Multipla skleroza

Objavil/a Marko Žužej, dne 2014-06-03 ob 12:12:37

Multipla skleroza

Multipla skleroza je najpogostejše obolenje živčevja pri mlajših odraslih. Napredujoče in ponavljajoče se okvare živcev v možganih in hrbtenjači povzročajo številne simptome, ki prizadenejo zaznave, gibanje, delovanje organov in ravnotežje. Specifični simptomi so odvisni od tega, kateri del možganov je prizadet. Okvara vidnega živca bo na primer povzročila meglen vid. Če so prizadeta živčna vlakna v hrbtenjači, je posledica šibkost ter občutek težkih rok in nog. Okvara živcev v možganskem deblu, predelu, ki povezuje možgane in hrbtenjačo, pa lahko povzroči motnje ravnotežja.

Pri številnih bolnikih z multiplo sklerozo simptomi lahko začasno prenehajo in bolnik nima težav – to označujemo kot obdobje remisije. Pri bolnikih s kroničnimi dolgotrajnimi simptomi pa se ti postopoma slabšajo.

Kaj povzroča multiplo sklerozo?

 

Multipla skleroza je avtoimunska bolezen pri kateri telesni imunski sistem napade lastno tkivo. V tem primeru osrednje živčevje. Številna živčna vlakna v možganih in hrbtenjači so prekrita z zaščitno ovojnico iz mielina, ki omogoča hitro prevajanje živčnih impulzov.

Pri multipli sklerozi imunski sistem poškoduje manjše predele mielinske ovojnice, zato se v njej tvorijo vrzeli, kar imenujemo demielinizacija. Ko je mielinska ovojnica poškodovana se živčni impulzi ne morejo več normalno prenašati po živčnem vlaknu iz možganov in hrbtenjače po telesu ali v nasprotno smer.

Na začetku bolezni je poškodba lahko omejena na en sam živec, sčasoma pa načne tudi mielinsko ovojnico drugih živcev. Na koncu okvarjene mielinske ovojnice nadomesti vezivno tkivo.

Domnevajo, da naj bi multiplo sklerozo sprožili zunanji dejavniki, na primer virusna okužba, pri sicer gensko dovzetnih posameznikih.

Katere tipe multiple skleroze poznamo?

 

Poznamo dve obliki multiple skleroze. Recidivno – remitentno in primarno progresivno. Recidivno – remitentna multipla skleroza je pogostejša. Simptomi lahko trajajo nekaj dni ali tednov (recidiv), čemur sledi nekaj mesecev ali celo let mirovanja (remisija). V nekaterih primerih recidivno – remitentne multiple skleroze so simptomi tako blagi, da tudi 20 let ne povzročajo nobenih težav. To obliko imenujemo benigna recidivno renitentna multipla skleroza.

V poznejših fazah katerekoli oblike tipa multiple skleroze se nekaj simptomov pojavlja tudi v obdobju remisije oziroma mirovanju bolezni.

Približno 15% bolnikov ima tako imenovano primarno progresivno obliko multiple skleroze, pri kateri se simptomi postopno slabšajo brez vmesnih obdobij remisije. Pri mnogih bolnikih, ki imajo na začetku recidivno-remitentno obliko, se pozneje razvije sekundarna progresivna oblika multiple skleroze, pri kateri se simptomi postopoma slabšajo z redkimi obdobji remisije ali brez njih.   

Kako odkrijemo multiplo sklerozo?

 

Specifične preiskave, ki bi potrdila multiplo sklerozo, ni. Diagnozo postavijo, ko izključijo druge možne vzroke simptomov. Zdravnik najprej preuči anamnezo in opravi pregled. Če ima bolnik težave z vidom, ga napoti k specialistu oftalmologu, ki pregleda vidni živec, saj je ta v prvi fazi bolezni najpogosteje prizadet. Zdravnik lahko s posebnimi preiskavami ugotovi, kako hitro se možganska središča odzivajo na znanje dražljaje. Najpogostejša preiskava meri okvaro vidnih poti. Zdravnik lahko bolnika tudi napoti na magnetno resonančno slikanje, ki potrdi demielinizacijo.

Ena od možnih preiskav je tudi lumbalna punkcija, pri kateri odvzamejo in analizirajo likvor, tekočino, ki obdaja in ščiti možgane in hrbtenjačo. Nepravilnosti v sestavi lahko potrdijo multiplo sklerozo.

Kako zdravimo multiplo sklerozo?

 

Za multiplo sklerozo ni specifičnega zdravila. Pri recidivno-remitentni obliki multiple skleroze lahko z interferonom beta, glatiramerom ali natalizumabom podaljšajo obdobja brez simptomov in skrajšamo napade bolezni. Zdravnik lahko predpiše tudi kortikosteroide, ki skrajšajo obdobje recidiva. Za upočasnitev kronično progresivne oblike multiple skleroze zdravila za zdaj še ni.

Številne najobičajnejše simptome, ki so značilni za vse oblike multiple skleroze, lahko lajšamo s številnimi zdravili. Mišične krče umirimo z mišičnimi relaksanti, prav tako lahko z zdravili omilimo težave z inkontinenco. Pri težavah z erekcijo pomaga zdravilo sildenafil. Pri težavah z gibanjem lahko bolnika napotijo na fizikalno terapijo, za lažje soočanje z vsakodnevnimi aktivnostmi pa na delovno terapijo.

Marsikateri bolnik z multiplo sklerozo verjame, da marihuana olajša simptome, na primer mišično okorelost in bolečine v mišicah. To potrjujejo tudi nekatere raziskave. Vendar uporaba marihuane v zdravstvene namene še vedno ni dovoljena. 

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Branko Gaber
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Jun 26, 2014
Za multiplo sklerozo zelo pomaga terapija, ki jo izvaja Zdenko Domančič. Moj zelo dober prijatelj je na ta način popolnoma USTAVIL bolezen. In takšnih primerov je pri Domančiču veliko.
http://www.youtube.com/watch?v=ut2ymkLChgI
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Marko Žužej
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Objavil/a 2014-06-03 12:12:37 (Jun 03, 2014)
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