EUROMEDICA  Hanover 3-4  Juni 2010	Advanced methods of diagnosis, treatment and prophylactics
	European Academy of Natural Sciences, Hanover European Scientific Society, Hanover Berliner Medizinischen Gesellschaft, Berlin

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At present much attention is paid to multiple sclerosis (MS) in children (M. Sevon et al., 2000).Young people and even children suffer from this disease more frequently. We investigated such people for a long time and our experience can help a great number of practical doctors. We presented here the analysis of clinical results and actual problems of rehabilitation.

Material and methods of investigation. We studied 31 children (19 girls and 12 boys) and 25 adult patients of young age with the debut in their childhood and who have the reliable diagnosis of MS according to the criteria of C. Poser and his co-author (1983) and

W. Mc Donald and his co-author (2001). They used clinical and laboratory methods of investigation of blood, liquor, magnetic resonance imaging (MRI) of brain and spinal cord, as well as visual evoked potentials (VEP) to the presentation of “chess pattern”. We studied children at the age of 4 – 15 years old and the adults at the age of 18 – 36 years old. The period of dynamic monitoring is 3 – 15 years.

Received results and discussion. Long–term investigations and the work with such patients revealed a lot of problems considering the peculiarities of diagnostics, tactic of investigation and rehabilitation of MS patients. For adequate rehabilitation the following conditions are necessary: 1) the timely and precise diagnostics of disease; 2) elaboration of the stage and degree of the process activity and the type of disease flow; 3) the knowledge of individual child’s reaction on the different kinds of therapy; 4) the definition of the disease forecast. The timely diagnostics of this disease is great importance. At is created on the knowledge of clinical picture of this disease with the use of additional methods of investigation, including VEP, MRI and MRI with contrast for confirmation of the spreading of the process “in time and space” according to Mc Donald and co-author (2001). Clinical picture manifestation of MS in children and algorithm of diagnostics were presented in details in the early works (Yefimenko V. N., 2000).

Breaking of aggravation (relapse) of MS in children as well as in adults should be conducted with the use of pulse-therapy by corticosteroids. As our experience shows, the alternative to such therapy does not exit. We have no single opinion about the effectiveness of use of the different types of therapy during the period of remission especially from the point of evident medicine.

Besides the problems of the treatment and the investigation of MS patients during the period of remission, a neurologist or sometimes a pediatrician should solve a lot of problems concerning the peculiarities of nutrition, regime, possibility of school education, therapeutic physical training, and sometimes even different sports, the use of alternative therapeutic methods such as rephlexotherapy, pharmacopuncture, homoeopathy, phytotherapy, the use of food supplements including those which influence the immunity.

We consider the question of the individual use of preventative immunity therapy (glathiramer acetate or interferon – β). Such children reaching the definite age face the problems of the choice of their profession depending on the stage of their disease, neurological deficit and the character of flow of their disease.

In general our conclusions are similar to the opinion of the main foreign clinics: we consider that in the process of rehabilitation of the children who supper MS not only neurologist should participate but also other specialists trained on special programs: dieticians, the doctor of therapeutic physical training, physiotherapists, reflexotherapists, homoeopaths, neuropsychologists, psychotherapists and others.

We need an active participation of both a patient and his parents. The families which have a child with MS as a rule need a social support from the state, especially they need free of charge expensive medicines for the treatment and prevention of the progress of this devious disease.

We can solve the problems of the children with MS only thanks to joint efforts of all the participants.