Multiple sclerosis course diagnosis and therapy guidebook health

Multiple sclerosis: disease with 1.000 facesMultiple sclerosis (MS) is also called the "disease with the 1.000 faces" called. The course of the disease can vary so much from patient to patient that general statements can only be made to a limited extent. In Germany, at least 130.000 people are affected by this chronic inflammatory disease of the nervous system, women about three times as often as men. Most sufferers are diagnosed with MS in early adulthood.

Cause of multiple sclerosis is still unclear

In multiple sclerosis, misdirected immune cells attack the nerves – leading to inflammation and pain. The causes of the malfunction have not yet been clearly explained. Research suggests that there is a link between the composition of the intestinal flora and diseases of the brain "Gut-brain axis called. Researchers ame that the central trigger is an initially seemingly harmless viral infection in childhood or adolescence, which disturbs the activity of the immune system.

MS is not contagious. It is also not a hereditary disease in the classical sense, even though it can occur in families with high incidence.

What happens in multiple sclerosis?

Different disorders as first Symptom of MS

– visual disturbances (double vision) – leg pain – paralysis – bladder and bowel disorders – balance and coordination disorders – speech disorders – tingling and other sensitivity disorders – chronic fatigue – sexual disorders

Initially, the disorders disappear again or only minor symptoms remain. Over time, new ones are added, some of which are permanent. Typical for the course of MS: The severity of symptoms increases with the course of the disease, but some disorders occur only temporarily. One speaks of relapses.

The Diagnosis of multiple sclerosis is not easy

MS is often difficult to diagnose even for experienced general practitioners because of the different manifestations.

The first step is to carefully take a history of the disease, the anamnesis. Classically, this is followed by a neurological examination of the musculoskeletal system, coordination, balance and sensory organs. Further, by means of magnetic resonance imaging (MRI), images of the brain and spinal cord are obtained. A so-called lumbar puncture (the removal of cerebrospinal fluid with a hollow needle from the spinal cord at the level of the lumbar spine) provides information about inflammatory cells and certain suspicious protein bodies. A blood test cannot detect MS, but is still important to rule out other diseases with similar symptoms.

The clinical appearance must be compared with the previous course of the disease, the neurological examination results and the findings from the additional examinations must then be considered in an overall view. According to the so-called McDonald criteria, the diagnosis of MS can be considered certain after the first relapse under certain circumstances.

Strengthening the immune system through nutrition

MS is not yet curable, but it is treatable. The aim is to slow down the course of the disease and maintain quality of life as far as possible. With the diet, MS sufferers can try to strengthen their immune defenses and minimize the inflammatory process. The diet should therefore consist mainly of vegetables, high-quality oils, nuts and seeds. The anti-inflammatory omega-3 fatty acids in particular have a positive effect. Carbohydrates (such as bread, pasta, sugary foods) should be avoided.

"Ketogenic diet" is one approach: Instead of glucose (blood sugar), so-called ketone bodies are used to meet the energy needs of organs and brain. Ketone bodies are formed in the case of carbohydrate deficiency – the liver then converts fatty acids into energy suppliers. High-fat protein sources such as fish, poultry, eggs, high-fat milk and dairy products should be consumed daily.

Another approach is to provide for more good intestinal bacteria: with pro- and prebiotics. Because intestinal bacteria produce valuable short-chain fatty acids such as butyrate and propionate from high-fiber foods. They are needed to repair the nerve cells.

According to recent studies, propionic acid can strengthen the immune system. Propionic salt is available as a dietary supplement.

Drugs to reduce inflammation

In acute relapses, patients receive high doses of anti-inflammatory drugs, usually steroid hormones (corticosteroids). Immune-stimulating interferons as well as immunosuppressants – i.e. drugs that dampen the immune defense – are shifted to the so-called basic and escalation treatment. They should stop the progression of this chronic disease.

Adjunctive treatment approaches for multiple sclerosis

In addition, physiotherapeutic and ergotherapeutic measures, logopedic help and – very important – psychotherapeutic support are provided. Acupuncture, homeopathic or anthroposophic healing methods (such as artistic therapy, wraps and compresses) can complement the therapy. They should definitely be discussed with the treating physician.

Stem cell transplantation for the most severe cases

When drugs have little or no effect and MS progresses rapidly and aggressively, a new, healthy immune system can develop from the patient's own stem cells. With a drug, stem cells migrate from the bone marrow into the bloodstream. Are taken with a kind of blood washing. These precursor cells can later give rise to healthy immune cells that no longer attack the nervous system. High-dose chemotherapy is first used to destroy the diseased immune system. This can be life-threatening, because the patient has no more white blood cells for about ten days. Since there is a high risk of infection, he must spend this time in the isolation ward. Then he gets back his own stem cells that were previously removed. They are supposed to grow in the bone marrow. Build up the fresh immune system.

Problem of cost coverage

Stem cell transplantation is more effective than drugs with which it has been compared. A conclusive study has shown: With stem cells, MS progressed in only three of 52 cases, and in the drug group in 30 of 50. Many transplanted patients have had no more MS relapses to date – in some cases for ten years. However, health insurance companies usually refuse to cover the costs of stem cell therapy.

New therapies against multiple sclerosis

Therapies against multiple sclerosis have improved in recent years. What medications are best at different stages of the disease?

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