When the immune system turns against your own nerve cells
Multiple sclerosis (MS) is an inflammatory disease of the central nervous system that affects the brain and spinal cord and usually begins in early adulthood. The disease still leaves many questions unanswered and varies so much from patient to patient in its course, symptoms and therapeutic success that generally valid statements can only be made to a limited extent. For this reason MS is also known as the "disease with 1000 faces" known. New diagnostic criteria allow MS to be diagnosed at a very early stage. However, a thorough examination is important in order to exclude other causes. An early start of therapy can delay the progression of the disease. Delay the occurrence of disabilities. New medications are increasingly available for more severe courses of illness, but these require good monitoring.
In the course, the paralysis symptoms are often associated with a feeling of stiffness ("like lead on the legs"), called spasticity. Spastic paralysis symptoms mainly affect the legs. Bladder disorders can manifest themselves as a frequent urge to urinate that cannot be controlled well (imperative urination), a bladder emptying disorder up to incontinence, or as a combined impairment.
In addition, complaints can play an important role, which are often not easily tangible and visible. These include abnormal, premature exhaustibility (so-called fatigue), cognitive disorders, limitations in attention, memory and concentration, depressive moods and depression, pain, dizziness and sexual dysfunction. At the beginning of the MS disease, motor disturbances – such as paralysis – often occur. Visual disturbances with blurred or foggy vision as an expression of an inflammation of the optic nerves (optic neuritis). In addition, sensory disturbances of the skin ("sensitivity disturbances") often occur, usually in the form of tingling, (painful) insensations or a feeling of numbness. In addition, a wide variety of symptoms can occur, such as bladder problems, unsteadiness when walking or grasping, double vision and "blurred" vision Speak occur.
Diagnosis and therapy
Multiple sclerosis is a disease that usually begins in young adulthood and can manifest and develop in very different ways. New diagnostic criteria allow MS to be detected at a very early stage. However, a thorough investigation is important in order to rule out other causes with certainty. Early initiation of therapy can slow down the progression of the disease. Delay the onset of disability. New medications are increasingly available for more severe courses of the disease, but they require good monitoring. Diagnosis is made according to the following measures:
– neurological physical examination – evoked potentials (nerve conduction and velocity) – lumbar puncture (nerve fluid extraction) – magnetic resonance imaging (MRI, magnetic resonance imaging of the brain and spinal cord)
Although multiple sclerosis is still not curable, there are treatment options that aim to:
– to inhibit the acute inflammatory reaction of a relapse (relapse therapy) – to stop the progression of the disease – to prolong the symptom-free/poor time (progression-modifying therapy) – to alleviate the MS symptoms and to prevent possible complications (symptomatic therapy)
Above all, the last two treatment areas are usually applied in combination. They can be adapted individually for and with the patient, depending among other things on age, sex, life situation and life planning, as well as concomitant diseases and the current disease situation. In the area of symptom management, there are many non-drug therapies available in addition to medications: Physiotherapy, occupational therapy, speech therapy, psychotherapy, neuropsychological therapy.