What is multiple sclerosis?

多发性硬化症(MS)是一种慢性中枢神经系统疾病, which is made up of the brain and spinal cord. MS is unpredictable. 多发性硬化症的症状从轻微到致残不等, such as losing the ability to write, speak, or walk.

What causes multiple sclerosis?

The cause of MS is unknown. Many things may contribute to someone getting MS, including viruses, autoimmune disorders, environmental factors, and genetic factors. 但所有可能的原因都有一个共同的特点. 人体的免疫系统会攻击自身的神经组织. In MS, 免疫系统攻击被称为髓鞘的蛋白质和脂肪物质层，髓鞘包围并保护中枢神经系统的神经纤维. 髓磷脂隔绝了神经系统用来交流的电信号. 当这种隔离被破坏时，通信就中断了. 部分神经系统永久性受损.

What are the symptoms of multiple sclerosis?

Symptoms of MS are erratic. They may be mild or severe. They may last a short or long time. 它们可能以不同的组合出现，这取决于受影响的神经系统的部分. 在整个病程中，您可能会出现以下任何一种或全部症状:

• Muscle weakness in the arms and legs

• Trouble with coordination

• Impaired walking or standing

• Partial or complete paralysis

• 痉挛性(不自觉的肌肉张力增加，导致僵硬和痉挛)

• Fatigue (may be triggered by physical activity, may ease with rest, or may be constant and persistent)

• Loss of sensation or tingling or numbness

• Speech problems

• Tremor

• Dizziness

• Hearing loss

• Loss of vision or changes in vision

• Loss of bowel and bladder control

• Sexual dysfunction

• Pain

• Emotional changes

• Changes in reflexes

MS may also cause cognitive effects. The effects may be mild. They're often found only after thorough testing. They may include problems with:

• Concentration

• Attention

• Memory

• Judgment

多发性硬化症的症状可能看起来像其他健康问题. 经常去看你的医疗保健提供者进行诊断.

How is multiple sclerosis diagnosed?

作为诊断多发性硬化症的第一步，你的医疗保健提供者会做一个全面的病史和身体检查. 你会被问到你所有的症状，它们发生的频率和持续的时间.

You'll likely have an MRI. 这个测试可以发现中枢神经系统独特的疤痕.

在某些情况下，您可能需要实验室检查或腰椎穿刺来确认诊断.

How is multiple sclerosis treated?

There is no known cure for MS. 但是有一些可以缓解疾病的疗法可以减缓疾病的进展并改善症状. These include:

• Beta-interferons

• Glatiramer acetate

• Monoclonal antibodies

• Dimethyl fumarate

• Fingolimod

• Teriflunomide

There are also treatments to help manage symptoms, treat flare-ups or relapses, improve your function and safety, and provide much needed emotional support. 以下康复疗法也可能有所帮助:

• Physical therapy

• Occupational therapy

• Speech therapy and swallowing assistance

• Cognitive therapy

• Assistive devices, like splints

Living with multiple sclerosis while pregnant

怀孕似乎不会加速病程，也不会加重多发性硬化症的影响. 几项研究表明，MS不太可能在怀孕后期突然发作. 怀孕后可能会有更高的风险突然发作或复发. 与您的医疗保健提供者谈谈您的任何担忧.

这种疾病的致残效应可能会使孕妇在身体上难以怀孕. 肌肉无力和协调问题可能会增加跌倒的可能性. Fatigue may get worse. 轮椅依赖可能会增加尿路感染的风险. There is no evidence that MS causes infertility. Studies have shown that pregnancy, delivery, 和出生缺陷率在有多发性硬化症的女性和没有多发性硬化症的女性之间没有太大的区别. 

许多用于治疗多发性硬化症的药物可能对胎儿有不良影响. 如果你正在考虑怀孕或怀孕了，和你的医疗保健提供者谈谈是很重要的. 您的医生将与您讨论各种药物的风险和益处, 包括对宝宝和多发性硬化症的影响.

During pregnancy, 你需要密切监测病情和胎儿的健康状况. You may need more frequent prenatal visits. If you have an MS flare-up, you may be given medicines, such as steroids, 哪些药物只在妊娠中期和晚期被认为是安全的. Talk with your provider for more information.

在怀孕期间，MS的支持性治疗和康复尤为重要. Rehab varies depending on your symptoms. But it may help with the following:

• Doing normal activities of daily living (ADLs)

• Maintaining independence

• Getting family involved

• 使用辅助设备(例如手杖、牙套和助行器)

• 制定适当的锻炼计划来增强肌肉力量、耐力和控制力

• Re-establishing motor skills

• 如果你因为面部和舌头肌肉无力或缺乏协调而说话有困难，提高沟通技巧

• Managing bowel or bladder incontinence

• Providing cognitive retraining

• 适应家庭环境的安全性和可用性

在分娩过程中，你可能没有盆腔感觉，也不会感觉到宫缩时的疼痛. 这也可能使分娩开始的时间难以判断. Delivery of the baby may be harder if you have MS. 虽然分娩本身不受影响，但多发性硬化症会影响分娩所需的肌肉和神经. 出于这个原因，你可能需要剖宫产，或者在产钳或真空的帮助下分娩.

分娩后，母乳喂养可以降低多发性硬化症发作的风险. 与您的医生讨论是否可以在母乳喂养时使用疾病缓解药物.

When should I call my healthcare provider?

如果你有多发性硬化症的几个典型症状，打电话给你的医疗保健提供者，以便立即开始治疗.

If you have MS and want to get pregnant, 在怀孕前与你的MS专家讨论怀孕的好处和风险.

如果你怀孕并患有多发性硬化症，尽快告诉你的医生.

妊娠期多发性硬化症要点

• There is no cure for MS. 但是有很多方法可以帮助减缓疾病的进展和控制症状.

• 患有多发性硬化症，你的症状可能会有很长一段时间的缓解.

• Pregnancy isn't ruled out just because you have MS. 怀孕似乎不会加速或加重多发性硬化症.

• MS can make carrying a pregnancy harder. It may also make labor and delivery harder.