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Multipel skleros, MS

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Sakkunnig:
Definition:
MS karakteriseras kliniskt av avgränsade episoder med fokala angrepp på hjärna, n. optikus och ryggmärg, alternativt en gradvis ökning av funktionsförlust (progression) eller kombinationer av dessa.
Förekomst:
Cirka 20 000 personer lever med MS i Sverige (prevalens 190/100 000). Vanlig ålder för symtomdebut är 20–45 år och mer än dubbelt så många kvinnor som män drabbas.
Symtom: 
Vanliga besvär är förlamningar med spasticitet och smärtsamma spasmer, ataxi och dysartri, sensoriska symtom, sfinktersymtom, fatigue, depression, kognitiv svikt och paroxysmala symtom som trigeminusneuralgi.
Kliniska fynd: 
Pareser, stegrade reflexer, Babinskis tecken, ataxi, sensoriska bortfall, diplopi, papillpåverkan.
Diagnostik: 
Diagnosen baseras på anamnes och klinisk neurologisk undersökning, MR och vanligtvis likvoranalys.
Behandling: 
Behandlingen riktas mot akuta skov, förebyggande av skov och progression (kliniskt och MR-mässigt), behandling av symtom och rehabilitering. 
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  • Petra Nilsson, med dr och överläkare, Neurologiska kliniken, Skånes universitetssjukhus, Lund
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet