Therapeutic measures for multiple sclerosis are very diverse, due to the very diverse and sometimes even ambiguous views of scientists on the nature and development of pathology. The question of the effectiveness of certain techniques is also very difficult because in multiple sclerosis, cases of spontaneous recovery of a sick child are very frequent.
For a number of the above-mentioned painful conditions, which are very similar to multiple sclerosis, but are not associated with it in any way, therapeutic measures are very simple. In this case, it is necessary, first of all, to treat the underlying disease, which led to damage to the nervous system. Most often, this underlying disease is rheumatism, tuberculosis, toxoplasmosis, tumor formations, etc.
The situation is much more complicated with patients suffering from true forms of multiple sclerosis. The main goal of therapy in this case is to increase and lengthen the periods of extinction of manifestations, complete or, if possible, partial restoration of the patient’s working capacity. To effectively achieve these goals, it is necessary to stop all exacerbations of the disease, manifested in the form of one or many symptoms, on time and as quickly as possible. At the same time, the specialist doctor is faced with a very difficult task, since the range of tasks to be solved is quite wide: it is necessary to restore the disturbed metabolism, eliminate allergic reactions, movement disorders and other disorders of the nervous system. The situation is very much more complicated if there are complications (sepsis, bedsores) or concomitant diseases such as influenza, tonsillitis, etc. During treatment recently, much attention has been paid to disorders of the endocrine glands, which need to be timely and most completely eliminate.
Especially insidious in terms of diagnosis and treatment are those forms of the disease that are somewhat erased, with only one manifestation. In general, there are two main approaches in the treatment of multiple sclerosis: treatment aimed at the infection that provoked the disease, and treatment aimed at eliminating the body’s allergic mood. Let us examine each type of treatment for multiple sclerosis separately.
Drug therapy
Treatment aimed at infection. Such therapy is especially indicated if the disease develops quickly, accompanied by significant rises in temperature, characteristic changes in laboratory tests. In such cases, the role of the infectious agent in the development of the disease becomes quite likely. In this case, antibiotics of a wide range of action, antiviral drugs, local measures in the form of mouthwash, inhalation, and elimination of infections of the genitourinary and digestive system are most often used. All this is aimed primarily at eliminating the existing foci of chronic infection.
A rather peculiar method of treatment is the administration of a special vaccine Margulis-Shubladze, also called a brain tissue vaccine, to the patient.
With a long, chronic course of the disease, these methods of treatment are ineffective and are not used, since in this case, it is not infectious agents that are of greatest importance in the development of the disease, but allergic reactions in the body.
Another group of drugs used for multiple sclerosis is antiallergic, suppressing immunity and, on the contrary, stimulating it. All these types of therapy should be used very carefully and under the indispensable control of immunity indicators, since they, if used ineptly, can lead to even deeper and more unfavorable disorders. The functional state of the adrenal cortex should be especially taken into account. Often , combined preparations are used that contain substances from different pharmacological groups.
Correction of metabolism and vitamin therapy are an important part of the treatment of multiple sclerosis. Often, after the elimination of metabolic disorders, most of the neurological manifestations disappear. For this purpose, substances that suppress enzymes are widely used. They also use drugs that are directly involved in metabolism, vitamins, especially group B, and in some cases, anabolic steroids are used.
Treatment aimed at eliminating certain individual signs of the disease. The following main medications are used:
1. Drugs that improve nerve conduction. In patients with an increased tone of paralyzed muscles, these drugs are used in combination with other treatments, such as electrical stimulation of muscle tissue.
2. Medicinal preparations containing amino acids as an active substance. As you know, some of the amino acids are also able to indirectly affect the improvement of nerve conduction.
3. Drugs that reduce muscle tone.
4. Psychotropic drugs to eliminate psychotic and some neurological disorders.
Non-drug treatment methods
As such, two different types of measures are used.
Therapeutic measures based on various physical methods of influence. These include:
– Electrosleep treatment. This procedure is especially effective in the initial stages of the disease in patients with a predominance of neurotic disorders. The essence of the procedure consists in the imposition of special electrodes on the occipital area and the supply of electrical impulses of a certain frequency to them, which is selected individually for each patient. With neuroses as manifestations of multiple sclerosis, this manipulation is combined with drug treatment and psychotherapy;
– oxygen therapy. Literally the term can be translated as “oxygen treatment”. In this case, a sick child is placed in a specially equipped oxygen tent for a certain time. The average duration of such treatment is about 3 weeks. This technique is especially effective in patients with impaired coordination of movements. At the same time, metabolic processes are significantly improved, the quality of simultaneously applied vitamin therapy is increased;
– underwater intestinal lavage. The procedure is used in cases when the patient has long been disturbed by constipation that does not respond to drug therapy. Before carrying out such manipulations, the patient must be very well examined and prepared;
– ultraviolet radiation. They are prescribed to the spine area in order to correct the excessively increased tone of the affected muscles. The course is held in general during the week;
– a galvanic collar with some medicinal substances is placed on the neck of patients who complain of frequent dizziness;
– applications with ozokerite on the lower extremities with their paralysis and increased muscle tone. Similar applications can also be done on the lower part of the thoracic spine. After a course of such manipulations, most patients show significant improvements: muscle tone decreases, motor function improves;
– when the oculomotor nerves are involved in the process, the use of electrophoresis with vitamins on the occiput and orbit areas is very effective. Also, in milder forms of multiple sclerosis, a very good effect is obtained when electrophoresis is applied to the eye sockets and the spine.
In order to reduce muscle tone, ionic reflexes with various drugs are used. In the presence of liver damage, inductothermy can be prescribed to the area of the right hypochondrium, but such appointments should be made only on strict indications and after a detailed examination of the patient.
With the defeat of the cerebellum and the autonomic nervous system, at one time among doctors there were attempts to apply dosed deep X-ray therapy.
It is quite clear that the above physiotherapeutic methods cannot be applied independently, but are prescribed only in combination with other types of treatment, most often with medication. Only such a combination can provide a lasting and pronounced positive effect. A distinctive feature in the treatment of patients with multiple sclerosis is that they are never sent for balneological and mud treatment due to the poor tolerance of such events. In general, they try not to prescribe many different types of treatment at the same time. In some cases, it is possible to recommend changing climatic conditions and moving to live in regions with a dry warm climate.
Physiotherapy. The specificity of this group of therapeutic effects is determined by the fact that with multiple sclerosis, movement disorders come to the fore in the clinical picture, therefore, the patient often cannot perform even the most elementary exercises. Such patients are always prescribed special sets of exercises, the main purpose of which is to provide relaxation of muscles in a state of increased tone, and at least partial restoration of their motor function. During these exercises, the patient’s environment should be appropriate: the absence of various stimuli, the optimum air temperature, etc. A very good effect is obtained when performing passive movements (movements performed with the help of a doctor) in a warm bath. In addition to the motor function, these exercises significantly affect the coordination of movements, greatly improving the patient’s quality of life.
In recent years, some doctors have rather successfully used various methods of biostimulation of the affected muscles using special devices. However, before starting these activities, it is necessary to find out how far the disorders from the nervous system have gone and whether it is possible to restore at least some movements in general.
Surgical treatments
They are used extremely rarely, since they are quite complex and sometimes the risk of surgery far exceeds the disorders caused directly by the disease itself. Operations are performed on the nuclei of the brain in order to correct muscle tone and partially restore movement. Sometimes surgical intervention consists only in the fact that various solutions are injected into the location of one or another affected nerve root.
Prevention
The most intensive preventive measures for multiple sclerosis should be carried out in northern countries, with a cold and humid climate, since it is their population that most often suffers from this disease. Persons with suspected allergic predisposition should be immediately registered for dispensary registration. Hardening procedures and the use of desensitizing medications are very important for such children. As a result, the child’s body becomes practically insensitive to the effects of provoking factors. Special preventive measures should be carried out for children under the age of 15, since it is this group that is most vulnerable to various negative environmental influences. When the first, even the most insignificant signs of the disease appear, it is necessary to completely exclude physical and psycho-emotional stress in the patient , since the system of endocrine glands suffers first of all, which is a very unfavorable moment. When the first signs of developing neurosis appear, the use of sedatives is of great importance. Patients with initially impaired metabolism are assigned special diets.
Forecast
Most of the patients who have suffered one exacerbation of multiple sclerosis do not experience any difficulties in this regard and can continue to do their usual work for many years. This is especially true of people engaged in mental types of work, whose work does not suffer as a result of certain minor persistent movement disorders. Some of the patients need to change their jobs and are forced to occupy lower-paid positions. However, in the process of competent treatment, the ability to work can be partially restored, and sometimes in the future the patient can again do his usual work.
The prognosis for the further quality of life and working capacity is much better in patients in whom the disease proceeds in the form of periods of exacerbations and improvements in their condition. It becomes worse if the disease is continuously progressive. If the improvement in the condition is very persistent and prolonged, then sometimes they even talk about the so-called temporary practical recovery. But all the same, no matter how slowly the disease progresses and no matter how qualitatively the treatment is carried out, the patient’s working capacity is gradually steadily decreasing over the years.
Disability of the patient occurs on average in the period from one to 10 years, which is determined by the type of disease, the quality of the therapy and the depth of metabolic disorders.
Rehabilitation
Rehabilitation measures for patients with multiple sclerosis are carried out in accordance with the above. Since the ability to work in patients with all forms of pathology ultimately decreases anyway, all of them are shown a change of place of work. Heavy physical labor is contraindicated even during periods of improvement. A very
important role belongs to the correct organization of the daily regimen of sick people. It is necessary to alternate periods of work and rest, to ensure a full night’s sleep. All patients are assigned a disability group depending on the severity of the symptoms of the disease. Most often, disability is caused by impaired movement and coordination. Correct and timely determination of the patient’s disability group largely contributes to the longer preservation of his ability to work.
A special contingent is made up of patients with very significant disorders of motor functions, in whom only vision and movements in the hands are preserved. Such patients are also able to remain able to work for a long time, provided they are provided with special jobs.
A very important role in the rehabilitation of patients with multiple sclerosis belongs to their timely registration in dispensary records in polyclinics at their place of residence or in specialized medical and preventive institutions. Such patients should be constantly monitored and consulted by a psychotherapist, physical therapy doctor, and in some cases – an orthopedist. All patients should undergo inpatient treatment during periods of exacerbation. Also, the task of prescribing various measures in relation to the patient’s rest and work is completely on medical workers. Particular attention should be paid to a number of provoking factors, such as trauma, hypothermia, infection, vaccination, and treatment with herbal medicines .