সংজ্ঞা

Multiple sclerosis (MS) is a disease of the central nervous system. It is a chronic condition that can be disabling.

There are several types of MS:

  • Relapsing-remitting MS—Symptoms suddenly reappear periodically. They last for a few weeks or months, then go back into remission (a period with no symptoms). Symptoms may get worse with each occurrence.
  • Primary progressive MS—Symptoms gradually worsen after symptoms first appear. Relapses and remissions usually do not occur.
  • Secondary progressive MS—After years of relapses and remissions, symptoms suddenly begin to progressively worsen.
  • Progressive relapsing MS—Symptoms gradually worsen after symptoms first appear. One or more relapses may also occur.

কারণসমূহ

কারণসমূহ

The immune system normally attacks viruses or bacteria that should not be in the body. With MS, a problem with the immune system causes it to attack healthy nerves. In particular, MS attacks the nerve fibers in the brain, spinal cord, and the nerves of the eye. The exact cause of these immune problems is unknown.

The following may contribute to the development of MS:

  • Viral or other infection
  • Genetic factors (heredity)
  • পরিবেশগত কারণ
  • Breaking down of parts of the nervous system

ঝুঁকির কারণ

Factors that increase your chance of MS include:

  • লিঙ্গ: মহিলা
  • Age: 15-50 years old
  • Being exposed to certain viruses
  • Having family members who have MS or other autoimmune disorders
  • Being of Northern European descent
  • Growing up in a colder climate, as opposed to a tropical climate
  • Having certain immune system genes
  • Having inflammation of the optic nerve

Other factors that may play a role include:

  • Having low vitamin D levels
  • ধূমপান
  • Having shingles

লক্ষণ

Symptoms may range from mild to severe and may include:

  • Numbness or tingling in the face or limbs
  • Impaired vision in one or both eyes, including:
    • ঝাপসা দৃষ্টি
    • ডবল দৃষ্টি
    • দৃষ্টি ক্ষতি
  • চোখ ব্যাথা
  • ক্লান্তি
  • মাথা ঘোরা
  • Muscle stiffness
  • পেশী আক্ষেপ
  • পেশীর দূর্বলতা
  • Incoordination or falling
  • Trouble walking or maintaining balance
  • Weakness in one or more limbs
  • Bladder problems including:
    • জরুরী
    • Hesitancy
    • Incomplete emptying
    • অসংযম
  • Bowel problems, including constipation
  • যৌন কর্মহীনতা
  • ঝাপসা বক্তৃতা
  • গিলতে অসুবিধা
  • Forgetfulness, memory loss, and confusion
  • Difficulty concentrating or solving problems
  • বিষণ্ণতা

Symptoms may worsen with:

  • Heat, including:
    • Hot weather
    • Hot baths or showers
    • জ্বর
  • Overexertion—intense physical activity
  • সংক্রমণ

রোগ নির্ণয়

ডাক্তার আপনার উপসর্গ এবং চিকিৎসা ইতিহাস সম্পর্কে জিজ্ঞাসা করবেন এবং একটি শারীরিক পরীক্ষা করবেন।

পরীক্ষা অন্তর্ভুক্ত হতে পারে:

  • MRI scan—a test that uses magnetic waves to make pictures of structures inside the brain and spinal cord
  • Sensory evoked potentials—a test that records the electrical responses evoked after a sensory stimulus
  • Lumbar puncture (spinal tap)—removal of a small amount of cerebrospinal fluid (CSF) from around the spinal cord to check for white blood cells, antibodies, and proteins
  • Blood tests to rule out other diseases that may mimic MS (such as, B12 deficiency,Lyme disease, autoimmune disease)
  • Visual evoked potential test—to look for problems in the brain that affect vision

চিকিৎসা

The goals of MS treatment are to relieve symptoms, prevent relapses, delay disability, and slow disease progression.

চিকিত্সা অন্তর্ভুক্ত:

ওষুধ

ওষুধ অন্তর্ভুক্ত হতে পারে:

  • Interferon beta (such as Betaseron, Avonex, Rebif)—(a protein that naturally occurs in the body)—used to suppress the immune system
  • Glatiramer acetate (Copaxone)—to help prevent MS relapses by modifying the function of the immune system
  • Other immunosuppressive drugs, such as:
    • IV immunoglobulin (IVIG)
    • Cyclophosphamide (Cytoxan)
    • Mitoxantrone (Novantrone)
    • Azathioprine (Imuran, Azasan)
    • Methotrexate (Rheumatrex, Trexall)
  • Natalizumab (Tysabri)—for relapsing-remitting MS (This medicine is under a mandatory registration program.)
  • Muscle relaxants—to treat muscle spasms or stiffness
  • Fingolimod (Gilenya)—a new oral medicine to reduce relapses and slow the progression of MS

Other medications may also be given to treat symptoms:

  • Corticosteroids—to reduce nerve tissue inflammation and shorten MS flare-ups
  • Dalfampridine (Ampyra)—a medicine to improve walking in patients with MS
  • Botox injections may be used to treat spasticity in the arms and legs
  • Other drugs to treat:
    • ক্লান্তি
    • বিষণ্ণতা
    • ব্যাথা
    • Bladder or bowel problems

Physical Therapies and Lifestyle Changes

Therapies and changes may include:

  • Regular moderate exercise with your doctor’s permission—Swimming may be especially beneficial.
  • Physical therapy to help maintain muscle strength and tone, dexterity, and walking ability
  • ম্যাসেজ
  • High-fiber diet to prevent constipation
  • Stress reduction techniques
  • Quitting smoking—Smoking may worsen MS, causing the condition to progress to a more severe form.

Psychological Therapies

Individual or group therapy will help you learn coping strategies for physical symptoms and emotional stress.

If you are diagnosed with MS, follow your doctor’s instructions.

প্রতিরোধ

There are no guidelines for preventing MS because the cause is unknown.

To prevent flare-ups or worsening symptoms if you have MS:

  • Take medications as prescribed.
  • Avoid hot weather.
  • Stay in air-conditioned places during periods of hot weather.
  • Get adequate rest.
  • Get regular, moderate exercise with your doctor’s permission.
  • Avoid hot showers or baths.
  • Make sure to get enough fiber in your diet.
  • To aid in stress reduction, consider getting regular massages.
  • Try to avoid infection. You can do this by:
    • Practicing good hygiene
    • Staying away from people who are sick
    • Cooking food thoroughly
    • Practicing safe sex
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