Multiple (multiple) inflammatory Entmarkungsherde, probably caused by the attack of endogenous immune cells on the Myelinscheiden the Nervenzellforts?tze are scattered in the white matter of the brain and spinal cord in multiple sclerosis. because the Entmarkungsherde in the entire central nervous system can occur, the multiple sclerosis can cause almost any neurological symptom . Visually impaired with reduction of Visual acuity and errors of the eye movement (internukle?re ophthalmoplegia) are typical, but not specific for multiple sclerosis.
The disease is not curable, but of course can often conveniently be influenced by various measures. Contrary to popular belief, the multiple sclerosis not inevitably leads to severe disabilities. Many years after the onset of the disease, the majority of patients is still capable of walking.
The first symptoms occur mostly between the age of 15 and 40. within the framework of a push. while the episodes at the beginning of the disease completely recede, neurological deficits remain present in the later course of the disease to batch mode. Vision and sensitivity disorders are frequently seen at the beginning of the disease. Often, the disease starts first with an isolated impact, for which the term of clinically isolated syndrome (CIS) has naturalized.
Which symptom in the single thrust occurs is dependent on the respective localization of active Entmarkungsherdes in the central nervous system: to cause inflammation in the area of optic nerve (optic neuritis) Visual impairment, which can become noticeable as Visual blur or Milky veil and also accompanied by sore eyes. Inflammation in the area of sensitive railway systems can cause sensitivity disturbances such as abnormal sensations (paresthesia), numbness, and pain. Often the hands and legs (feet and lower legs) are affected. Pain can be caused by a trigeminal neuralgia, muscle cramps, as well as by the Lhermitte Symptom .[68] The Lhermitte sign is considered typical for the MS and may be a reference to herd in the area of the neck part of the spinal cord. The motor system is affected, paralysis (palsy) of the extremities encounter, where by abnormal involuntary increasing of muscle tone (spastic tone increase) the mobility of patients can be additionally constrained. Herd in brain stem and cerebellum can result in errors of the eye movements (diplopia and Nystagmen), swallowing disorders (dysphagia), dizziness and errors of movement coordination (ataxia) and speech impediments (dysarthria). Charcot’s triad refers the Entmarkungsherden common in the area of the upper cerebellar stem syndrome of intention, nystagmus, and skandierender (abgehackter) language. A temporal Abblassung of optic papillae, the existence of a Paraspastik and the absence of the abdominal hautreflexe is referred to as Marburg’s triad . Vegetative centres and trains are affected, it can come to errors of the control of the bladder and bowel function and sexual dysfunction. in many patients, an increased physical and mental fatigue (fatigue) occurs in the course. this fatigue occurs regardless of physical and mental stress and increases in the course of the day. as also the other symptoms can increase the fatigue in the framework of the Uhthoff phenomenon (clearer emergence of symptoms by temperature rise). Cognitive and mental disorders are not to neglect. in particular errors of affect occurs often.[69] in the late stage can occur even a subcortical dementia.
A means to quantify the impact of the patient is to determine which expanded disability status scale (EDSS). The current deterioration of the person concerned in seven neurological systems is determined in this scale. If you look at the entire history of the disease, there are the fatigue, errors of bladder function, as well as errors of the motor system such as paralysis and spastic tone increases, affecting the lives of those affected most often.
So far it is hardly possible to make a forecast on the course, at the beginning of the disease which charged to the patient. some epidemiological studies on the prognosis of multiple sclerosis have been published in recent years. The results were overwhelmingly positive, and showed that the disease is not often less difficult than generally assumed.[125] A Web based computer program for the determination of individual risk profile based on disease progression, is based on the disease development of 1059 patients, by a Munich team expanded disability status scale, disease duration, shear rate and age has been developed
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