Encephalomyelitis disseminata

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Encephalomyelitis disseminata (breviter ED) sive vulgo sclerosis multiplex (ICD-10: G35) est morbus cum inflammatorius tum neurodegenerativus[1]. Inflammationes progressivae in cerebro et medulla spinali myelinum cellulas neurales cingens destringunt. Initio non raro multiplex sclerosis ut perturbationes visus sive pareses fugaces apparet. Damna systematis nervosi partim reparabilia sunt, partim non.

Dee Dean, incola Alpine comitatus, sella rotali surrecta lineam finalem ambulationis multiplicis sclerosis anni 2005 transgredit, duabus amicis nitiens.

Quattuor formae decursus morbi descriptae sunt.

Signa et symptomataRecensere

Inflammationis causa cum axonorum myelinorum damnis velut reparationes sequentes tum signa et symptomata in diversis corporis regionibus oriuntur[2]. Initio non raro multiplex sclerosis perturbationes visus sive pareses fugaces apparet. Imprimis sunt symptomata autonomica, visus, motuum, sensuum[3], quamquam tardiore in cursu symptomata mentis quoque oriantur[4].

SpasticitasRecensere

Motus spasmodici saepe narrantur ab aegrotis encephalomyelitidem disseminatam tactis. Observantur rigor muscularis, tonus muscularis auctus, motus diminuti, imbecillitas musculorum, dolores constantes, vesicae urinariae gubernatione reducta, velut insomnia. Tractatio per medicamenta et physiotherapiam[5] fit.

DiagnosisRecensere

Diagnosis disseminatae encephalomyelitis criteriorum diagnosticorum ope ponatur. In criteriis McDonaldiensibus symptomata et signa collecta sunt. Signa imprimis ad mutationes diagnosticae imaginariae ope visibiles spectant.

CursusRecensere

Quattuor typi cursuum valituri sunt[6]: CIS, RRMS, PPMS, SPMS.

  • Syndroma singularis clinicalis (Anglice:Clinically Isolated Syndrome, breviter CIS)
  • Relabens remittensque Encephalomyelitis disseminata (Anglice: Relapsing-Remitting Multiple Sclerosis, breviter RRMS)
  • Primitus progressiva encephalomyelitis disseminata (Anglice: Primary Progressive Multiple Sclerosis, breviter PPMS)
  • Serius progressiva encephalomyelitis disseminata (Anglice: Secondary Progressive Multiple Sclerosis, breviter SPMS)

Nuper investigatio Bohemica per tomographiam resonantia magnetica factam elementarum morbi prodidit, ut quarta pars syndroma "CIS" affectorum iam specimina morbo pleno similia exponant[7].

TherapiaRecensere

  Commentatio principalis: Encephalomyeliditis disseminatae tractatio

Tractationis morbi multipliciter est: Non solum therapia pharmacologica sed etiam cura per infirmeriam, physiotherapia, ergotherapiam, logopaediam, psychologiam, psychotherapiam, opera socialia, curam pastoralem.

Tractatio pharmacologicaRecensere

Passionis tractatio pharmacologica molimenti non parvi requirit. Noti sunt diversi interferona, anticorpora monoclonalia, immunomodulatores. Spasticitatis baclofenum, tizanidinum, gabapentinum, postea diazepamum, dantrolenum commendantur[8]. Gravioribus in casibus etiam cannabidiolum/tetrahydrocannabinolum et botulinumtoxinum adhibentur[9].

Nexus interni

NotaeRecensere

  1. Haider L, Zrzavy T, Hametner S, Höftberger R, Bagnato F, Grabner G, Trattnig S, Pfeifenbring S, Brück W, Lassmann H (2016). "The topograpy of demyelination and neurodegeneration in the multiple sclerosis brain". Brain 139: 807-15 
  2. Compston A, Coles A (2008). "Multiple sclerosis". Lancet 372: 1502-17 
  3. Compston A., Coles A. (Oct 2008). "Multiple sclerosis". Lancet 372 (9648): 1502-17 
  4. Haussleiter I. S., Brüne M., Juckel G. (Ian 2009). "Psychopathology in multiple sclerosis: diagnosis, prevalence and treatment". Therapeutic advances in neurological disorders 2 (1): 13-29 
  5. Etoom M., Khraiwesh Y., et al. (Nov 2018). "Effectiveness of Physiotherapy Interventions on Spasticity in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis". American journal of physical medicine & rehabilitation 97 (11): 793-807 
  6. National Multiple Sclerosis Society: De mutata descriptione typorum apud encephalomyelitem disseminatam. (Anglice).
  7. Hynčicová E, Vyhnálek M, Kalina A, Martinkovič L, Nikolai T, Lisý J, Hort J, Meluzínová E, Laczó J (2017). Cognitive impairment and structural brain changes in patients with clinically isolated syndrome at high risk for multiple sclerosis. 264(3). pp. 482-93 .
  8. Otero-Romero S., Sastre-Garriga J., et al. (Oct 2016). "Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper". Multiple sclerosis 22 (11): 1386-96 
  9. Sartori A., Dinoto A., et al. (Mar 2021). "Nabiximols and botulinum toxin injections for patients with multiple sclerosis: efficacy on spasticity and spasms in a single-centre experience". Neurological sciences 

Nexus externiRecensere

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