Multiple sclerosis: etiology, pathogenesis, clinic, diagnosis, differential diagnosis, treatment (clinical lecture)

Multiple sclerosis is a chronic inflammatory demyelinating disease of an infectious and allergic origin, which usually begins at a young age, manifested by signs of a multifocal lesion mainly in the central nervous system, it has a remitting, less progressive nature of the course, often leads to disability. Multiple sclerosis is the most famous and widespread throughout the globe demyelinating diseases of the nervous system. According to the prevalence, it ranks fourth after cerebral stroke, epilepsy and parkinsonism, and is among the so-called "Four riders of the neurological apocalypse", according to their medical consequences and social consequences. The main variants of the development of multiple sclerosis are remitting, secondary and primary-progressive flow. The remitting flow (85-90% of patients in the early stages of the disease) is characterized by pronounced exacerbations followed by complete or partial restoration of impaired functions without signs of progression during remission periods. With secondary progressive scattered sclerosis, the remitting nature changes with a gradual increase in neurological symptoms with or without rare exacerbations, with minor stabilization or remission periods. A similar transformation is observed 10 years after the onset of the disease in almost 50% of patients, and in 25 years - in 80% of patients. At the primary progressive scattered (10-15%) progression is noted from the very beginning with isolated periods of stabilization and temporary minor improvement. Etiology, pathogenesis, clinic, diagnostics, differential diagnosis, treatment of multiple sclerosis are considered.