With such a serious disease as multiple sclerosis, the immune system “attacks” the nerve fibers and destroys their myelin sheath, which is a means of protection and acts as an accelerator in the transmission of impulses. The nerves of both the spinal cord and the brain are affected.
If a large volume is affected, the patient suffers from a number of symptoms: concentration decreases, vision decreases, and memory deteriorates. Due to the fact that the disease progresses at a slow pace, the clinical picture is initially mild, and patients lead a full, active life.
True, over time, patients get tired faster and faster, their sleep and breathing at night are significantly disturbed, convulsions and attacks of sudden falling asleep appear. Studies have shown that with multiple sclerosis, every 5th person develops apnea, the treatment of which must be started immediately, and 50% of patients have a high risk of breathing disorders. There can be no talk of a full night's rest at all in this state.
Causes of Lhermitte's sign -
Lhermitte's sign is most common in people with MS. MS is a disease that mistakenly affects the central nervous system (CNS). The CNS includes the brain and spinal cord.
MS damages the myelin sheath, the protective, insulating material that covers nerve fibers in the brain and spinal cord.
This damage interrupts the flow of signals through parts of the central nervous system, which can result in a range of sensory and motor symptoms.
The two main causes of Lhermitte's sign are:
- demyelination, in which the myelin around nerves is damaged.
- increased excitability or increased firing of nerve fibers in the brain.
Miscommunication between damaged nerve fibers can also cause Lhermitte's sign.
Lhermitte's sign is also present in other demyelinating disorders such as neuromyelitis optica, which affects the optic nerve and spinal cord.
Doctors also associate Lhermitte's sign with other conditions that affect the spinal cord in the neck. These include
- Behçet's disease is a rare autoimmune disease that causes inflammation of blood vessels in the body.
- An Arnold-Chiari deformity, in which the base of the skull is too small, pushes part of the brain down through the skull and into the upper spine.
- Myelopathy resulting from inflammation or damage to the spinal cord.
- Spondylosis, which is a degenerative disease affecting the spinal cord.
- A herniated cervical disc that affects the spine.
- Spinal cord tumors.
- Spinal cord injury.
- Vitamin B-12 deficiency.
- Some methods of radiation or chemotherapy for cancer.
Vitamin B-12 deficiency can lead to signs of Lhermitte's disease, as vitamin B-12 is essential for the production and maintenance of myelin. Myelin is a fatty substance that makes up the myelin sheath and covers nerve fibers.
In one study of 114 people with MS, researchers found that a third of the participants experienced Lhermitte's sign. About 16% of these people had a symptom during their first episode of MS.
Triggers
Fatigue, stress and heat, in addition to certain neck movements, can cause Lhermitte's sign to appear. These aspects may also cause other MS symptoms in people with the disease.
Average life expectancy after diagnosis
For RS, the “5 year rule” applies. If during this time the patient scores no more than 3 points on the EDSS scale, then the disease progresses favorably. The course of the disease was influenced by the discovery of PED. Thanks to these medications, exacerbations became rare.
Before the era of new drugs, patients' disability occurred 5-7 years after diagnosis. After 25 years he found himself bedridden. Now this figure will change.
Life expectancy for severe forms of the disease did not exceed 7 years. Primary progressive MS paralyzed young people for 3-4 years. Thanks to modern medicine, this type of disease can be controlled. Scientists expect 50-75 years of active life without complications and consequences of the disease.
When to see a doctor
Lhermitte's sign is a short, intense and often unexpected sensation similar to an electric shock.
People new to Lhermitte's sign may fear that their MS is getting worse. However, Lhermitte's sign does not indicate that the disease is progressing.
However, people with MS who think they may have Lhermitte's sign should talk to their doctor about treatment options. This may help them cope with the pain of Lhermitte's sign and any other symptoms of MS.
A person without MS or another known demyelinating condition who has Lhermitte's sign should consider talking to a doctor. This is because Lhermitte's sign may be the first sign of multiple sclerosis in some people.
How to treat apnea in multiple sclerosis?
It's worth starting small. The most important method of therapy is to develop your own ritual that will help you achieve good sleep.
- Evening calm also contributes to proper rest . Put all your problems out of your head and go to bed as soon as you are tired. Try to do this at a certain time.
- Cozy pajamas and a comfortable pillow will help . Adjust the temperature in your bedroom and don't fall asleep with the lights on.
- If you still can’t fall asleep, then after 15 minutes you can get up, read a little, for example, you can move briefly . Instead of lying in bed and “counting elephants,” it is better to try to achieve natural fatigue.
- Avoid daytime naps and smoking . Do not consume caffeine 5 hours before bedtime.
- In the evening, you should not drink a lot of liquid and eat too much . Drink your quota during the day, go to bed with a slight feeling of hunger. If you have an uncontrollable desire to eat something, take a few sips of warm milk.
- Don't forget about the benefits of exercise, but do it during the day.
If these recommendations do not provide a positive effect, discuss the problem with your doctor and sleep specialist. Perhaps a specialist will prescribe CPAP therapy. Don’t delay visiting a specialist!
Treatment Options
Relaxation techniques such as meditation or massage, deep breathing and stretching exercises can be helpful for pain management.
Wearing a soft neck brace can also help a person avoid neck movements that can cause Lhermitte's sign.
Electrical stimulation devices, such as transcutaneous electrical nerve stimulation devices, use a weak electrical current to relieve pain. These electrical impulses help reduce pain signals and relax muscles.
They can also lead to the release of hormones called endorphins, which act as natural pain relievers.
Your doctor may prescribe medication to relieve nerve pain. Possibly drugs:
All of these medications may help register Lhermitte in people with multiple sclerosis.
How it works[edit]
With this disease, the most delicate and most complex tissue of the body loses the ability to one of its most important functions - communication between individual elements. Just as the destruction of cables between computer components leads to its unusability, all sorts of problems arise here: even taking into account the high plasticity of the nervous system and the possibility of compensation by surrounding neurons, the manifestations can be anything that exists in neurology - from sensory, motor and coordination disorders to intellectual and mental.
A PC can be imagined as a flame-engulfed tangle of tightly intertwined wires in an electrical panel that loses its insulation, and the wire strands begin to create massive short circuits among themselves. That’s it, this shield is of no use, it’s a demyelinated lesion. After some time, drunk Uncle Vasya, the electrician, comes, is shocked by what he sees and wraps up the whole mess with blue electrical tape. It hasn’t gotten any better, the wires are still shortened, but at least you can’t see a spark—now it’s an old hearth with a duct tape scar.
In 85% of cases, everything begins in the form of a clinically isolated syndrome (CIS) for a very long time, during which even the most cunning neurologist does not immediately think about the subject. 45% of cases start with motor (muscle weakness, rapid physical fatigue) or sensory problems (paresthesia or decreased sensitivity in any part of the body); 20% with optic neuritis, 10% immediately with stem problems, and the remaining 25% get more than one of the listed syndromes at the very beginning. [4] Problems with the pelvic organs (bladder and intestines) often occur.
The symptoms can be any of those known to neurology, but since it is the wood and not the cerebral cortex that is affected, damage to the neuron bodies is generally uncharacteristic, for example, dementia, aphasia, epileptic seizures and extrapyramidal disorders, although they do occur, are rare.
The disease can occur in one of two main scenarios: [5]
- Episodes of deterioration from several days to months (attacks/exacerbations/relapses/relapses/exacerbations/bouts/attacks/flare-ups) followed by improvement: remissions & relapses (RRMS) - 85% of cases;
- Gradually increasing deterioration without light intervals at all (PPRS/PPMS) - 10-15%.
There may also be a combination of these options (progressive with exacerbations/progressive-recurrent/PRMS), or it may start with the first, then moving to the second (SPMS). SPMS - secondary progressive multiple sclerosis (SPMS) is a second potential shock for a person who has already been shocked by the diagnosis itself. If many patients are generally prepared for disability and progression, then SPMS becomes a completely unpleasant surprise, although it often occurs specifically in RRMS. There is only one thing I can recommend here: psychotherapy.
Some exacerbations are provoked by everyday triggers, for example, viral infections (ARVI, gastroenteritis) and occur more often in the spring and summer; Stress and pregnancy can also be triggers, although the risk increases in the first few months after birth [6], [7]. No association has been found (but is still suspected) with vaccination, breastfeeding, physical trauma, and Uthoff's phenomenon. [8]
Uthoff phenomenon[edit]
Also known as the “hot bath sign” (Uhthoff's sign) is a temporary worsening of the neurological symptoms of multiple sclerosis (and other demyelinating diseases) with increased body/air temperature in a sauna/bath/Africa, during exercise, during a fever, and even simply from stress and anxiety . The effect occurs due to the influence of elevated temperature on the conductivity of neurons - a study of the conduction of impulses along peripheral nerves has revealed that an increase in T by just half a degree (healthy nerves) or by 0.1-0.2 degrees (demyelinated) can reduce or even block this very conductivity [9], [10].
For example, patients with optic neuritis may temporarily lose vision when overheated during any physical activity.
Since it is completely crazy to prohibit patients from physical activity (because it helps slow down the progression and prevent related problems), it was proposed to pre-cool the bodies by immersing the lower part of the patients in cool (16-17 degrees) water for half an hour, which really reduces the intensity of the phenomenon allows you to lift weights without annoying ataxia. [eleven]
Previously, this was one of the diagnostic criteria for the disease, which was checked using a hot bath.
Because of it, it is impossible to provoke adrenaline surges (logically leading to an increase in T) with stimulants (caffeine, nicotine, amphetamines) and psychoactive substances in general, including alcohol.
And it is also necessary, at the first signs of an impending fever from colds, to throw NSAIDs in the name of controlling the pace and completely It is logical to avoid saunas, hot showers, hot weather and rooms without air conditioning.
Lhermitte's sign[edit]
“Lhermitte sign” or “the barber chair phenomenon” - a sensation of electric shock from the back to the legs when bending the head, coughing or other movements that lead to tension on the spinal cord. Characteristic not only of MS, but also of many other conditions.
It is not dangerous, but according to reviews it is wildly unpleasant.
Summary
Lhermitte's sign can be restless, annoying, and sometimes frightening. Despite this, it is important to note that Lhermitte's sign is not life-threatening.
This symptom does not indicate disease progression in people with demyelinating disorders such as multiple sclerosis.
If a person with MS experiences a sudden electrical shock to the neck and spine after bending or flexing the neck, they should see a doctor immediately.
Treatment options are available to treat signs of Lhermitte's disease and other symptoms of MS. These procedures aim to change a person's behavior and lifestyle to minimize pain and stress and improve quality of life.
3.Diagnosis of the disease
Diagnosing sclerosis is not always easy. The first symptoms can be very vague and often coincide with signs of other diseases. Diagnosis of multiple sclerosis
is not given if there is no certainty that the patient has had at least two manifestations of the disease (attack). The doctor examines the patient, asks questions about symptoms, and may also perform several special tests. MRI is often used to confirm the diagnosis, as it allows you to see the areas affected by the disease.
About our clinic Chistye Prudy metro station Medintercom page!
Doctor, what will happen to me?[edit]
Thanks to advances in alternative medicine science, MS reduces life expectancy by only 5-10 years compared to the rest of the population. However, life will not be sugar, but for whom is it sweet? The disease occurs in both the poor and the rich (NHL hockey player Josh Harding was diagnosed with the condition in 2012, a year later he received a prestigious award and still continues to play), and in the children of celebrities, for example, the son of Ozzy Osbourne. About a third of people with SD live relatively normal lives without significant accumulation of deficits (and without disability) over the course of their lives.
Comparing any other chronicle with the topic of the article, the latter has a fairly large community of users of active people who search for information together and support each other, which is not at all surprising - the debut occurs at the most active age. They almost look like they are pregnant, especially considering that there are more women among the patients, who from time to time are actually pregnant.
Treatment[edit]
The therapy is specific, narrowly targeted and limited to drugs that can be counted on one hand, and then with the same fingers one can point to the sky which option will work. This is the gold standard, a classic (having hundreds of studies and approved by the FDA/EMA) and the only hope, also called “DITs” - drugs that modify the course of MS.
- Interferons:
- beta-1a - Avonex, Rebif, Genfaxon, Synnovex (the latter is recommended by patients to inject terrorists sentenced to death, because it is a low-quality generic; although some are satisfied, the taste and color of all interferons are different);
- beta-1b - Betaferon, Extavia, Ronbetal, Infibeta. First generation, the oldest drugs with a bunch of side effects.
- Chemotherapy (antitumor - it treats lymphomas, leukemia, prostate cancer, breast cancer):
- Mitoxantrone (Novantron, Oncotron). Due to significant side effects, it is used primarily for SPMS, PRMS, and rapid progression of RRMS.
- The most pathogenetic drug that blocks autoimmune reactions:
- Glatyromeracetate (Copaxone) is perhaps the only drug in general that can seriously be called immunomodulatory. It often causes allergic reactions, which is contraindicated for the target group, although the effectiveness of the drug is excellent.
- Antibodies are the last word in treatment, which gives some optimism:
- Natalizumab (Tysabri);
- Fingolimod (Gilenya);
- Daclizumab (Zenapax);
- Ofatumumab (Arzerra);
- Alemtuzumab (Campas);
- Ocrelizumab (Ocrevus)
- Rituximab.
- Steroids:
- in the form of pulse therapy during exacerbation: for example, methylprednisolone (Solu-Medrol);
- or in the form of ACTH analogues (Tetracosactide/Synacthen), which stimulate the synthesis of GCS in the adrenal glands.
All of them are used only by injection, cost a lot of money (compare with interferons and immunomodulators for acute respiratory viral infections - do you think people on DMT suffer from colds less?) and some have unpleasant effects, incl. interferons cause a flu-like condition, which necessitates a whole ritual of drug administration - the “dry needle rule”: after drawing the drug into the syringe, it is necessary to change the needle to a clean one; increase the dosage gradually over weeks; half an hour before the injection, take paracetamol/ibuprofen.
There are also a couple of unclassified drugs that are approved and well used: Teriflunomide (Abagio) - an inhibitor of the mitochondrial enzyme DHO-DG and Dimethyl fumarate (Tecfidera) - somehow an immune system suppressor.
When traveling, people have to carry medicines with them in thermal bags because they need cool storage.
Dietary supplement[edit]
Main article
:
Dietary supplement
Thanks to the unpredictable cyclical nature of the disease (in the case of the most common RRMS), people can be treated for a long time with untested remedies and say, “Here, it’s been 2 years without exacerbations!” I just want to be happy for them, but this never means that the methods used somehow contribute to this.
One can understand patients that they are not very happy with the current state of pharmacology, but it is what it is; Unfortunately, given the small number of drugs, people often find themselves in the tenacious hands of dietary supplement makers who offer a lot of neuroprotectors, antioxidants and other useless pills that only play on trust and hopes. It is worth understanding that this is not at all a disease where you can experiment with treatment, especially with untested drugs.
| I have been in an international company for 3 years, which has been on the market for 15 years. And I take our products - these are dietary supplements. With their help, I improved a lot in my body. But recently I was diagnosed with optic nerve MS, I purchased all the products that are necessary for MS. I only take them and have decided to refuse drug treatment, which the doctor is supposed to prescribe for me tomorrow. I believe that I can cope with this illness. Don’t be afraid of dietary supplements, dietary supplements are great. You just need to find quality ones and know how and when to take them. |
| a typical patient who has found faith in dummies (that’s exactly what you shouldn’t do). |
There are no “proven dietary supplements”: a substance has either been tested, works and is a medicine, or its manufacturer is somewhat obscure, not wanting to register it as a normal drug.
More[edit]
| The article was written with the participation of consultant A. Nasretdinov, a regular at the neurological clinic. — Adel-Madcat |
- A large portal for patients in Russian, many first-hand descriptions (almost not updated for two years, but there is good information).
- The question of vaccinations is open, since according to various sources, vaccination can provoke an exacerbation;
- Bourgeois site for patients and relatives; Most Memorable MS Quotes.
Home reading[edit]
- More sclerosis!
- Multiple Sclerosis: Hope Through Research;
- The Lancet Core Clinical Collection: MS;
- Defining the clinical course of multiple sclerosis.
| [ + ] Multiple sclerosis is detected using a hammer. | |
| Head | Headache: Primary (Tension • Migraine • Cluster) • Secondary (Abusus • Vascular • CSF) • Additional examination of headache Concussion • VSD • Dizziness • Stroke • Dementia |
| Rest | Osteochondrosis • ALS • Sensory disorders • Paresthesia • Polyneuropathy • Guillain-Barré syndrome • Multiple sclerosis |
| Epi | Epilepsy • Classification Seizures: Absence • Treatment |
