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Treatment of multiple sclerosis

Multiple sclerosis is a disease that causes damage to the myelin sheath of neurons and the pathological changes of processes of nerve cells called axons. It is a heavy disease of the Central nervous system, the latter consists of the brain and spinal cord, and optic nerves. With chronic multiple sclerosis causes of disability, including the effects of disturbance of sensation or mobility of the limbs, paralysis, partial or complete loss of vision.

The disease is accompanied by a number of negative symptoms associated with disorders of the Central nervous system is the deterioration of memory and concentration ability, depression, loss of concentration. Medicines that can completely cure this disease does not exist, but medicines can slow its progression and reduce the severity.

The content of the article:


Containment of disease progression

To restrain the development of disease following drugs that belong to the base:

  • Accompanied by seizures (interferon beta-1a);
  • Ambaji (teriflunomide);
  • Betaferon (interferon beta-1b);
  • Copaxone (glatiramer acetate);
  • Gilenia (fingolimod);
  • Takfeer (dimethylfumarate);
  • TYSABRI (natalizumab);
  • Novantrone (mitoxantrone);
  • Rebif (interferon beta-1a).

These drugs affect the immune system, inhibiting its activity or by adjusting it in the right direction. There is a theory that inthe pathogenesis of multiple sclerosis plays a big role unconventional immune response, which immune cells attack the myelin sheath of neurons. Thus, the use of funds that reduce immune activity, may help to reduce the frequency of relapses of the disease and prevent the formation of new affected areas in the brain. With regular use of immunosuppressants progress of multiple sclerosis is reduced, which reduces the extent of damage and improves the quality of life of the patient. One of the medicines of this group the doctor prescribes immediately after a diagnosis of "multiple sclerosis".

The choice of drug for the treatment of multiple sclerosis by the doctor according to individual patient characteristics such as lifestyle, the most convenient method of administration, hypersensitivity to the drug, predisposition to any of the side effects. The table below shows the comparative characteristics of the drugs in the parameters: method of introduction and frequency of use, side effects, recommendations for use.


Options of medical treatment of multiple sclerosis

If the specialist on the basis of the inspection and observed symptoms are diagnosed and identified the disease as multiple sclerosis, medical treatment in the future aimed at slowing disease progression and reducing the severity of symptoms. To solve the first problem, the doctor will prescribe one of the basic drugs but to remove the unpleasant symptoms of multiple sclerosis, there are other options of medical treatment.

Change MS course: basic medications

Control over the course of the disease is done using basic drugs immunomodulatory actions. They can be used to reduce the likelihood of recurrence of the disease during the active phase remittiruuschem-relapsing multiple sclerosis, to maintain the activity of the patient and reduce the risk of disability.

Interferon beta-1b (also released under the names of Extavia and Betaferon) and glatiramer acetate (Copaxone, Patirot) reduce the number of exacerbations of the disease.

To the group of basic drugs that reduce the severity of bouts of illness and slow its progression include such drugs as interferon beta-1A, teriflunomide, fingolimod, mitoxantrone, dimethylfumarate, natalizumab.

Interferon and Copaxone are introduced by injection, what has caused most of the observed side effects – redness, burning, itching at the injection site. Other side effectsare rare, the drugs are safe for the body. Sometimes after the introduction of the symptoms of the flu – chills, fever, fatigue and weakness. It is typical for the adjustment period to the drug, these symptoms often disappear after several months. In addition, after a course of interferon may decrease active immunity regarding the actual germs, as a result of taking the drug decreases production of white blood cells. This effect is useful against multiple sclerosis, as it inhibited the immune attack the body's own cells, but may make the patient more vulnerable to infectious diseases.

Oubadia, Gilenia and Takfeer – oral drugs that are used in the therapy of relapsing forms of multiple sclerosis.

Ambaji available in the form of tablets which should be taken once a day. Has a large number of side effects, so in USA, this drug is marked by a black square for warning of danger. To side effects that may occur after taking the pills, include nausea, hair loss, liver dysfunction, birth defects in children. So women in pregnancy should not take this drug, and before the appointment Oubadji the doctor must monitor the liver function of the patient.

Gilenia also taken 1 tablet a day and is prescribed for the treatment of relapsing multiple sclerosis. Nausea, headaches, back pain, cough, diarrhea and abnormalities of tests of liver from the norm – a common phenomenon after taking the drug. Before his appointment, the doctor should ask the patient whether he had chicken pox in childhood, and, otherwise, to vaccinate before prescribing the drug. This precaution is associated with one known case of fatal outcome for a person who got chicken pox while taking Gilenia. Another dangerous side effect – slowing of heart rate that can occur in some patients on a background of reception of preparation. To avoid life-threatening in patients with cardiac disorders, receiving Gilani is strictly under the supervision of a physician. Know about case of progressive multifocal leukoencephalopathy (a rare brain disease that can lead to death) the man from Europe, who took Gilenia.

Takfeer, unlike other listed medicines for oral use, taken twice a day. Side effects observed while taking – abdominal pain, indigestion, nausea, vomiting and diarrhea, fever, and hot flashes. In the admissions processTachidori the patient may need to constantly make blood and immune cells, as the drug can significantly reduce the number of them that can trigger the development of other diseases.

Natalizumab or TYSABRI – another basic drug for the treatment of relapsing multiple sclerosis, which is applied if all the above measures proved ineffective. The mechanism of action of TYSABRI based on blocking the progress of immune cells in the brain and spinal cord, which prevents them to damage myelin. It is taken only under medical supervision and with monitoring of blood tests, as was the connection of this drug with cases of progressive multifocal leukoencephalopathy (PML). On the basis of blood test the doctors can determine the probability of developing the disease and to prohibit the use of TYSABRI when the risk becomes too great.

In severe forms of relapsing multiple sclerosis is not treatable by other drugs, your doctor may prescribe Mitoxantrone chemotherapy that suppresses the immune system. His admission is low doses under constant supervision of a physician to reduce the risk of developing heart disease and leukemia, the most common among the side effects of Mitoxantrone.

Treatment of exacerbations of multiple sclerosis

Basic drugs in multiple sclerosis necessary to prevent the outbreak of diseases, but ineffective at the moment of exacerbation. In milder forms of aggravated multiple sclerosis complementary therapy is not required. But if there are significant violations of the mobility of the patient, which he can't do daily chores, for the early conclusion of the outbreak, a doctor may give an intravenous injection of steroids. This does not affect the course of disease in General, but helps to quickly remove the aggravation.

Sometimes in such cases the doctor may prescribe plasmapheresis procedure – the patient's blood is taken, break it up into fractions (blood cells and blood plasma), plasma substitute, blood transfusions back. This technique is used only in severe cases of recurrence not amenable to correction steroids.

Other techniques

Pharmacological treatment of negative symptoms of multiple sclerosis is carried out using the following medications:

  • Muscle relaxants (Tizanidine, Baclofen) and sedatives (Clonazepam, Valium) can help relieve muscle spasms and rigidity;
  • Amantadine, Modafinil, Nuvigil help relieve fatigue;
  • Antidepressants (Fluoxetine, zoloft, Bupropion) cope with the depression that often accompanies the ambientsclerosis;
  • Oxybutynin and Tolterodine normalize the function of the bladder.

To restore physical activity to maintain mobility does help to work with a physical therapist who prescribes a course of physiotherapy. In some cases, the patient may need additional devices – canes, walkers, corsets.

Selection of effective drug for the treatment of multiple sclerosis is very important as to have good results you must start taking it as early as possible and use long term. So when pronounced side effects and complications after taking the prescribed remedies, you must contact your doctor to change the medication, but treatment must not be interrupted.


Empire in multiple sclerosis

Empire or dalfampridine is a drug which is used to restore the mobility of patients with multiple sclerosis on disease progression are not affected. It is a modern facility that improves the conduction of nerve impulses damaged neurons, which allows to restore the mobility of part of the body that they Innervate. The mechanism of action of Empire based on blocking potassium channels, which are located on the surface of nerve cells. When damage to the myelin sheath potassium ions do not remain in the channel region, that is, cannot transfer momentum farther down the nerve fibers. Blocking the potassium channel helps to restore communication between the damaged and healthy nerve cells.

Empire is available in the form of tablets to be taken twice a day, observing the interval of twelve hours. You can't drink more than one pill at a reception, and a day should not take more than two tablets. Swallow it immediately without chewing, as when grinding the active substance will begin to stand out too fast, which could trigger seizures.

Advantages Empire in multiple sclerosis

74% of patients with multiple sclerosis believe that inability to walk independently most unpleasant manifestation of the disease. Efficiency Empire the restoration of mobility and walking for patients confirmed by clinical trials, where the drug showed great effectiveness in comparison with placebo. Empire is the first approved drug that is designed to restore the ability to walk. Its mechanism of action aimed at improving the connections between neurons, rather than suppressing the immunity as most other agents used in the treatment of multiple sclerosis.

Potential side effects

Among the side effects, the most common after taking Empire, there are dizziness, sleep disturbances, headachespain and back pain, nausea, weakness, infectious diseases of the urinary tract, electrolyte disturbance, burning, and itchy skin, worsening of digestion, diarrhea, constipation, irritation of the nasal passages, pain in the throat. Does not exclude the possibility of recurrence of disease in patients receiving the drug.

Contraindicated reception Empire simultaneously with the reception of the compound 4-aminopyridine, patients with renal pathologies, moderate and severe. The drug should not be taken during pregnancy and lactation during pregnancy and in infectious diseases of the urinary tract.

In consultation with the doctor will inform him, did you have convulsions before, do you take extra vitamins or dietary Supplements, you must also inform him about all medicines that you are currently using.

If after taking the drug, experiencing seizures, cancel it immediately and seek emergency treatment. Increase the dosage of the drug is prohibited, the interval between meals is strictly 12 hours.


Interferon preparations

Alpha, beta and gamma interferons are proteins produced in the human body and maintain the immune system. They regulate the activity of the immune system and in themselves possess antiviral properties inhibit the growth of viruses inside the cell and outside. Studies have shown that beta-interferon shows a high effectiveness in the treatment of multiple sclerosis, so products based on it are included in the list of basic medicines in this disease.

The ability of beta-interferon can make cells less susceptible to viruses is very relevant if we take into account one of the hypotheses according to which multiple sclerosis may have a viral nature.

Medicinal products based on beta-interferon – Rebif, Betaferon, accompanied by seizures, Extavia. The structure of the main active ingredient they are very similar to those of natural interferon, which is produced in the human body.

Accompanied by seizures

Appoint, accompanied by seizures in the early stages of relapsing multiple sclerosis patients with signs of brain damage visible on MRI scans, with episode of exacerbation of the disease in history. This drug can slow disease progression, reduce the frequency of attacks and delay the onset of disability. Method of administration – intramuscular injection.

Betaferon

An effective remedy for the treatment of multiple sclerosis with frequent relapses. The same as accompanied by seizures, prescribed to patientswith signs of diseases that can be detected on MRI to slow the progression of disease and reduce the extent and severity of injuries that cause physical disabilities. Form of administration – subcutaneous injection.

Rebif

Is indicated for the treatment of multiple sclerosis relapsing forms helps to reduce the frequency of attacks and decrease the severity of lesions of the brain under the influence of the disease. Is introduced into the body by subcutaneous injection three times a week.

Adverse effects of interferon drugs

In the first month of taking interferon may experience symptoms typical of the flu – fever, chills, sweating, muscle pain. To facilitate the well-being of the patient during the period of habituation to the drug taking it can be combined with taking Advil, Tylenol or Motrin before injection or the next day. The optimal time for the injection at night before bedtime.

Local reactions – swelling, itching and redness of the skin – a fairly common phenomenon which is of concern only if the injection site became hard and the redness subsides in a few days. In this case, the next injection do in a new place.

From the nervous system frequent adverse reactions are irritability, causeless anxiety, worsening mood, depression, disturbances of consciousness, sleep, memory, focus and concentration. If you experience one or more of the above symptoms should consult a physician.

Precautions

Contraindications to the appointment of the interferons are pregnancy, lactation, depression. Conception in the process of the drug can adversely affect the health of the unborn child, so during treatment you need to use contraceptives.

Interferon can cause severe degradation in patients with impaired liver function, known cases of liver damage in people taking accompanied by seizures. Therefore, before prescribing this group of drugs the physician must ascertain that the patient's liver is functioning normally, and control the state of the body through regular blood tests. The tests also allow early detection of thyroid disease and to determine the condition of red blood cells, what can also cause problems when taking a beta-interferon.


Copaxone

Copaxone – an artificially synthesized protein, structurally resembling a structural protein of the myelin sheath of nerve cells. Copaxone prescribed for treatment remittiruuschem-relapsing forms of multiple sclerosis, reduces the frequency of exacerbations of the disease and slow its progressionconcomitant damage to the neurons of the brain. Method of administration – subcutaneous injection three times a week.

Among the common side effects Copaxone occur as local reactions (swelling, redness, tenderness and discomfort in the area of injection) and reactions from the nervous and cardiovascular systems (anxiety, palpitations). Other adverse events – chest pain, shortness of breath, feeling heat, tides.

Precautions

Pregnancy and lactation are absolute contraindications to the use of Copaxone.


Multiple sclerosis and Cytoxan

Cytoxan is a drug that can help slow the progression of multiple sclerosis by suppressing the immune system, non-standard reactions which are considered to be the main cause of the pathogenesis of the disease. In the course of treatment Cytoxan decreases the activity of white blood cells, resulting in less damage to myelin sheath of neurons. The introduction of the drug is via intravenous drip. A large number of side effects and complications that may occur after taking the drug, limit its use. The doctor prescribes Cytoxan only after detailed consultations from several specialists and assess all risks.

Side effects Cytoxan

Among the common side effects Cytoxan – hair loss, severe nausea and vomiting, abnormalities of leukocyte count from the acceptable norms.

Less common, yet quite often there are headaches and dizziness, diarrhea, constipation, fatigue, causeless anxiety.

To relieve nausea, the doctor will prescribe additionally taking Zofran or Raglan.

Treatment with Cytoxan and preparations

Before starting the course of treatment of multiple sclerosis need to do ECG, blood and urine, and also measure height and weight. Introduction Cytoxan is made through an IV in an outpatient setting, before and after treatment measurements of blood pressure and pulse. Additional drugs that can be administered during the procedure, Zofran or Reglan for nausea and anti-inflammatory drugs (Solumedrol).

The recovery period after treatment with Cytoxan

At the end of the course of treatment necessary to observe a number of rules designed to protect the body from diseases, which it becomes very vulnerable. In particular this applies to infections, because the Cytoxan weakens the immune system. So howat least two weeks after the treatment it is necessary to avoid close contact with sick people. At a constant feeling of weakness, nausea and vomiting, consult your doctor.


Multiple sclerosis treatment and Imuranum

Imuran another drug with immunomodulatory properties that is used in the treatment of multiple sclerosis. Reducing the activity of immune cells against the structures of his own body, Imuran slow the progression of multiple sclerosis. The advantages of this drug include the possibility of its combination with other drugs against multiple sclerosis. For example, its combination with Avoneksom allows to increase the effectiveness of treatment. Another advantage Imuran – convenient form of issue and method of administration, good tolerability in most patients.

Imuran is available in tablets of 50 mg for oral administration. Begin treatment with small dosages, a single dose is determined based on the weight of the patient and the level of leukocytes in the blood. One tablet can be divided into two stages, make Imuran twice a day. Increase dosage gradually by following the doctor's recommendations. To increase or decrease the amount of drug for a single reception on their own without the advice of a specialist is impossible.

Recommendations for use Imuran:

  • To prevent the deterioration of health in the use of the drug should regularly do blood tests to determine the functional state of the liver and cells;
  • Nausea, which may occur at the beginning of treatment Imuranum, it is better to endure. This side effect passes as addiction of the body. However, if the sensations become intolerable, to seek help to the doctor he prescribes additional medications to correct the condition of the patient or adjust the treatment;
  • Should not be vaccinated during treatment of multiple sclerosis Imuranum, it is necessary to avoid other situations which increases the risk of infection of the body.

Side effects Imuran

Among the side effects of the drug are nausea, vomiting, stomach irritation, thinning and changes in the structure of the hair, hair loss, loss of appetite, presence of blood in the urine, fatigue, ulcerations of the oral cavity. Increases the risk of pathologies of the liver and infectious diseases.

In most cases these side effects only occur nausea, as Imuran well tolerated by patients.

Follow the rules of storage of the drug – Imuran stored in a cool and dry room, as exposure to hightemperature and moisture can destroy the active substance. If you forget to take Imuran at the specified time, no need to up the dosage next time, stick to the course of treatment prescribed by the doctor.

Warning Imurane

When the following symptoms during treatment with Imuranum should immediately contact the doctor:

  • The increased body temperature to 39C, chills, fever, sweating;
  • Skin rashes, burning, swelling and soreness;
  • Long unhealed, oozing pus, a wound or a cut;
  • Pain in the throat when swallowing, nasal congestion, a cough that persists for two or more days;
  • Nausea, vomiting, diarrhea, signs of intestinal infection;
  • Weakness, malaise, flu symptoms;
  • The presence of blood in the urine, an unpleasant odor;
  • Violations of urination – soreness and burning, frequent urge.

All of these can be signs of infection of the body, which is very likely when taken regularly Imuran and dangerous, as the immune system in the treatment of multiple sclerosis is in a depressed condition.


Multiple sclerosis and Baclofen therapy

Muscle spasms – a common symptom of neurologic disease, which often accompanies multiple sclerosis. Increases muscle tone, causing muscles to become rigid feeling of the limb in a relaxed condition unbent by labor. Hyperactivity of muscles in multiple sclerosis is linked to the wrong passage of electrical impulse along the nerve fibers. Baclofen normalizes the signal transmission through the nerves, prevents muscle contraction and weakens the tonus of the limbs.

Side effects of Baclofen

Among the side effects of the drug often nausea, weakness and drowsiness, dizziness and headaches.

Sub introduction of Baclofen

Sub space is the area of the spine that contains cerebrospinal fluid, nerve roots and spinal cord. This area is often practiced introduction of Baclofen, the active ingredient gets faster to destination, and side effects such as weakness and confusion, are less than when administered orally tablet form of Baclofen.

Side effects of the drug sub when the introduction is minimized by reducing the dosage forachieve the same effect with this method will require less medication.

Sub baklofenbuy pump system

Sub balapanova pumping system consists of a catheter and a pump, which is surgically implanted under the skin in the waist area. The pump allows you to control the dosage and the speed of its receipt, to adjust the quantity of a medicine the doctor can use external device for programming. By means of the pump moves the medication from the catheter to the destination required for the course of treatment the volume of funds is in the pump reservoir. Pump replacement is needed at the end of the shelf life of the battery, which is 5-7 years.

The procedure of injection of Baclofen through a pump sub system is part of the therapy, which can pass each patient with the problem of muscle spasms difficult to treat with oral medications. The technique is more effective for the lower limbs, the results of the treatment of spasm and hypertonicity of the hands is not so strongly expressed.

Sub balapanova therapy requires the participation of a team of professionals – physiotherapist, social worker, nurse, therapist. Pumps PBT is also used in the practice of anesthesiologists.

Benefits of therapy:

  • There is no need in preparations for oral use minimized dosages of drugs that reduces the severity of side effects;
  • Increases the patient's quality of life, improved physical activity and sleep;
  • The possibility of individual correction of the feed rate of the drug for each patient;
  • Decreases pain, muscle spasms provoked by.

Disadvantages baklofenbuy pumping system

The biggest drawback baklofenbuy pump systems is the difficulty of installation of the pump. The process of implantation is associated with some risks, including bleeding, unusual reaction to anesthesia, infection, loss of bladder control, failure of the pump or twisted catheter may become the reason for re-operation.

When a faulty pump is an unpleasant consequence can be a too large amount of the drug entering the bloodstream. This leads to pronounced side effects of the Baclofen – insomnia or drowsiness, nausea, muscle weakness, confusion, diarrhea. The most dangerous complication is respiratory depression, blurred vision, presyncopal state, coma.

Before installing the pumping system assesses the effectiveness of sub introduction of Baclofen in the outpatient setting – ifafter injection, the muscles relax, the PBT will give good results. To evaluate the effectiveness of funds required 2-4 hours, in the absence of the expressed results of the procedure can be repeated using Baclofen in a greater dosage.


Treatment of multiple sclerosis botulinum toxin

Botulinum toxin produced bacteria Clostridium botulinum, the substance belongs to the class of neurotoxins and is used in the treatment of multiple sclerosis to alleviate the condition of patients with muscular spasms.

For therapeutic purposes suitable for the following types of botulinum toxin:

  • Botulinum toxin type a;
  • Botulinum toxin type B;
  • Abobotulinumtoxina A;
  • Innobarometer A.

The type of botulinum toxin used for the correction of the patient's condition, multiple sclerosis, prescribed by your doctor.

How does botulinum toxin?

Transmission of the nerve signal to the muscles via the neurotransmitter acetylcholine. Botulinum toxin blocks acetylcholine, preventing the transmission of the signal. Thus, the muscles relax, decreases their tone and the associated discomfort.

The introduction of botulinum toxin is carried out by intramuscular injection with a thin needle. The first effect seen after a week or two after the injection and lasts from two to six months depending on the individual characteristics of the organism. To make injections more often than every three months is not recommended that the body has not developed antibodies against botulinum toxin.

The technique is not suitable for treatment of spasms of large muscles, as the amount of drug for a single introduction may not be very large. The same is true of hypertonicity affecting a whole group of muscles.

Side effects of botulinum toxin

Among the probable side effects – weakness in nearby muscles, which may hinder the mobility of the plot, in which the injection took place. Additionally, in the first week after the botulinum toxin treatment may experience flu-like symptoms, but they last more than a day.

Some patients after injection of botulinum toxin antibodies to this substance that reduces the effectiveness of treatment. To prevent this, the frequency of injection is restricted and the number of drug for one injection.

The choice of treatment and the time of treatment to the doctor

The repeated injection of botulinum toxin is required not earlier than three months after the first injection.Accordingly, consultation with a physician for the purpose of estimating the need for re-treatment is 3-6 months. To see a specialist you need if the drug has not shown effectiveness after two weeks or if you experience unpleasant symptoms, which can be provoked by injection of botulinum toxin.

Multiple sclerosis and therapy Novantrone

Novantrone a remedy, the essence of the effect consists in the suppression of immunity to weaken his attacks on the surrounding conductive myelin sheath of the nerves. Thanks Novantrone in patients with multiple sclerosis decreases the percentage of disability and the likelihood of recurrence. The drug is recommended for patients with exacerbated varieties progressive-relapsing remitirse-relapsing and secondary-progressive multiple sclerosis.

Efficiency Novantrone traced on MRI scans, which recorded a decrease of the rate of appearance of lesions nerves in the cerebral hemispheres.

The introduction of this drug into the body is effected by means of intravenous fluids. The course of medication involves regular visits to the hospital every three months.

To begin therapy, you must pass these tests:

  • A blood test for blood cells and the liver;
  • Electrocardiogram;
  • An echocardiogram on the strength of the heart muscle;
  • Fixing height and weight.

If you are considering therapy Novantrone as the primary method of treating multiple sclerosis, will also undergo special training. It is necessary to inform each patient about the medications that are introduced before the beginning and after the end of therapy for the control of nausea, the timing of the blood tests and necessary follow-up treatment.

The patient, who is going to start treatment of multiple sclerosis Novantrone is required to inform a physician about these conditions:

  • Dental disease;

  • Gout;

  • Any viral infection;
  • The liver dysfunction;
  • Allergic States;
  • Planning or have a pregnancy;
  • Breast-feeding;
  • Unexpected bleeding;
  • Heart disease;
  • The passage of the radiation therapy or chemotherapy.

Heart disease and anticancer therapy(the last three States) are strict contraindications to the use of Novantrone.

The doctor should check the patient all the above points, to avoid dangerous side effects that can occur in the treatment Novantrone. For the beginning of therapy required is also serious discussion of all risks with a patient and members of his family.

Treatment Novantrone

For the introduction of Novantrone the patient remains in the hospital for about two hours for the gradual introduction of medication through the IV. To ensure the safety of the procedure, the nurse checks physiological parameters (blood pressure, heart rate, weight) and the results of the above tests.

To without stress to spend time introducing Novantrone experienced patients wear comfortable clothes and bring items for long-term sedentary entertainment: book, magazine, pocket computer, etc.

Because immune suppression increases the risk of infection, therefore, recommend careful communication with patients to avoid vaccination with live vaccines, and strictly adhere to the rules of hygiene. To ensure the safety of the patient with a suppressed immune system and living with it and people are not allowed the oral polio vaccine.

In connection with the immunodeficiency of the patient undergoing therapy Novantrone should immediately inform the doctor about these symptoms:

  • Hyperthermia;
  • Sores in the mouth or on the lips;
  • Shortness of breath;
  • Redness and pain in the throat;
  • Stomach cramps, nausea, diarrhea;
  • Disorders of the heartbeat;
  • Problems with urination;
  • Swelling of the legs;
  • Abnormal bleeding and bruising;
  • Problems in the area of the injection (redness, swelling, etc.).

Other side effects Novantrone

Except for those dangerous side effects that were mentioned above, during the adaptation of organism to Novantrone may be a manifestation of other passing with time effects:

  • During the day after drug administration, the urine color may change to blue-green;
  • Occurs mild nausea;
  • At easy level there is hair loss that grows back after undergoing therapy;
  • Disturbed menstrual cycle.

Treatment of multiple sclerosis with intravenous steroids

Such powerful steroids, such as Decadron and Sola-Medrol that can ease the inflammatory process, which are used in the treatment of acute attacks of RS.

Acute attacks of multiple sclerosis (exacerbations or relapses) characterized by a worsening of the basic symptoms. The beginning and peak of the attack stretched over time, and may take from two to three days to several weeks. During this time, develop existing and can manifest new symptoms: tingling and numbness of the limbs, difficulty speaking and blurred vision.

To stop an attack, carried out emergency outpatient treatment above mentioned steroids. To visit the hospital within 2-5 days. The procedure of drug administration lasts approximately an hour. Pre-made blood to control the level of potassium and sodium.

Before and after each administration the patient also checked the pulse and blood pressure.

Treatment of multiple sclerosis with steroids does not affect daily life – the patient is allowed to engage in any Affairs and even to drive a car.

After a course of intravenous or intravenous injection of steroids may continue therapy on the testimony of the oral form of the drug is Prednisone. Schedule of steroids and related drugs to prevent stomach irritation, is the attending physician.

Side effects of intravenous steroids

During steroid treatment in rare cases manifest various side effects, the most common of which are:

  • Stomach upset, heartburn;
  • Intensification of energy metabolism;
  • A rush of blood to the chest, neck and face;
  • Acceleration of the pulse;
  • False sensations of cold or heat;
  • Fluid retention in the body (it is necessary to reduce salt intake);
  • A sharp change of mood, the border States (euphoria, anxiety);
  • A metallic taste in the mouth;
  • Nausea;
  • Insomnia.

Besides them, there are long-term pathological changes leading to the development of the following diseases:

  • Thins osteoporosis;
  • Gastric ulcer;
  • Obesity;
  • Acne and furunculosis;
  • Cataract;
  • Diabetes.

In connection with the risk of osteoporosis (the most frequently occurring severe side effect) in the diet of patients taking steroids, it is desirable to include dairy products and greens rich in calcium. In coordination with the attending physician also may receive calcium supplementscalciferol (vitamin D). See also:Properties and vitamin D products.


TYSABRI

For patients with recurrent RS there are approved monotherapy medication that can reduce the number of exacerbations and to delay the development of disability.

Almost immediately after the initial approval in the United States, TYSABRI was withdrawn from the market, as did reports of increased use among his patients a rare brain infection – progressive multifocal leukoencephalopathy (PML). To return the drug, the manufacturer had to develop and implement special programs to minimize the risks which require the registration and regular monitoring of all patients with fixation of each possible case of PML.

It was found that the risk of this infection increases in proportion to the received dose, TYSABRI. In addition, the risk increases if the patient previously had therapy associated with artificial immune suppression. That is why TYSABRI is recommended only when the patient has intolerance or no response to other medications used in multiple sclerosis.

The uniqueness of TYSABRI in comparison with other drugs for the treatment of RS is its ability to bind the protein present on the membrane of leukocytes – white blood cells. It is assumed that the destruction of the myelin sheath of nerves in multiple sclerosis occurs with these cells. TYSABRI is a monoclonal antibody type, due to which is complicated by the ingress of leukocytes in the organs of the Central nervous system.

The diagnosis of recurrent PC as well and is the reason for the use of TYSABRI. The medicine based on it reduces the likelihood of attacks of multiple sclerosis, and prevents a severe impairment, leading to disability. The introduction of TYSABRI is carried out every month in the doctor's office within one hour intravenously.

Side effects of TYSABRI

Among the common side effects when using TYSABRI meet:

  • Infectious diseases;
  • Migraine;
  • Depression;
  • Fatigue;
  • Pain in the joints;
  • Violations of the cycle and the flow of menstruation.

To lock in rare cases, allergic reactions for patients who received a dose of TYSABRI, see inan hour. Infusion is considered successful if after it does not appear itching, redness, breathing problems, nausea, rashes and dizziness.

In addition to allergies and the risk of PML, the list of complications associated with the administration of TYSABRI include liver damage and infection.

Following the above, before taking TYSABRI, you must carefully weigh all its advantages and disadvantages. Always consult with your doctor how this kind of therapy is the PC for you.


Multiple sclerosis and deep brain stimulation

DBS (deep brain stimulation) is a surgery that was developed on the basis of the old operative method of treatment of tremor in patients with Parkinson's disease and multiple sclerosis. In 1960 developed a methodology, whose aim is the destruction of one of the areas of the brain: the thalamus (then the operation is called "talktome") or pale globe ("pallidotomy").

Now such operations are rarely used in connection with the advent of alternative fuel and greater risk of complications. As Teletopia and pallidotomy conducted by the destruction of the relevant parts of the brain, so the neurosurgeon error of a few millimeters are possible such consequences as deprivation of sight, speech and even paralysis.

Deep stimulation differs from the above-mentioned operations so that the necessary part of the brain is inactivated without destroying it. This reduces the risk of complications, although increases the cost of the procedure.

To implement the DBS, the surgeon inserts into the appropriate area of the electrode tip (in multiple sclerosis and tremor in the thalami in Parkinson's disease – the subthalamic nucleus or pale globe). This electrode is a thin wire connected to the device, resembling a pacemaker. The electrode remains in the brain and United with him the device is implanted under the skin of the breast to generate a current.

The advantages of the procedure

Operation deep stimulation has significant advantages over surgical destruction of the thalamus or the white ball. Stimulation with electricity can be regulated with four contacts used in combination. Thus, a correction stimulation in response to a change in patient response without repeated surgical intervention.

Another advantage is the possibility to stop the stimulation for testing of other methods of therapy of multiple sclerosis. It is enough to remove the implant, generating electricity.

Help in the treatment of RS

Fuel, first of all, necessary for control of tremor. Other problems arising on the background of multiple sclerosis (loss of the ability to see, to feel, or apply a force) by stimulating are not permitted.

GSM alsonot able to cure or even prevent the progression of multiple sclerosis. This is confirmed by the fact that the FDA does not approve this method of treatment RS. Despite this, deep stimulation of the thalamus is not an experimental treatment, and it is approved by the US FDA in the same operation to eliminate tremor, Parkinson's disease and dystonia (violation of movements in the direction of the torsion impulses and abnormal postures).

Due to the fine specificity of GSM, its appropriateness is a complex issue that should be discussed with a specialist in musculoskeletal disorders.

In any case, first is to test the drug treatment of multiple sclerosis. If the symptoms of the disease can control of pharmaceuticals, the need for surgery is eliminated. Deep stimulation is considered only when there is no effect from the medication. Even in this case, if you are not sure of the correct operation, it is necessary to consult an expert.


Alternative and complementary therapy multiple sclerosis

To include alternative medical techniques, the performance of which is not attested in the scientific literature. These therapies are of uncertain safety and their effectiveness, especially in a particular state (in our case, multiple sclerosis), it is difficult to say for sure.

However, such treatment use quite often, as evidenced by the large variety of diet, mental training, procedures, Oriental medicine, nutritional Supplements and other similar methods of treatment.

When an alternative therapy is used in conjunction with traditional treatment, it is called complementary (e.g. acupuncture, in parallel with interferon).

Alternative therapies

Creating a positive mood. Of course, this does not relieve you of MS, but it will be great if this way will avoid stress and depression.

Physical exercise. Usually promote relaxation, reduce the pressure of stress and support the immune system. Patients with MS recommend yoga or tai Chi, although it is possible that the mobile and energy-consuming types of physical activities, some will fit you better.

Healthy eating. If the patient with MS has no problems with internal organs requiring special diets are advised to follow a healthy agreed with the doctor diet.

Other additional options alternative andcomplementary therapies

Massage demand among many MS patients. The procedure helps to cope with depression and stress, which can accelerate the progress of the disease. Evidence that massage can affect the course of the disease, no. If drug therapy for multiple sclerosis has led to thins osteoporosis, massage becomes dangerous for the patient. This gives rise to the discussion whether this kind of alternative therapy with your doctor.

Acupuncture, according to patients, is able to relieve such symptoms of multiple sclerosis, as spasms, the pain and the lost of control over urination. Scientific experiments proving the safety of acupuncture for patients with MS, at this point were not conducted. The main risks of acupuncture include infection that can be transmitted to the penetration of unsterile needles into the body. This can be especially dangerous for patients whose immune system suppressed by medication in the treatment of multiple sclerosis.

The intake of linoleic acidcontained in the oils of sunflower and evening primrose, can lead to some relief of the symptoms of multiple sclerosis. The use of oral administration of linoleic acid in the form of food supplements proven by several medical researches.

The effectiveness of alternative therapies

Therapy multiple sclerosis alternative methods may contribute to the improvement of the performance during a traditional treatment, but not for all of the possible ways. Some of them are just useless, while others, in addition, yet too expensive.

In the worst case, the use of unproven methods of treatment may harm the patient, so before you make a decision about the alternative therapy PC, we require the following information:

  • What is the specific kind of therapy;
  • How it is carried out;
  • How long is the treatment;
  • How therapy affects the body;
  • Are there any side effects;
  • How great is the risk of complications;
  • Is there evidence of efficiency, it is desirable to documentaries;
  • What is the full cost of all necessary procedures.

This information will help you weigh the "pros"and"cons" for each option to reduce the risk of loss to a minimum. To make the decision to use alternative or complementary treatment, you need first of all to ensure the safety of your health and wallet.

Tips that contribute tothe right solution:

  • Do not blindly believe the statement about the benefits of a particular type of therapy. To verify the veracity of advertising, it is necessary to communicate with representatives of audited organizations for the provision of services, contacts, and friends, as well as to discuss the issue with family;
  • The question of holding additional therapy should be discussed with your doctor. Only he can reliably predict what effect a particular treatment for the current condition of the patient in the presence of a primary therapy. Perhaps the doctor has a familiar doctors or their own patients who used the same therapeutic combination.
  • Find people who have used the considered type of treatment. Should not satisfied with the feedback provided only by the manufacturer or service provider;
  • It is better not to agree to the provision of services by companies that are unwilling to cooperate with your doctor. When you need a reliable supplier always sends the patient to any doctor, not only to their own specialist.
  • Try to make sure that you read the full cost of therapy. Get ready for that alternative treatments in most cases are not covered.

Be sure to pay attention to:

  • The presence of Intrusive advertising: on the cover of publications, in commercials on the Internet, telemarketing and other public media. Providers that use the above distribution methods of products or services, should be treated with suspicion. Really effective treatment does not require advertising;
  • A pretentious statement about the unprecedented benefits and amazing results of using the technique, and also mention the facilities as a certified cure for multiple sclerosis seem, at least, doubtful;
  • The presence of only one manufacturer suggests that the product is not generally recognized drug companies, and, therefore, does not meet modern quality requirements;
  • A secret formula. The composition of the proposed product should include all active components. If the formula of the drugs, "secret", she's hardly trustworthy;

  • Recommendations provided by the manufacturer. If they are attributed to people listed only by name, these data are likely to be falsified.