Introduction. Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system, which is characterized by demyelination and degeneration of nerve fibers and has a polymorphic clinical picture and a tendency to an unfavourable course [1]. The disease usually affects young and working-age people, leading to early disability and poor quality of life, which makes it a socially significant problem of our time [2]. The main objective was to increase the efficiency of diagnosis and treatment of patients with multiple sclerosis based on a comprehensive analysis of clinical-neurological, psychodiagnostic, and neuroimaging features of the onset and course of the disease. Materials and Methods: Clinical and neurological examination of patients using the Functional System Score (FSS) and Expanded Disability Status Scale (EDSS); cognitive functions examination using the Mini-Mental State Examination (MMSE), the clock-drawing test, the five-word test; brain magnetic resonance imaging; the 36-Item Short Form Health Survey (SF-36). According to statistics, there are about 3 million patients with multiple sclerosis worldwide. In Ukraine, about 20,000 people have multiple sclerosis. Currently, a hypothesis has been made about multiple sclerosis as a multifactorial disease that is, to a great extent, attributable to genetic predisposition (i. e., features of the immune reaction) and the influence of external factors [1]. Multiple sclerosis mainly affects young and mature people – 12 to 55 years old. Although multiple sclerosis can sometimes make its debut in puberty, however, the frequency of the disease gradually increases with age up to the middle of the third decade of life, with a subsequent decrease up to the age of 50–60 [3]. Recently, a trend toward the rejuvenation of multiple sclerosis has been observed. About 3% of all patients with multiple sclerosis are children under 16. Multiple sclerosis debuting at a later age is not sufficiently studied and is rarely diagnosed, although in about 20% of patients, the first signs of this pathology appear after age 40 [4, 11].
Introduction. Degenerative disc disease is one of the most common diseases of the musculoskeletal system, characterized by dystrophic changes in the intervertebral disc and vertebral bodies adjacent to it. The main symptoms of this disease are pain and sensory and motor disorders, which, according to various authors, occur in 50–80% of adults. The main objective of the study was to find and implement the optimal set of treatment measures for degenerative disc disease depending on the age of a patient. Materials and Methods. The medical records of inpatients who were treated in the Neurosurgical Department of the Sumy Regional Clinical Hospital in 2019–2020 were analyzed. The course of treatment of 93 patients (61 men and 32 women) was studied. The patients were divided into groups according to their age: young age (under 25) – 13 men and 8 women; middle age (under 60) – 24 men and 19 women; and elderly age (over 60 years) – 18 men and 11 women. The combined use of pathogenetically justified physiotherapeutic measures in the treatment complex is gaining more and more interest. Their distinctive features are physiologic nature, absence of allergic manifestations, the ability to influence most of the pathogenesis of the disease, and the organic combination with other therapeutic factors. Unfortunately, there is an increase in the incidence of temporary incapacitation and progressive course, which often leads to disability and significant financial costs associated with expensive modern methods of diagnosis, treatment, and further provision of employment to patients. The results of our study show that complex treatment including pathogenetic drug therapy, complex paravertebral block, therapeutic physical exercise, and physiotherapy treatment methods provides adequate recovery of spinal function regardless of dystrophic and degenerative changes severity and patient's age. Treatment of degenerative disc disease should be comprehensive and directed at the various symptoms and links of the pathological process.
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