Multiple sclerosis is a severe, incurable disease that is caused by autoimmune processes. As a result of damage to the membrane within which the nerve endings are located, the transmission of impulses and the function of nerve cells are disrupted. Autoimmune processes lead to the production of antibodies that attack the myelin sheath of the nerves, leading to the appearance of neurological symptoms. Symptoms may appear and then disappear, the patient feels better and is in no hurry to visit a doctor. Then the disease can manifest itself as a rapid deterioration of the condition, the appearance of numerous neurological symptoms.
Multiple sclerosis cannot be cured; with timely treatment of the patient, doctors will be able to stop the process of myelin destruction in the patient’s body and delay the onset of a serious condition. The Neurology Clinic of the Yusupov Hospital uses modern methods of treating multiple sclerosis, relying on the experience of Russian and foreign researchers, as well as our own research and development. To treat the disease, innovative medications and rehabilitation measures are used, which are prescribed to the patient for life. Depending on the severity of the condition, patients with multiple sclerosis can register for a disability group.
Initial signs of the development of multiple sclerosis
The risk group for multiple sclerosis is teenagers, young adults and middle-aged people. The disease leads to damage to the central nervous system, which does not allow one to fully perform one’s duties and leads to a deterioration in the patient’s quality of life. Initial signs of the development of the disease may appear in the form of visual impairment:
- The patient feels a foreign body in the eye.
- A veil appears before the eyes, the image becomes fuzzy and cloudy.
- The patient may lose visual color perception, not distinguish between colors or just one color.
Such visual impairment may occur in one or both eyes. Symptoms last for several days and then disappear. The patient may experience pain when moving the eyeballs, when pressing on the eye, and increased sensitivity to bright light. Other symptoms of multiple sclerosis include impaired calligraphy, inability to make coordinated movements of the legs and arms, general unsteadiness of the body, sensory disturbances, and urinary retention or frequent urination. The disease can manifest itself as depression, irritability, constant fatigue, and memory impairment.
Examination at VTEK for multiple sclerosis
VTEC doctors carefully study the conclusion of the attending physician and independently examine the patient in the clinic or at home if the patient is unable to move on his own. Based on the results of the examination, the commission makes a final decision on whether or not to assign a disability group to a person, and its validity period is also immediately indicated. Re-examination must be carried out after the expiration of the disability period; in some cases, it is possible to issue a 2nd group instead of the 3rd or 1st instead of the 2nd, if the patient’s condition has noticeably worsened. If experts note an improvement in health, the disability is removed. It is worth noting that with multiple sclerosis, patients, as a rule, receive one of 3 disability groups after examination at the VTEK.
Before making a final decision, the following aspects may influence the opinion of doctors:
- degree of motor dysfunction;
- level of visual impairment;
- a person's ability or inability to care for himself;
- general health of the patient.
Multiple sclerosis: which disability group is given?
The progression of multiple sclerosis leads to severe damage to the nervous system and ends in the death of the patient. In patients with early symptoms of the disease, the ability to work is not impaired, there are no pronounced dysfunctions of the central nervous system. The disease has several degrees of development, depending on the degree of damage to the central nervous system, the patient is assigned the status of a disabled person and a disability group. To register a disability, the patient provides a package of documents from the medical institution where he is being treated for the disease to the ITU Regional Office at his place of residence.
Multiple sclerosis: disability group 3
In case of multiple sclerosis, there are 3 groups of disabilities: patients with the first (rare) or second degree of development of central nervous system disorders. The second degree is characterized by partial disability, rare exacerbations of the disease, a favorable course, symptoms of impaired coordination and vision, and other symptoms.
Multiple sclerosis: disability group 2
In multiple sclerosis, group 2 disability is given to patients who require periodic outside assistance, have a third degree of severity of symptoms of the disease, the disease is characterized by a decrease in the quality of life, in some cases, rapid progression in certain forms of the disease. This disability group applies to workers, but requires special conditions for a disabled person, which are regulated by regulations and legislation.
Multiple sclerosis: disability group 1
In case of severe manifestations of the disease (fourth degree of severity of symptoms of multiple sclerosis): dysfunction of the central nervous system, dysfunction of organs, inability for full self-care, movement, the commission assigns the patient the first group of disability. Depending on the severity of the disease, confirmed or permanent disability is issued. People with a severe course of the disease are assigned permanent disability, while other patients confirm their status:
- Disabled people of the first group – once every two years.
- Disabled people of the second group – once a year.
- Disabled people of the third group – once a year.
Neurologists at the Yusupov Hospital have achieved excellent results in the treatment of multiple sclerosis. Patients are given the opportunity to undergo examination, treatment and rehabilitation at the clinic. Multidisciplinary specialists and highly professional medical staff are at the service of patients. You can make an appointment with a neurologist by calling the Yusupov Hospital.
Escalation of hope
Multiple sclerosis (MS) is not chronic forgetfulness, as many people think. This is a serious disease of the central nervous system, which often affects young, active, full of strength and hope people. MS is the second most common cause of disability in young patients after injuries. At the same time, early detection of the disease and the prescription of modern effective medications can significantly slow down, sometimes practically stop, the further development of the disease and allow people with MS to live a full life.
According to the All-Russian Public Organization of Disabled Persons with Multiple Sclerosis (OOIBRS), in the Federal Register of persons with hemophilia, cystic fibrosis, pituitary dwarfism, Gaucher disease, malignant neoplasms of lymphoid, hematopoietic and related tissues, multiple sclerosis, persons after organ transplantation and (or ) tissues, about 85 thousand patients are registered with a diagnosis of MS, 75 percent of whom are disabled.
The growth rate of such patients is alarming. Over the past five years, the number of patients has grown by almost 20 thousand people. If in 2013 there were 62.3 thousand, then in 2018 there were already 82.2 thousand, and the growth continues. According to the president of LLCIBRS, Professor Yan Vlasov, such a rapid increase in the number of patients is associated with improved detection and effective early diagnosis.
“Many new patients are identified at an early stage of the disease thanks to the introduction of new medical technologies,” says Yan Vlasov. — By 2021, the country has created an optimal complex for the early diagnosis of this disease. In addition, all main groups of drugs for the treatment of this disease have become available in Russia. The tasks we are solving today are selecting optimal treatment, improving the quality of patient rehabilitation, and organizing employment. We have come a long way in introducing new technologies in the diagnosis and treatment of this disease, and the key to new achievements is a constructive dialogue between the authorities, the medical and scientific communities, patient organizations and pharmaceutical companies.
However, it is too early to calm down, the expert is sure; people's awareness of this disease is still insufficient. Therefore, some patients are not detected at an early stage, when treatment is most optimal.
Symptoms of the disease can vary greatly, but the earliest and most typical are weakness, fatigue, numbness or tingling sensation in one or more limbs, double vision, partial or complete loss of vision, dizziness, and urination problems. With such complaints, patients often turn not to a neurologist, but to a therapist, urologist or ophthalmologist. They are treated for a long time, the symptoms seem to go away for a while, the patients forget about them and can not worry about anything for a long time, while the disease continues to progress.
Social projects can unite patients, businessmen, and cultural figures
Because of this, after some time, symptoms may appear again or worsen, completely different symptoms may appear or be added - for example, a tingling sensation or numbness in the arm may be added to weakness. The patient again turns to the wrong specialist, undergoes unnecessary examinations, wasting valuable time. Treatment is prescribed, but it does not help - and this “walk through agony” sometimes drags on for years. The average time from the appearance of the first symptoms to diagnosis in our country is 18 months or more. Time is lost for adequate treatment, which is aimed precisely at suppressing activity at the very initial stage of the disease, and these lost months, sometimes years, unfortunately, cannot be returned.
True, recently, neurologists note, doctors in other areas have become more attentive to the diverse symptoms of multiple sclerosis. For example, ophthalmologists have become more trained and, as a rule, in case of characteristic complaints, they refer the patient for consultation with a multiple sclerosis specialist (a highly specialized neurologist). Doctors of other specializations should adhere to the same tactics, viewing patients with characteristic symptoms with caution.
But both doctors and society need to know that in medicine the view of multiple sclerosis as a whole has become more optimistic: it is not yet possible to completely cure it, but with timely diagnosis and regular use of innovative therapy, it is possible to slow down, stop the progression of the disease and lead a normal lifestyle.
Even 20-30 years ago, there were severely ill patients who, after 5-10 years, became disabled, confined to a wheelchair. But 25 years ago, treatment was only symptomatic. Then, multiple sclerosis course-modifying drugs (MDTs) appeared, the use of which made it possible to stop the progression of the disease and maintain quality of life. They are divided into first and second line drugs. For a long time, first-line drugs were less effective but safer than second-line drugs. Because of this, more effective DMTs were prescribed when first-line drugs did not help. But recently everything has changed. Recently, new, not only highly effective, but also safer second-line drugs have appeared. This allows doctors to prescribe highly effective therapy from the very beginning of the disease, without fear of the risk of side effects.
Another important aspect is the ability for MS patients to live a full life. This becomes more realistic when there is no longer a need to take medications for a long time. Already, the pharmaceutical industry is trying to help solve these challenges by offering innovative drugs.
Drugs to fight multiple sclerosis are reaching a new level
So even if you are diagnosed with multiple sclerosis, there is no reason for deep despair, you need to accept your diagnosis, receive the right effective therapy and return to normal life.
Using modern treatment methods, these patients can live a full life - work, travel, play sports, start a family, meet friends. However, the cost of treatment is high, so it is important that new effective drugs enter the public safety system more quickly.
“With timely diagnosis and properly selected therapy, patients return to normal life, receive higher education, create families, build a career and remain active in modern society,” emphasizes Professor of the Department of Neurology of the First St. Petersburg State Medical University. acad. I.P. Pavlova, Doctor of Medical Sciences Natalya Totolyan.
But informing society and initiating social projects on the problem of MS is still important. One of these projects was the #livelife to the fullest project, aimed at raising public awareness, which was launched by a press conference held on International Multiple Sclerosis Day, in which experts, representatives of the State Duma, and cultural figures took part.
“Today we are observing how social projects can unite patients, business representatives, the general public, cultural and artistic figures,” said Professor Dmitry Morozov, Chairman of the State Duma Committee on Health Protection, at a meeting with journalists. — It is very important for members of modern society, despite illness, to maintain their pace and standard of living. The #livelife project encourages patients and their families not to stop there, to continue to develop, inspiring us all to new achievements.
An important part of the project will be its cultural component, in which cultural and artistic figures take part.
“I have planned a series of publications on my Instagram account to share information about multiple sclerosis and draw the attention of my subscribers to the lives of people with this disease,” says popular singer Natalya Podolskaya.
Merck pays great attention to supporting patients with multiple sclerosis, implementing various projects whose goal is to inform the public.
“We are grateful to all our partners for their serious involvement in the project and the opportunity to implement joint initiatives,” says Matthias Wernicke, General Director of Merck in Russia and the CIS countries. — The main goal of our project #livelife to the fullest is to support people with multiple sclerosis and preserve their quality of life. The prospects for treating this disease are directly related to breakthrough technologies, thanks to which the approach to therapy itself has changed. But the support of society and all caring people is no less important for them.
Criteria for determining disability in multiple sclerosis
When establishing a group, as well as assessing the ability to work in people with multiple sclerosis, commission members take into account the following factors:
- Progressive nature of the disease.
- Alternation of remissions and exacerbations, as well as their frequency and duration.
- Violation of muscle tone, characterizing central paresis of the limbs.
- The patient’s young age and the phenomenon of clinical-labor discrepancy, when a person underestimates his labor capabilities due to illness.
