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multiple sclerosis(MS), chronic, slowly progressive autoimmune disease in which the body's immune system attacks the protective myelin sheaths that surround the nerve cells of the brain and spinal cord (a process called demyelination), resulting in damaged areas that are unable to transmit nerve impulses. The disease also gradually damages the nerves themselves. There are elevated numbers of lymphocytes in the cerebral spinal fluid and of T cells in the blood (see immunityimmunity,
ability of an organism to resist disease by identifying and destroying foreign substances or organisms. Although all animals have some immune capabilities, little is known about nonmammalian immunity.
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The onset of MS is usually at age 20 to 40 years, and its many symptoms affect almost every system of the body. There may be visual difficulties, emotional disturbances, speech disorders, convulsions, paralysis or numbness of various regions of the body, bladder disturbances, and muscular weakness. The course of the disease varies greatly from person to person. In some patients, the symptoms remit and return, sometimes at frequent intervals and sometimes after several years. In others the disease progresses steadily.
There is a genetic predisposition to MS, and environmental factors also seem to play some role. The disease is more common in temperate climates (1:2,000) than in the tropics (1:10,000).
There is no cure for MS, but a number of drugs—the first of which became available in the 1990s—can slow its underlying progress and/or reduce the frequency of attacks. These are beta interferon (a synthetic version of a natural substance produced by the immune system), glatiramer acetate, and natalizumab.
See R. Rubinstein, Take It Or Leave It: Aspects of Being Ill (1989); U.S. Dept. of Health and Human Services, Warren Grant Magnuson Clinical Center, Multiple Sclerosis (1990).
a chronic progressive disease of man, characterized by the development of foci of demyelination in the central and peripheral nervous systems; a neurological disease. The etiology is not clear; according to the infectious allergic theory, an infectious (viral or bacterial) agent initiates a prolonged autoimmune process.
In multiple sclerosis, sclerotic patches of varying sizes form in the matter of the brain and spinal cord. Microscopic examination reveals demyelination and proliferation of glia in these patches. The disease usually develops at an early age. In 1868, J. M. Charcot described the classic triad of symptoms: nystagmus, intention tremor (irregular oscillations of the eyes occurring when the patient moves), and staccato speech. Also characteristic are visual disturbances (changes in the fields of color perception, changes in acuteness of vision, and double vision); disturbances of the vestibular apparatus (dizziness); impairment of coordination; changes in the pyramidal system (spastic paresis of the lower extremities, pathologic Babinski’s and Ros-solimo’s reflexes, and loss of abdominal reflexes); disturbances in vibration sensitivity; and changes in the cerebrospinal fluid. The course of the disease is slow, and there are usually recurrent exacerbations; in time, the periods of remission become shorter and the neurological symptoms progress.
Multiple sclerosis is treated with desensitizing agents, immunosuppressants (chloroquine phosphate, glucocorticoids, cyclophosphamide, and histaglobin), transfusions of blood and blood substitutes, and drugs that normalize metabolism, vitamin balance, and neurohumoral influences (ATP, B-complex vitamins, glutamic acid, neostigmine methyl sulfate, and diethazine). Other methods of treatment include physiotherapy (electric sleep, applications of ozokerite, inductothermy), exercise therapy, and bioelectric stimulation of muscles and coordination of movements. Research is being conducted on methods of surgical treatment of multiple sclerosis.
REFERENCESDemieliniziruiushchie zabolevaniia nervnoi sistemy v eksperimente i klinike. Minsk, 1970.
Panov, A. G., and A. P. Zinchenko. Diagnostika rasseiannogo skleroza i entsefalomielita. [Leningrad] 1970.
Pentsik, A. S. Rasseiannyi skleroz. Riga, 1970.
V. B. GEL’FAND