CLINICAL AND NEUROLOGICAL FEATURES OF MULTIPLE SCLEROSIS
Keywords:
multiple sclerosis, clinical and neurological course, climate, diagnosticsAbstract
The urgency of the problem. Multiple sclerosis (MS) is the most common chronic inflammatory disease of the central nervous system (CNS), affecting more than 3 million people worldwide and is currently incurable. The main risk factors include latitude (higher incidence in temperate climates), which may reflect seasonal variations in sunlight exposure, affecting vitamin D levels or pathogens common in these regions. Exposure to tobacco, obesity, and mononucleosis are also associated with an increased risk of MS. Multiple sclerosis has a varied clinical course and there is no single test that would have the appropriate diagnostic sensitivity and specificity for a quick and accurate diagnosis.
The aim of the study was to investigate the clinical and neurological course of multiple sclerosis in hot climates and to establish specific criteria for accurate diagnosis.
Material and research methods: We observed 67 patients with MS living in the Bukhara region of the Republic of Uzbekistan. Patients were divided into 2 groups depending on the duration of the disease: the 1st group of patients with a prescription after 1 year (30 people) and the 2nd group (39 people) with a prescription of the disease more than 5 years. Duration of the onset of the disease: 1-10 years. Patient age: 18 to 64 years old.
Research results and their discussion. We used a new classification of types of MS course, taking into account the presence of signs of activity and/or progression of the disease in each individual patient, proposed in 2013. Activity is understood as either its clinical manifestations (exacerbations) or MRI manifestations. When studying the types of MS course, it was found that the main indicators are the presence and frequency of clinically determined exacerbations and the rate of increase in neurological symptoms, which is assessed using the Expanded Disability Status Scale (EDSS). In our studies, out of 67 patients, 28 people were in the stage of exacerbation (exacerbation) and 39 people were in remission.
Conclusions:
- In the development of MS, genetic factors interact with environmental factors that predispose to the disease, cause it and change its course.
- Hot climate, hyperinsolation, seasonal changes in exposure to sunlight affect the level of vitamin D. This helps to slow down the progression of the disease, prolongs the period of remission and has a positive effect on the patient's life expectancy.
- The main diagnostic and prognostic biomarker of patients with MS is MRI, which is currently the only method that allows examining the entire central nervous system in vivo.
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