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Multiple sclerosis

Multiple sclerosis (MS) is an incurable chronic inflammatory autoimmune disease of the central nervous system that results from the breakdown of myelin sheaths. There is no cure in the world yet and it is considered an incurable disease. Recent research suggests that this is primarily a disease of the younger population. The disease most often affects women before the age of 40. The number of sick women in the world is three times higher than the number of sick men.

Symptoms

Doctors and experts agree on MS and say it is a disease with thousand faces. In almost every patient, the symptoms are different, and the course of the disease can be completely different. Most often, the first signs of the disease soon pass and patients eventually forget about them. Patients begin to pay more attention to the disease in the later period, when the first signs of functional and motor problems start to appear. The most common signs include visual disturbances, dizziness, balance problems and problems with coordination in space. The disease is accompanied by other signs, which include fatigue, spasticity, difficulty walking, sleep disturbances, pain, urinary problems and problems with bowel movements, etc. Frequent tingling is also a typical sign, depression and anxiety can also occur.

Is the disease hereditary?

It is unknown at this time what causes the disease. It is estimated that the disease is not hereditary, although some research suggests that the risk of developing multiple sclerosis is increased by about 5% in cases where the relative in the first generation has a disease. Some research suggests that the disease and its onset could be linked to vitamin D and its deficiency in the body.

Examination and diagnosis

Taking into account the first signs of the disease and the associated anamnesis, it is possible to make a diagnosis quickly and early enough. In case of the above mentioned signs, it makes sense to talk to your personal doctor as soon as possible. If the patient is suspected or confirmed, the patient will be referred for additional tests to a specialist, where an MRI scan of the head and sometimes the spinal cord will be performed. An additional option is to perform a lumbar puncture and examine the cerebrospinal fluid for oligoclonal strips. Early detection of the disease is very important because we can start treatment very early. Medications are very effective in the early stages, and in the later stages a little less or even ineffective.

Treatment of multiple sclerosis

Approximately 3,500 patients have been diagnosed with MS in Slovenia, and according to the International Federation for MS, around three million people are diagnosed with MS worldwide. The first drug appeared in 1993. According to data from 2017, 53% of patients in Slovenia were cured, which ranks us fourth in Europe. Treatment is divided into treatment of disease onset, treatment of disease symptoms, slowing of disease progression, and neurorehabilitation.

After visiting a neurologist at a neurology clinic, a patient who has signs of onset of the disease decides whether treatment with corticosteroid infusions is necessary. Another option for treating disease onset is drugs that slow down the inflammatory disease process and consequently reduce the number of disease onset. Fingolimid is an oral medicine, it is very effective and has some side effects.

The next group includes drugs that treat various signs or. symptoms of illness, including fatigue, spasticity, pain, etc. 

There have been a lot of studies recently that promise a lot. In the past, many medicines were only in the form of injections, but in recent years more and more medicines or tablets for oral use have appeared. 

Use of cannabis and cannabinoids in association with multiple sclerosis

Multiple sclerosis was the first disease for which the use of cannabinoids received a positive opinion from the professional public. Cannabinoids reduce the number and strength of triggers and reduce disease progression. In a 2007 study, Wiley and colleagues studied the effect of tetrahydrocannabinol (THC) on locomotor function in rats. In a 2011 study, Uchiyama and colleagues studied the pharmacological effects of three synthetic
cannabinoids. In 2017 and 2018, a lot of research was done on the use of cannabinodioids in the treatment of MS. An extensive study from 2018, where Libzon and coworkers sampled 234 patients, revealed that the optimal combination of THC and CBD in a 1: 1 ratio is helpful in treating MS and has a strong impact on improving neurological abnormalities. There are currently two medicines on the market in the EU to relieve the problems of multiple sclerosis and epilepsy, and main preparations are being prepared that would allow patients to use prescription cannabis extracts.

It should be borne in mind that the results in the field of MS and cannabis are already very well researched. Unfortunately, the condition or use of cannabis, which contains large amounts of THC, is prohibited in Slovenia. As a result, users are forced to resort to preparations on the black market or are forced to grow their own plants. This, too, is legally controversial or forbidden, but lately, for many people, legally speaking, it is overlooked.

Resources:

- Multiple sclerosis, a disease of thousands of faces, portal rtvslo.si, link (access 20.10.2021),
- Diagnostics of MS, portal abczdravja.si, link (access 20.10.2021),
- Use of cannabinoids, professional development in the field of pharmacy, link (access 20.10.2021),
– Wiley J.L., O’connell M.M., Tokarz M.E., Wright M.J. Jr. Pharmacological effects of acute and repeated administration of Delta(9)-tetrahydrocannabinol in adolescent and adult rats. J Pharmacol Exp Ther. 2007; 320: 1097-1105, link (access 20.10.2021),
Uchiyama N., Kikura-Hanajiri R., Matsumoto N., Huang Z.L., Goda Y., Urade Y. Effects of synthetic
cannabinoids on electroencephalogram power spectra in rats. Forensic Sci Int. 2012; 215: 179-183, link (access 20.10.2021),
– Libzon S, Schleider LB, Saban N, Levit L, Tamari Y, Linder I, Lerman-Sagie T, Blumkin L. Medical Cannabis for Pediatric Moderate to Severe Complex Motor Disorders. J Child Neurol. 2018; 33: 565- 571, link (access 20.10.2021)

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