extremities, the appearance of pathological reflexes that should not normally be detected, as well as deterioration of coordination and balance.
2. Changes in sensitivity. Paresthesias of various localizations are observed. Hearing and vision decrease.
3. The psychoneurological sphere is also affected: neuroses, depression, dementia are possible.

At the onset of the disease, patients can move independently, lead a normal lifestyle and perform their job duties.

MS often leads to disability and disability

As the disease progresses, movement disorders gradually become more severe: at first, a cane or crutch may become a necessary support, but later the need for a wheelchair may arise.

Diagnosis is not a death sentence

If it so happens that a diagnosis of multiple sclerosis has been established, then you should not leave work in order to avoid unnecessary stress, withdraw into yourself, lose interest in life and spend your days at home, waiting for something, doing nothing. No, life must go on, be active and rich. In most cases, the disease has a benign course, the average life expectancy is approximately the same as in the general population, death from multiple sclerosis occurs rarely, patients die from many other diseases (oncology, heart disease, etc.), to which they are susceptible to the same extent, as do other people. All efforts should be aimed at treating the disease, preventing exacerbations, but otherwise you need:

• continue doing what you love;
• eat well and rest, walk in the fresh air;
• spend more time with family, relatives, friends;
• Do not allow yourself to be overcome by anxiety and depression; if they appear, be sure to consult your doctor. Master relaxation and auto-training techniques.

Thanks to the advent of drugs that change the course of multiple sclerosis (Interferon beta-1a, beta-1b, Glatiramer acetate, Mitoxantrone, Human Immunoglobulins), it has become possible to maintain the disease in long-term remission, prevent exacerbations and reduce their severity.

With timely diagnosis of multiple sclerosis and its treatment, with the help of modern medications, it is possible to significantly slow down the rate of development of the pathology and improve the quality of life of patients. In later stages, the focus is on symptomatic treatment and prevention of complications.

At the same time, science does not stand still; doctors are always looking for new drugs that can bring even more encouraging results.

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What kind of disease is multiple sclerosis?

A chronic pathology affecting the spinal cord and brain is defined in medicine as multiple sclerosis. The main reason why such a serious disease develops is a malfunction of the immune system.

What is a disease?

Many people think that this disease only affects older people. But this is not entirely true. Much more often, multiple sclerosis attacks young adults. Sometimes experts detect symptoms of this disease even in small children who have barely reached the age of two. In a person who has crossed the fifty-year barrier, symptoms of the disease are extremely rare.

Today, multiple sclerosis is in 2nd place as a cause of post-traumatic neurological disability in young men and women. At least twenty cases of morbidity are diagnosed per hundred thousand population.

Most often, according to doctors, this disease occurs in regions with a northern climate. Out of one hundred thousand, about seventy cases are diagnosed. The reasons for this lie in the deficiency of vitamin D, which a person receives due to exposure to ultraviolet rays. Representatives of the fair sex get sick two to three times more often than men.

Having discovered symptoms of the disease in a patient, doctors of a special expert commission usually make a decision regarding disability. Disability is assigned after determining the extent to which the disease occurs, as well as clarifying the patient’s ability to work. The main criterion, as can be seen in the photo, is damage to motor functions. There are 3 disability groups:

• ​The third group is characterized by the presence of a moderate movement disorder;
• the second group is characterized by the presence of a pronounced movement disorder;
• The first group is characterized by the presence of a distinct movement disorder.

Approximately 1/4 of people who have had symptoms of this disease retain both physical and mental health even into old age.

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Why does pathology develop?

The causes of this disease, like many other autoimmune disorders, still remain a mystery to doctors. The exact factor that provokes the development of this disease has not yet been established.

Many doctors believe that the disease develops against the background of a combination of several provoking factors. They can be internal and external. The following are the causes of multiple sclerosis:

• Heredity.
• Epidemiology (Swedes, English and Scots get sick more often than Asians).
• Environmental factor.
• Penetration of various viruses into the human body.
• Being in a stressful situation.

According to some reports, the causes of the disease are associated with hormonal changes. Often this happens immediately after delivery. But during the lactation period, the risk of developing multiple sclerosis decreases sharply.

Doctors have found that in the United States, the symptoms of this disease are predominantly found in people of the Caucasian race. The risk of developing the disease increases if a person decides to change his place of residence and move from one country to another.

How does the anomaly manifest itself?

As can be seen in the photo, the symptoms of multiple sclerosis appear gradually. The development of this disease in the first stage is almost unnoticeable. This happens because cells that are not affected by the lesion replace the diseased areas.

The first symptoms of multiple sclerosis occur when a person's nerve fibers are half affected. In this case, a person may complain of such signs of illness as:

• visual impairment (it can be either 1 or 2-sided);
• double vision;
• painful sensations in the eyes;
• a slight tingling sensation in the fingertips;
• decreased sensitivity of the skin;
• severe weakness;
• impairment of motor activity.

For many patients, the symptoms of the disease vary greatly. Even in one patient, the symptoms of the disease may disappear on their own or be replaced by other signs.

Often the symptoms of the disease intensify while taking a hot or warm bath. Also, the symptoms of multiple sclerosis can be aggravated by sore throat and lingering flu. Another provoking factor may be prolonged exposure to a hot room. To avoid negative consequences, a person at risk should avoid overheating as much as possible.

How else does the disease manifest itself?

Over time, the number of sclerotic plaques increases markedly. This contributes to the appearance of other signs of the pathological condition.

First, the person complains of muscle spasms. A little later, painful sensations appear. The patient then develops symptoms of constipation. This condition is aggravated by urinary retention, and the person loses control over the discharge of natural needs.

The next stage is the disruption of the patient’s sexual life. Often, against this background, a person develops depressive and subdepressive states. Then comes the turn of abnormal pyramidal reflexes, which are never found in ordinary people. Only a highly qualified neurologist can determine the presence of pyramidal reflexes.

At the next stage, as can be seen in the photo, the patient begins to show signs of cranial nerve palsy. The oculomotor nerve is affected first, followed by the trigeminal nerve. The last to be affected are the facial and hypoglossal nerves.

The patient's eyeballs begin to oscillate rhythmically. Symptoms of decreased intelligence appear. At the same time, the patient develops significant behavioral disorders. Depression often gives way to a state of euphoria.

Many people are interested in the question of whether this disease is inherited. Statistics show that if the mother has specific symptoms, the risk of developing multiple sclerosis in the fetus varies from three to five percent. It is believed that the disease is not inherited if the doctor cancels immunomodulatory therapy several months before the expected conception.

Judgment or not?

Some people think that multiple sclerosis is a dangerous disease that will certainly end in death. But that's not true. As you can see in the photo, people with this diagnosis can lead a normal life. This is not a contagious pathology, and there is no point in limiting contact with others like you. Doctors recommend their patients not to isolate themselves, but to communicate as much as possible with both fellow sufferers and healthy people.

In 1/4 of all cases of morbidity, the anomaly is benign. A person affected by this disease remains able to work for a long time and is able to take care of himself independently. In 10 percent of cases, approximately five years after detection of the disease, disability occurs.

If the disease affects a child or teenager, then it is characterized by a period of prolonged remission. Relapse of the disease can occur after a person reaches adulthood. All the time before this, the person seems absolutely healthy.

This pathological condition is characterized by an individual course. If it was detected on time, and if a specialist prescribed appropriate treatment, then the person has every chance that his life will be significantly easier. With proper treatment, the patient can live a very long life.

Preventive measures

Considering that today it has still not been possible to establish the exact mechanisms influencing the development of multiple sclerosis, there is no need to talk about specific preventive recommendations. Western experts are actively testing a vaccine designed to stop this disease. According to some reports, the miracle vaccine will appear on the market in about five to seven years.

Today, doctors recommend that people prone to developing this disease give up destructive habits and radically reconsider their diet. It is equally important to avoid being in stressful situations. It is recommended to avoid intellectual overload whenever possible. If a person is forced to spend most of his time at a sedentary job, he definitely needs to take walks more often and periodically arrange physical exercise minutes.

If a child develops frightening symptoms, you should not send him to sports. Physical activity should be constant, but not exhausting. The best solution would be to visit the swimming pool with your child.

Even when there is a long process of remission, the pregnant woman must undergo treatment. Taking hormonal contraception is strictly not recommended.

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6 Myths About Multiple Sclerosis

Contrary to popular belief, multiple sclerosis (MS) is not associated with sclerotic changes in the walls of blood vessels, nor with age-related forgetfulness and problems with concentration. This is a disease of an autoimmune nature. The pathological process is expressed in the degradation of nerve tissue and the destruction of the outer layer of nerve fibers, consisting of myelin. The development of the disease results in multiple lesions of the nervous system, manifested by decreased vision, fatigue, impaired coordination of movements, tremors, muscle weakness, decreased peripheral sensitivity, and local paresis. In severe cases, there may be a deterioration in the functioning of the pelvic organs (retention of stool and urination, urinary incontinence, etc.), the appearance of neuroses, depression, hysteria or, conversely, euphoric states combined with a decrease in intelligence.

Multiple sclerosis is a fairly common pathology: there are more than 2 million people suffering from it in the world. There are several described forms of MS, but the set of symptoms, severity and specific course of the disease are individual for each patient.

Although MS is not considered a rare disease, most people are not very familiar with its features. Let's try to dispel some of the myths that have developed around this disease.

Multiple sclerosis is a deadly disease

This is wrong. The most severe forms of sclerosis, accompanied by serious damage to the central nervous system, are relatively rare. In addition, modern medications can significantly improve the condition of patients. Unfortunately, the situation is complicated by the fact that clinical manifestations of MS often appear late, when about half of all nerve fibers have already been damaged. In such cases, the start of treatment is delayed, which negatively affects its outcome.

The use of modern medications and improved living standards have a beneficial effect on the condition of people suffering from MS. Despite the fact that cases of complete cure are unknown, the progression of the pathological process can usually be slowed down. In general, the life expectancy of patients with multiple sclerosis in developed countries does not differ from that of their peers who have avoided this disease.

MS patients are doomed to immobility

It is believed that every person with multiple sclerosis will eventually experience mobility using a wheelchair and complete helplessness. In reality, forecasts can be much more optimistic: with early diagnosis and timely initiation of adequate treatment, disability may not occur. Of course, much depends on the individual characteristics of the course of the disease, but most patients with MS manage to maintain the ability to move independently, take care of themselves and live in their usual routine.

Multiple sclerosis is a disease of old age

Quite the contrary: the onset of the disease usually falls within the age interval between 10 and 50 years. Among children, there are three times more girls suffering from MS than boys, but in older age groups the number of men and women among patients is almost the same. In the fairer sex, the disease manifests itself on average 1.5-2 years earlier than in their male peers, but in the latter the disease is more active and takes on more severe forms.

The cause of multiple sclerosis is still unknown; only risk factors have been studied:

• ethnic (racial) identity. Europeans suffer from MS more often than Africans, and among the Chinese, Japanese, and Koreans the disease is almost never diagnosed;
• region of residence (the so-called “latitudinal gradient”). The risk of developing MS is highest for those people who live north of the 30th parallel. For the inhabitants of other regions of the Earth, this parameter gradually decreases in the direction from north to south. The minimum number of cases has been recorded in the southern parts of the African and South American continents, as well as in Australia;
• stress. There are observations confirming an increased incidence of multiple sclerosis among representatives of “nervous” professions (air traffic controllers, firefighters, pilots, etc.);
• smoking;
• genetics. A family history of MS increases the risk of developing the disease tenfold. However, the disease is not considered hereditary, since its occurrence is usually caused by many factors.

Women with MS should not become pregnant

Multiple sclerosis is not an obstacle to bearing a child. On the contrary, many women suffering from MS experience significant relief during pregnancy, and after the birth of the baby, many years of remission can occur.

The illness of the expectant mother does not in any way affect the development of the fetus or the health of the newborn. The only problem is taking medications prescribed to treat MS, as some of them cannot be used during pregnancy and breastfeeding. Therefore, the patient must consult with her doctor even before conception and be under his supervision throughout the entire period of pregnancy.

People with MS should avoid physical activity

For a long time, doctors actually believed that exercise was harmful for people with multiple sclerosis. Numerous studies have proven that this is not so: patients can and should exercise moderate physical activity (of course, dosed taking into account the manifestations of the disease). Specially selected sets of aerobic exercises are very useful for MS patients: in most cases they reduce the severity of symptoms. Patients are also advised to walk, swim, and simply relax in the fresh air.

People with MS cannot continue to work

Many people suffering from MS, thanks to adequate treatment, maintain for decades not only their usual lifestyle, but also physical and mental activity, allowing them to successfully perform work duties. Even the onset of disability does not always become a reason for leaving work, especially since labor legislation obliges employers to provide such employees with working conditions that take into account the characteristics of their condition. Therefore, the majority of MS patients who are of working age are not in danger of being thrown to the margins of life.

Multiple sclerosis is a serious progressive disease, but not a death sentence. By following the instructions of the attending physician, the patient may well remain an active, self-sufficient and successful person. It is important not to give up, maintain an optimistic outlook on the world, and maintaining a normal standard of living will be a completely solvable task.

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Education: First Moscow State Medical University named after I.M. Sechenov, specialty "General Medicine".

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Multiple sclerosis - what is it and how long do you live with it? Forecasts

One of the most dangerous human neurological diseases is multiple sclerosis. The life expectancy of an individual suffering from this disease directly depends on his psychological and physical condition. Properly selected medications prescribed by a medical professional improve the patient’s condition, giving him the opportunity to live without experiencing serious problems. Treatment is more effective before the age of forty. A combination of medications and intensive therapy can help relieve movement problems and various psychological disorders.

The course of MS can be mild, which does not have a serious impact on life, or severe. Let's consider the latter in more detail. The severe form is accompanied by severe tremors of the limbs, and subsequently paralysis of the body develops. During severe attacks of mental disorder, the patient often forgets to take medications prescribed by doctors and does not go to medical institutions. As a result, the patient’s life is shortened due to psychoneurological disorders.

According to statistics: if complications of MS occur before the age of fifty, then the patient is unlikely to live more than twenty years with this disease.

Causes of the disease

Scientists continue to research the causes of multiple sclerosis, as it is the key to successful treatment. The main version today is an autoimmune process, due to which the body attacks itself. There are many reasons for the development of sclerosis:

• systematic exposure to toxic substances;
• radiation exposure;
• the effect of sunlight on the body;
• mental disorder and emotional stress;
• allergic reaction to various products;
• injuries received;
• consequences of surgical operations.

Symptoms at an early stage appear in a mild form, and exacerbations occur at varying intervals: every other day, month or year. Each new exacerbation can be much more severe than the previous one, this is worth taking into account.

Often the first signs of an illness are ignored by the patient, this will lead to irreparable consequences. Multiple sclerosis often manifests itself with only one symptom, such as blurred vision. The patient turns to an ophthalmologist, who is unable to determine an accurate diagnosis - a neurological disorder; only a neurologist can do this. As a result, valuable time is lost and the prognosis worsens.

The earlier multiple sclerosis is diagnosed, the greater the likelihood of sustained remission. Don't miss a visit to the doctor!

Manifestations of multiple sclerosis

Symptoms accompanying the disease:

1. Trembling of limbs. When trying to write something, it will be noticeable that the patient’s handwriting has changed greatly.
2. Impaired coordination of movements. Maintaining the ability to move without assistance is the main task for the patient and the doctor.
3. Rapid movement of the eyeballs.
4. Loss of some reflexes and weakening of tactile sensitivity.
5. Weakening of taste sensitivity. Loss of appetite and satisfaction from eating.
6. Sexual impotence.
7. Frequent dizziness.
8. Frequent urination.
9. Constantly accompanied by dizziness.
10. Mental disorders. Frequent depression, decreased level of intelligence and brain activity in general (thinking). These disorders occur in the cerebral form of multiple sclerosis and belong to its cortical variety.

Disability

The life expectancy of a person suffering from this pathology does not exceed seventy years. Based on the complexity of the disease, the patient can receive one of three disability groups:

• The first group is prescribed if there are serious disorders in the musculoskeletal system (MSA);
• The second group is awarded to the patient for obvious violations in the functioning of the musculoskeletal system;
• The third group is given to able-bodied patients who have minor deviations in the functioning of the musculoskeletal system.

The development of MS is accompanied by loss of sensation in the arms and legs, damage to certain areas of the brain occurs, convulsions, weakness and paralysis occur. As the disease progresses, it becomes more difficult for a person to live fully in society.

Average life expectancy after diagnosis

The main thing you should know about this disease is that it manifests itself before the age of fifty. And if its mild form is detected in a timely manner in children and adolescents, MS responds quite well to treatment, followed by stable remission.

If multiple sclerosis is diagnosed in time and the correct treatment is prescribed, the disease will not affect the child’s life expectancy, and he can then live as a completely healthy person.

Scientists are constantly developing new and improving existing drugs to combat the disease. In addition, the causes of sclerosis are constantly being studied. In the late 19th and early 20th centuries, people suffering from this disease lived an average of twenty years. With the invention of drugs and drugs that change the course of MS, the lives of patients have increased, and in modern society every neurologist knows how to live for a patient with this pathology and how he can be helped.

According to statistics, the average life expectancy of a patient suffering from multiple sclerosis is about thirty-seven years. With the development of severe forms of this disease, it is reduced.

That is why the fight against complications is a top priority. Without treatment, multiple sclerosis is accompanied by serious disturbances in human consciousness. The patient experiences convulsions, mental disorders appear, and coordination of movements is impaired.

How many years a patient will live also depends on the characteristics of the body: some live longer, others less. The patient is often unable to care for his body, which is why skin ulcers and bedsores appear. Their occurrence is facilitated by bacteria that infect the cells and tissues of the body, so you need to take care of your body very carefully. Some manifestations of MS that arise as a result of complications often become causes of death - kidney failure, heart attack, and urinary tract infection.

Treatment

Unfortunately, there is no medicine that would completely cure MS yet, but scientists around the world are actively working on it. The medications created to date allow patients to achieve stable remission.

• means for relieving acute conditions;
• drugs to inhibit the development of MS;
• medications intended to alleviate the condition of patients.

The course of medications is prescribed and adjusted if necessary by a neurologist.

Treatment of MS with folk remedies

Along with the use of chemicals, traditional medicine is also used to treat MS - “herbs” and tinctures, which, together with a course of drugs prescribed by the attending physician, can alleviate the patient’s condition. Traditional medicine will not replace PEDs and other medications, but can serve as a good addition to them. Here are some of the examples:

1. An hour before meals, you should take two hundred grams of onion, mixed in equal quantities with honey.
2. The familiar mummy, in the amount of five grams per hundred milliliters of water, is taken three times a day before meals.
3. Various vodka tinctures with various herbs also help alleviate the disease.

It is also worth noting that food should contain the required amount of carbohydrates, fats and protein, various vitamins and microelements. There are established cases of achieving remission with the help of a proper diet.

In general, with timely detection of multiple sclerosis and the necessary therapy, the life prognosis is quite positive. The main thing is to relieve symptoms of exacerbations in time and consult a doctor.

Pavlenkov Sergey Pavlovich,

Sviridov Alexey Gennadievich,

Medical portal “About sclerosis.RU”

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We invite specialists to consult patients and prepare materials for the site.

Prognosis and life expectancy for multiple sclerosis

It is possible to see a person with such a disease on the street only if motor functions are intact. But more often, multiple sclerosis is recognized only by those who have had this problem in their family.

Multiple sclerosis is a chronic disease that leads to disability. With it, people rarely live to old age, especially in cases where there is a remitting form and constant treatment.

The main cause of death is the presence of infection or bulbar disorders (problematic swallowing, chewing, etc.).

• All information on the site is for informational purposes only and is NOT a guide to action!
• Only a DOCTOR can give you an ACCURATE DIAGNOSIS!
• We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
• Health to you and your loved ones!

Disability

In the presence of multiple sclerosis, patients receive disability, the degree of which is determined by specialists of medical expert commissions. The nature of the attacks is taken into account.

Factors influencing life expectancy

Only a few people manage to live long with multiple sclerosis.

The influencing factors are:

• mental disorders;
• the presence of bedsores and ulcers on the extremities, which cause infection of other organs.

Such causes lead to death gradually.

But changes may occur in which life ends immediately:

• with heart attack;
• with lesions of the respiratory centers;
• with renal failure;
• with infection of the urinary system.

Life expectancy also depends on the stage at which pathological processes are detected. If the disease is diagnosed in a timely manner, then with proper treatment, disability does not occur.

Life expectancy for multiple sclerosis

It is rare to find a person with multiple sclerosis who has lived for more than 40 years. And in order to understand how far modern science has advanced in the search for effective treatment, it is worth waiting more than a dozen years. This is also difficult to do because with atypical forms of MS, people die within 5–6 years.

Here you can find out why multiple sclerosis is dangerous.

But experts were able to ensure that life expectancy increased.

For comparison, here is the following table:

After being diagnosed with multiple sclerosis, the average person still lives 35 years. If the disease occurs in an acute form, then the person has much less time. The frequency of this type of pathology is every fourth patient.

Modern medicines increase human life expectancy. Their particular effectiveness is noted in forty-year-old patients.

If problems arise with coordination of movements in a patient at 50 years old, there is a chance that he will live no more than 70 years.

There are several groups of people with this diagnosis, whose lives have different durations:

Consequences and complications

The following complications may occur:

• loss of sensation in the limbs;
• the brain is affected;
• inability to control urination, defecation;
• weakness in the legs;
• paresis and paralysis;
• the appearance of seizures;
• the occurrence of dizziness;
• feeling tired;
• depression;
• disorders in the sexual sphere.

Frequently Asked Questions

People who have encountered this disease themselves or observe its progression in a member of their family are wondering how to live further.

Can a person with MS study or work?

Due to the fact that MS is not characterized by a general manifestation, severity and frequency of occurrence, it is difficult to answer this question unambiguously. The ability to perform job duties or attend classes is affected by the degree of disability.

Therapeutic exercises for multiple sclerosis

If a person has group 3 disability, he can continue to lead the lifestyle to which he is accustomed.

During remission, the patient must assess the level of his capabilities in a specific industry:

This will allow you to move towards the goal not only at this stage, but also in the future.

Should you talk about your illness to your family and friends?

The patient has every right to decide for himself whether to hide the discovered illness or tell his loved ones.

If there are no visible signs, then you don’t have to rush to inform your family.

But when you discover the secret, you will be able to take advantage of the benefits provided. For example, in educational institutions such patients are trained under special programs, can count on individual exams, etc.

How to live further after diagnosis?

If the disease is detected early, treatment will be more effective. It is necessary to take beta interferons, which will help slow down the process of disability and reduce the severity and frequency of exacerbations.

The patient should adapt to the disability (if it is not very pronounced) and continue to live the same life.

There is no general treatment method. If a serious exacerbation is observed, the doctor will prescribe corticosteroids, methylprednisolone intravenously, with a further transition to prednisolone.

The severity and severity of exacerbation is reduced with certain drugs that were approved for use only recently:

The patient must undergo rehabilitation after an exacerbation.

In case of remissions, maintenance therapy is prescribed, as well as:

• physical exercises (stretching and coordination);
• speech therapy classes;
• physiotherapy.

Which specialists should I contact?

How to live without exacerbations or reduce them to a minimum? It is worth seeing specialists. Multiple sclerosis is the responsibility of a neurologist. Your family doctor will help you and your loved ones learn all the nuances about the course of the disease.

Many also turn to medical institutions for psychological support.

For specific problems that may arise due to the disease, contact:

Will volunteers help if I'm lonely?

Single people can count on support from social assistance workers in managing their household.

There are volunteer movements in the country that will support and help in solving problems.

Such organizations have special literature on multiple sclerosis, which is provided to patients free of charge. You can find the trust numbers and address of such a company on the RS International Portal.

Does MS in older people differ from the disease in young people and children?

MS can debut in a person of any age, but is most often diagnosed in people 25–35 years old, with females being at greater risk. In old age, as in young age, the disease rarely appears.

The course of multiple sclerosis in a two-year-old child is mild, and complications are minimal.

In young people and children (as opposed to older patients), the disease is accompanied by:

The remaining symptoms are general. According to research, if a child gets sick before the age of 16, the course of the disease will be more favorable. But there are cases when, after 20–30 years, such people experience significant disability.

What are the forecasts?

No one can predict how multiple sclerosis will develop. It can be partially foreseen, taking into account the type of course of the disease (remitting or progressive), the group of disability that was received at this stage.

Most patients lead a normal lifestyle (45%), since the disease does not cause a significant deterioration in their condition. In 40% of patients, multiple sclerosis changes from a remitting type to a progressive one.

Those people with multiple sclerosis who work, during exacerbations, take steroid hormones and drugs prescribed by a neurologist to minimize them. In rare cases, a person must sit in a wheelchair.

Read about what senile sclerosis is here.

In this article you will find a list of multiple sclerosis medications for memory.

15% of patients do not develop significant disorders for more than 25 years. Everyone's life expectancy with multiple sclerosis is different, but you can do everything possible to alleviate the condition and lead a fulfilling lifestyle. The main thing is to identify the disease in a timely manner and not avoid meeting with a doctor.

Multiple sclerosis is a pathology that results in disruption of the conduction of nerve impulses in the cerebral cortex. This autoimmune process occurs due to damage to the myelin sheath. As a rule, the disease is characteristic of an early age; the disease begins to manifest itself between 15 and 40 years. There are cases of later onset of pathology, but they are extremely rare.

Statistics and general concept

The term multiple sclerosis is misinterpreted by many. It is associated with senility, dementia and memory problems, etc. In fact, multiple sclerosis has nothing in common with senile pathologies. Sclerosis is a scar of connective tissue, and diffuse, in this case, means multiple.

The peak age for the development of the disease is the working age of 25-35 years. Women are more susceptible to pathology than men. The diagnosis of multiple sclerosis is heard by about fifty people per 100,000 population. Regarding the speed of development, it is individual. There may be a sluggish process against the background of the general course, or, on the contrary, it may be rapid and quickly lead to disability.

Unfortunately, the pathology is incurable, so treatment can only stop the destructive process, but not completely get rid of sclerosis. Therapy has several goals, including:

• stop the destruction of the myelin sheath, thereby slowing down the progress of the pathology;
• symptomatic treatment, its task is to alleviate the patient’s condition and relieve the disturbing clinical picture;
• treatment of complications.

Forecast

The lifespan of multiple sclerosis cannot be said with certainty. With the development of medicine, doctors have been able to achieve an increase in life expectancy for sclerosis over the last century. So, if in the 30s of the last century, it was possible to live with such a diagnosis for a maximum of twenty years, then already in the second half of the 19th century, this figure increased to thirty. And at the beginning of our millennium, the lifespan of a patient with sclerosis became shorter than the usual lifespan of a healthy person by only seven years.

So, on average, with normal treatment, a patient manages to live with the diagnosis for about 35 years. But, in cases where the pathology occurs in an acute form, this figure is much lower. In cases where multiple sclerosis occurs in an atypical form, then life expectancy is about 5-10 years.

Experts have identified groups of people with this disease, according to which the estimated life expectancy is determined. There are four of these groups:

• the first group, people who were diagnosed at an early age (20-40 years). With proper treatment, their life expectancy will be seven years less than that of healthy people;
• second group. Detection of pathology at the age of fifty, with adequate therapy they will live up to seventy years;
• the third category of people who were diagnosed with sclerosis with complications at the age of 50, in this case, life expectancy will be approximately another ten years;
• the fourth group is a rapid course of pathology. In this case, life expectancy, as a rule, does not exceed ten years from the moment of diagnosis of sclerosis.

Complications and disability

Multiple sclerosis is accompanied by remission and relapses. So, depending on how often relapses occur and what degree of severity and impact they have on everyday life, patients are assigned the appropriate disability group. There are three disability groups:

• The first group is the most difficult; it is prescribed if severe disorders of the musculoskeletal system are detected. As a rule, in this case the patient is not able to care for himself;
• the second group - serious problems with coordination and movement;
• third group - violations are identified, but they allow the patient to continue working.

The progress of the disease is inexorable and every year new symptoms and complications arise, among them:

• numbness of the limbs;
• the occurrence of seizures;
• paresis or paralysis of the limbs, starting with numbness and weakness in the muscles of the arms and legs;
• inability to control the process of urination;
• frequent dizziness and loss of coordination of movements;
• sexual disorders;
• depressive states;
• increased fatigue and lack of ability to work.

In most cases, multiple sclerosis does not lead to a wheelchair, but of course, such a development of pathology is also possible. According to statistics, 45% of patients lead a normal lifestyle, continuing to work, and about 15% of patients have not felt any signs of the disease at all for 25 years.

What affects life expectancy?

It should be understood that death does not come from multiple sclerosis itself, but from the consequences that it causes. Sclerosis can cause the development of various concomitant diseases. Thus, sudden death can occur as a result of:

• heart attack;
• stroke;
• damage to the respiratory system;
• development of renal failure.

Indirect causes that can accelerate the approach of death are considered to be mental disorders, as well as bedsores and ulcers that form on the body in case of complete disability. The latter can lead to infection of other organs, thereby complicating the overall picture of the disease.

Multiple sclerosis is an autoimmune disease that has a chronic course. The pathology is accompanied by remission and relapses; the more of the latter are diagnosed, the worse the prognosis for the patient. The average life expectancy of a patient is more than 30 years, provided proper systematic treatment is provided and the disease does not develop rapidly. In almost half of the cases, patients remain able to work.

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To treat multiple sclerosis, drugs with anti-inflammatory and immunosuppressive effects are used. The goal of immunotherapy for multiple sclerosis is to improve the outcome of exacerbations, reduce the risk of recurrent exacerbations, and prevent or slow the progression of the disease. Glucocorticoids and adrenocorticotropic hormone preparations have the longest history of use and are most widely used in the treatment of multiple sclerosis. Currently, preference is given to intravenous administration of high doses of methylprednisolone, which, during exacerbation, accelerates recovery and improves functional status in the short term. However, neither this technique nor the long-term use of oral glucocorticoids improves the functional state in the long term, although a very small proportion of patients develop steroid dependence, and when trying to stop glucocorticoids, an exacerbation of multiple sclerosis occurs.

Extended Disabi1ity Status Sca1e - EDSS

• 0 - normal neurological status
• 1-2.5 - minimal defect in one or more functional systems (for example, pyramidal, brainstem, sensory, cerebral/mental, cerebellar, intestinal and urinary, visual, others)
• 3-4.5 - moderate or severe impairment in one or more functional systems, but capable of independent ambulation at least within 300 m
• 5-5.5 - pronounced defect in one or more functional systems; capable of moving without additional support within a range of at least 100 m.
• 6 - requires unilateral support (e.g., crutch or cane to walk at least 100 m)
• 6.5 - requires bilateral support (for example, a walker, two crutches or two canes to walk at least 20 m)
• 7-7.5 - confined to a wheelchair
• 8-8.5 - bedridden
• 10 - death due to multiple sclerosis

In recent years, new immunomodulatory agents have emerged for the treatment of multiple sclerosis. Non-selective agents include the antiviral cytokine INFb. Currently, 2 INFb drugs are approved for use in multiple sclerosis - INFb1b and INFb1a. A more specific approach to treating multiple sclerosis is based on the use of glatiramer acetate.

Determining the effectiveness of drugs in multiple sclerosis is based mainly on neurological examination data, supported by quantitative neuroimaging assessment of the number of lesions and their activity. To assess a functional defect, the Kurtzke Functiona1 Status Sca1e (FSS) and the Kurtzke Extended Disabi1ity Status Sca1e (EDSS), created more than 30 years ago, are most often used. Both scales assess the state of neurological functions that are most often affected by multiple sclerosis.

Problems of treating multiple sclerosis

Early therapy

Currently, these drugs are usually prescribed to patients with clinically significant multiple sclerosis, which has signs of an active process. At the same time, they are not used in cases of probable multiple sclerosis, when the patient experienced only one exacerbation. However, there is no consensus on when long-term therapy should be started. A study has been completed showing that early use of INFb1a after the first attack of a demyelinating disease can delay the development of a second attack and, therefore, clinically significant multiple sclerosis. Currently, the cost of treatment is high (about US$10,000 per year), but it is potentially balanced by the cost of treating exacerbations or complications of the disease, as well as maintaining the patient's economic productivity.

Combination therapy

Another issue that is being increasingly studied is the possibility of combining drugs with different mechanisms of action. For example, in combination in vitro glatiramer acetate and INFbeta1b had an additive effect, reducing the proliferation of INFu-activated OMB-reactive cells obtained from healthy volunteers. To date, there is no data on the use of the combination of glatiramer acetate and INFb in clinical settings. Some centers have tested patients with progressive multiple sclerosis using a bolus of cyclophosphamide and methylprednisolone as induction therapy, followed by INFb maintenance therapy to stabilize the patient's condition. At this time, any reports of a beneficial effect of combination therapy should be considered preliminary, since the effectiveness and safety of such methods have not been studied in adequately controlled clinical trials.

New treatment strategies for multiple sclerosis

There are a number of other possible immunotherapies that could potentially have a beneficial effect in multiple sclerosis. In the future, this series is likely to expand as knowledge of the immunopathogenesis of the disease increases. Some drugs have undergone preliminary clinical trials (eg, transformed growth factor P, T-cell vaccine, anti-α4 integrin antibodies, phosphodiesterase inhibitors, anti-CD4 antibodies, T-cell antagonist peptides). Sometimes the results of these studies are inconsistent with expectations, reflecting an incomplete understanding of the pathogenesis of multiple sclerosis. For example, treatment with anti-TNF antibodies in two patients with rapidly progressive multiple sclerosis had no effect on clinical status but did cause a transient increase in the number of active, contrast-enhancing lesions on MPT.

Prognosis of multiple sclerosis

When examining 1099 patients, it was noted that 51% of them retained the ability to move independently. In this study, 66% of patients had a relapsing course at the onset of the disease, while 34% tended to progress. The frequency of transformation of a remitting course into a secondary progressive one in the first 5 years after diagnosis was 12%. Within 10 years, such a transformation was noted in 41% of patients, and within 25 years - in 66% of patients.

Other studies have shown a trend toward steady, albeit slow, progression, with the proportion of patients with mild disease decreasing over time. In a study by Weinshenker et al. (1989) it was noted that on average for the group from the moment of diagnosis to the moment when the patient’s movement becomes impossible without some outside assistance, 15 years pass, but in patients with a progressive course this period averaged 4.5 years. Similar data were obtained when observing 308 patients with relapsing-remitting disease for 25 years. In both studies, it was noted that female gender and early onset of the disease are favorable prognostic signs, as well as the onset of the disease with sensory disorders (including optic neuritis) with subsequent complete recovery, the rarity of exacerbations in the first years of the disease, minimal limitation of functions after the first 5 years of illness.

Biological factors that predetermine the variability in the age of onset of the disease and the transformation of a relapsing course into a progressive one are the focus of scientific research. Their identification will allow more rational treatment planning for specific patients.

MRI studies. Dynamic MRI studies allow us to deepen our understanding of the pathogenesis of multiple sclerosis and the course of the disease. Although in cross-sectional studies the relationship between the volume of lesions measured by MRI and the degree of functional impairment appears variable, in prospective studies, an increase in the volume of lesions is accompanied by an increase in functional defect. In addition, a relationship has been established between the clinical activity of the disease and the appearance of new active lesions emerging with the help of gadolinium contrast on T1-weighted images. The size of the lesions usually increases over 2-4 weeks and then decreases over 6 weeks. Lesions that are both hyperintense on T2-weighted images and hypointense on T1-weighted images are of clinical significance. These lesions correspond to areas of gliosis, more severe demyelination, or more significant axonal degeneration.

A dynamic MRI study in patients with a relapsing course reveals new active lesions from month to month and an increase in the total volume of affected white matter over time, even in the absence of clinical signs of progression. It is assumed that the transformation of a relapsing course into a secondary progressive one is associated with the accumulation of such foci of demyelination.

Another important indicator is the degree of spinal cord involvement. In patients with spinal cord damage, the degree of functional defect is higher. When studying dynamic MRI in patients with relapsing-remitting and secondary progressive disease, a comparable rate of increase in the volume of the lesion is observed. At the same time, with a primary progressive course, the volume of brain tissue damage is, as a rule, lower than with a secondary progressive course, and the lesions are less contrasted by gadolinium.

Important to know!

This article briefly reviews the most common symptoms of multiple sclerosis and their pharmacological treatment. In patients with multiple sclerosis, pseudoexacerbations may occur against the background of fever of any origin, which are explained by reversible temperature-dependent changes in the conductivity of demyelinated axons.