Peculiarities of the Course, Diagnosis, and Treatment of Multiple Sclerosis

Abstract

Introduction. Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system, which is characterized by demyelination and degeneration of nerve fibers and has a polymorphic clinical picture and a tendency to an unfavourable course [1]. The disease usually affects young and working-age people, leading to early disability and poor quality of life, which makes it a socially significant problem of our time [2]. The main objective was to increase the efficiency of diagnosis and treatment of patients with multiple sclerosis based on a comprehensive analysis of clinical-neurological, psychodiagnostic, and neuroimaging features of the onset and course of the disease. Materials and Methods: Clinical and neurological examination of patients using the Functional System Score (FSS) and Expanded Disability Status Scale (EDSS); cognitive functions examination using the Mini-Mental State Examination (MMSE), the clock-drawing test, the five-word test; brain magnetic resonance imaging; the 36-Item Short Form Health Survey (SF-36). According to statistics, there are about 3 million patients with multiple sclerosis worldwide. In Ukraine, about 20,000 people have multiple sclerosis. Currently, a hypothesis has been made about multiple sclerosis as a multifactorial disease that is, to a great extent, attributable to genetic predisposition (i. e., features of the immune reaction) and the influence of external factors [1]. Multiple sclerosis mainly affects young and mature people – 12 to 55 years old. Although multiple sclerosis can sometimes make its debut in puberty, however, the frequency of the disease gradually increases with age up to the middle of the third decade of life, with a subsequent decrease up to the age of 50–60 [3]. Recently, a trend toward the rejuvenation of multiple sclerosis has been observed. About 3% of all patients with multiple sclerosis are children under 16. Multiple sclerosis debuting at a later age is not sufficiently studied and is rarely diagnosed, although in about 20% of patients, the first signs of this pathology appear after age 40 [4, 11].