Features of the treatment of demyelinating diseases.
Two approaches are used to treat demyelination. Pathogenetic therapy is aimed at curbing the destruction of myelin fibers, eliminating circulating autoantibodies and immune complexes. Interferons - Betaferon, Avonex, Copaxone are generally recognized as the drugs of choice. Betaferon is actively used in the treatment of multiple sclerosis. It has been proven that with its long-term administration in the amount of 8 million units, the risk of disease progression is reduced by a third, the likelihood of disability and the frequency of exacerbations are reduced. The drug is injected under the skin every other day.
Immunoglobulin preparations (sandoglobulin, ImBio) are aimed at reducing the production of autoantibodies and reducing the formation of immune complexes. They are used for exacerbation of many demyelinating diseases for five days, administered intravenously at the rate of 0.4 grams per kilogram of body weight. If the desired effect is not achieved, then treatment can be continued at half the dosage.
At the end of the last century, a CSF filtration method was developed, in which autoantibodies are removed. The course of treatment includes up to eight procedures, during which up to 150 ml of cerebrospinal fluid passes through special filters. Plasmapheresis, hormonal therapy and cytostatics are traditionally used for demyelination. Plasmapheresis is aimed at removing circulating antibodies and immune complexes from the bloodstream. glitchocorticoids (prednisolone, dexamethasone) reduce the activity of the immune system, suppress the production of antimyelin proteins and have an anti-inflammatory effect. They are prescribed for up to a week in large doses. Cytostatics (methotrexate, cyclophosphamide) are applicable in severe forms of pathology with severe autoimmunization.
Symptomatic therapy includes nootropic drugs (piracetam), painkillers, anticonvulsants, neuroprotectors (glycine, semax), muscle relaxants (mydocalm) for spastic paralysis. To improve the nervous transmission, B vitamins are prescribed, and in depressive states, antidepressants are prescribed. Treatment of demyelinating pathology does not aim to completely rid the patient of the disease due to the peculiarities of the pathogenesis of these diseases. It is aimed at curbing the destructive effects of antibodies, prolonging life and improving its quality.
International groups have been created to further study demyelination, and the efforts of scientists from different countries already allow providing effective care to patients, although the prognosis for many forms remains very serious. Demyelination of the brain. symptoms, treatment. Myelin is a fatty substance that forms the sheath of nerve fibers. This sheath plays the role of insulation, preventing excitation from spreading to neighboring fibers. At the same time, there are peculiar windows in the myelin sheath - spaces where myelin is absent.
Their presence greatly accelerates the process of transmission of a nerve impulse. When the myelination of nerve fibers is disturbed, the conductivity of the nervous tissue is disturbed, and various neurological disorders occur. When demyelinating processes occur in the brain, perception, coordination of movements, and mental functions are disturbed. In severe cases, this process can lead to disability and death of the patient. Currently, there are three known demyelinating diseases of the brain.