Multiple sclerosis ms course therapy life expectancy

Multiple sclerosis (MS disease): relapse, progression& TherapyDiagnosis of multiple sclerosis (MS) is a hard blow for many sufferers, because the disease is not yet curable, its course is difficult to assess, and the symptoms are varied and often distressing. But one thing is certain: not every MS is so severe that it leads to complete immobility. Life with MS is possible! explains how an MS disease can progress and what treatment options people with multiple sclerosis have.

Table of Contents

MS relapse

Often, the onset of multiple sclerosis (MS disease) is characterized by a
so-called relapse. MS relapses occur in about 70 percent of those affected. Are characterized by many symptoms. (1) Depending on where inflammation occurs, the signs of a relapse are quite different.

Recognizing MS relapse

It is not easy to recognize an MS relapse. Therefore, it is helpful to deal with the possible symptoms of MS:

– At times, the ability to move certain parts of the body (for example, arms or legs) is impaired. – Sometimes bladder and/or bowel functions are impaired, which can lead to incontinence and/or constipation. – Sometimes vision or speech is impaired. – Sometimes impairments develop quite suddenly, sometimes they begin insidiously and then gradually increase in severity.

An MS relapse occurs when new or known symptoms appear more than 24 hours and more than 30 days after the onset of the last relapse. Symptoms are not explained by change in body temperature or infection.

MS relapse: duration

The duration of a multiple sclerosis relapse varies between a few hours, days or weeks. Afterwards, the symptoms slowly subside. Sometimes the relapse symptoms disappear by themselves, sometimes only with the help of medications.

MS without relapses

A large number of people with MS do not have any more relapses after about ten to 15 years. In this case, MS is no longer relapsing (more precisely "relapsing-remitting"), but the disease takes on a so-called secondary chronic-progressive course, in which the relapses become less frequent as the disease progresses.

According to the most comprehensive global study to date, the Atlas of MS, about 12 percent of people with MS have a slowly progressive deterioration from the beginning (primary chronic progressive), so that MS progresses without relapses. (2)

Multiple sclerosis (MS): Course of the disease

There is no uniform course of MS that applies to every patient. For example, it is not possible to predict how long an MS relapse will last, when the next relapse will occur and whether the consequences of the disease will disappear again. In many cases, the MS-typical inflammatory foci form in the brain. spinal cord completely back again. However, scars (lesions) often remain, which show up in X-rays or MRI images.

Three forms of MS progression

Basically, the three MS courses distinguish:

Relapsing course (relapsing-remitting MS):
Symptoms start suddenly over days or weeks, can be treated with cortisone therapy. Then follow again symptom-free intervals over months and even years.
Primary chronic-progressive (creeping-progressive) course:
The limitations increase without clearly definable relapses appearing. Gradual onset of MS is more common in first-time sufferers after the 40. The course of multiple sclerosis. (1)
Secondary chronic progressive: The limitations do not completely disappear, but increase from relapse to relapse.

MS relapses during the course

At the beginning of the disease, relapses occur in about 85 percent of those affected. (2)

Only 12 percent of MS patients have a primary chronic progressive course from the beginning, i.e. a gradual progressive deterioration, without individual relapses being clearly distinguishable from one another. (3)

On average, the disease changes to a secondary chronic progressive course after about 15 to 20 years. However, the secondary chronic progressive phase does not develop in all affected individuals. Thus, many of those with the disease remain in a relapsing-remitting course. (2)

Types of multiple sclerosis, ©

End stage in MS? Courses of MS are highly individual. Thus, the stages of MS also differ. However, there are a number of so-called prognostic factors that indicate a rather favorable (mild) or a rather unfavorable (severe) course of multiple sclerosis:

Prognostic factors that tend to favor a favorable course of MS include:

– Only one symptom at the beginning (either tingling or numbness or visual disturbances) of the MS disease course – Short duration of the symptom and good regression after the MS relapse – Long intervals between relapses – Low degree of disability after five years of disease duration – No paralysis or balance disorders – Onset of disease before age 35. Age of onset

Prognostic factors that indicate a rather unfavorable course are, for example:

– Several symptoms at the beginning of MS (among others, if they indicate an inflammation in the cerebellum or spinal cord, such as gait disturbances, trembling of the arms or legs, movement and speech disorders, muscle cramps or muscle stiffness) – Long-lasting relapses with poor regression of symptoms – Recognizable inflammations and scars (lesions) in the MRI image

MS: Therapy/Treatment

MS is not curable even with therapies. The treatment serves to contain the symptoms of the disease as far as possible. MS treatment focuses on four major goals: (4)

1. Inhibition of the acute inflammatory reaction (relapse therapy) 2. Prolongation of the relapse-free/poor time (course-modifying therapy) 3. Alleviation of symptoms (symptomatic therapy) 4. Avoidance of possible complications (symptomatic therapy)

These therapeutic goals are usually combined with each other, individually tailored to the patient and constantly modified – depending on the disease pattern.

In Progression-modifying therapy medications are also used, but then as a long-term therapy.

Especially during symptomatic therapy the focus is not only on anti-inflammatory drugs, but on a wide range of supportive measures, such as

– Exercise therapy – Physiotherapy – Occupational therapy – Speech therapy – Psychotherapy – Neuropsychological therapy – Rehabilitation measures

Relapsing-remitting therapy

For relapse therapy, mainly cortisone preparations are available, which are supposed to reduce the inflammation. In acute relapses, they are administered as infusions over three to five days (high-dose relapse therapy). They are considered to be well tolerated. Nevertheless, in individual cases, stomach problems, sleep disturbances or an increase in blood sugar and blood prere can occur.

If the symptoms persist after several days, the therapy can be repeated (with a higher dose).

Blood washing (plasmapharesis)

In many cases, blood is washed (plasmapheresis), in which blood is removed, purified and returned to the body. In about half of the cases blood washing has proven to be helpful as therapy in MS.

Plasmapharesis is only available in special centers and is also only in case of severe acute relapses carried out. During this blood washing, proteins are removed from the blood – which in turn increases the patient's susceptibility to infections.

blood washing (immune adsorption)

A special form of blood washing, the so-called immune adsorption, in which the blood is separated into plasma (blood fluid) and blood cells, has fewer side effects. Only the plasma is purified, reunited with blood cells and returned to the body.

This form of treatment opens up new perspectives, for example in severe relapses that do not respond to cortisone therapy. The therapy takes place on an inpatient basis and lasts about one to two weeks . This involves about every other day a treatment of about three hours duration carried out. As a rule, there are a total of five to six treatments.

The cost of plasmapharesis or immunoadsorption is usually covered by health insurance. These medical treatments are given in clinics.

Immune-strengthening preparations

There are a number of drugs to strengthen the immune system and prevent inflammation. However, some of these have severe side effects. They can increase susceptibility to infection, cause pain in the head and/or back, damage the liver, and alter blood counts. Application requires an experienced expert. Close monitoring of the patient.

MS& Natural medicine

Many MS sufferers turn to natural remedies to alleviate their complaints and symptoms. This includes, for example, medicinal plants such as St. John's wort or the herbal remedies made from them. St. John's wort, for example, is a popular. Important medicinal plant for depressive moods. Mistletoe preparations affect the nervous system. (5)

Many symptoms that occur during the course of multiple sclerosis can also be accompanying treated with homeopathic remedies. Depending on the MS symptoms and complaints, different homeopathic remedies are available to those affected, which must be individually selected and coordinated for a successful therapy procedure. In order to find the appropriate homeopathic remedy, patients should therefore always discuss its use with their doctor and a therapist.

Multiple sclerosis: life expectancy

A study from Norway showed that MS patients live on average between 72 years (men) and 77 years (women). This is only slightly less than the life expectancy of healthy people, which ranges from about 78 years (men) to 84 years (women). (6) Moreover, all these are statistical values; therefore, they have only a limited significance for the individual person.

Cure: Is MS curable?

Multiple sclerosis is currently not curable. Since the cause of the inflammations has not yet been clarified, there is only the possibility of treating the symptoms – but the treatment of MS symptoms can achieve good results and often lead to patients living as symptom-free as possible. Research into the causes. The treatment of MS has long occupied experts. Although a cure has not yet been found, doctors can now diagnose multiple sclerosis much earlier and also treat it more effectively thanks to the latest diagnostic procedures.

Competence Network MS

The science has discovered the disease multiple sclerosis meanwhile completely for itself. A large competence network for multiple sclerosis developed from the research interest. Multiple sclerosis research is now looking at the disease from many angles. All aspects of the disease are being heavily researched, from causation to diagnostic procedures to optimal therapies and the possibility of containing inflammatory forms of MS.

Thus, not only neurologists and immunologists deal with MS, but also occupational therapists and physiotherapists are involved and new job descriptions such as the MS nurse or the MS caregiver have emerged.

Prof. Dr. Heinz Wiendl, a representative of neuroimmunology and MS research, affirms in a 2018 article published by the German Society of Neurology "that a disease that was de facto untreatable more than 20 years ago has become a diagnosis with which patients can often lead an almost normal life". (7)

Living with MS

The diagnosis of multiple sclerosis makes most people at first very afraid. It unsettles you, because those affected can never really rule out another relapse with certainty. But this much should be said: The longer the disease remains stable – i.e. does not worsen – the more favorable the prognosis is.

Life can be worth living despite an MS diagnosis. Provided that those affected accept their disease and shape their lives with MS – instead of against it. This includes:

Accepting impairments
Accept impairments, but do not make them the main content of life: If walking is ever difficult, bicycling may be easier. If it is difficult to change gears when driving a car because the arms are weak, an automatic car can be a good alternative. Recognize stress limits Acknowledge the physical stress limits and, for example, dose the sports program in such a way that you do not exceed your capacity. In general, there are no limits to your preferences when it comes to sports. Whether you prefer water gymnastics or climbing in the high mountains. Possibly you learn new kinds of sport during a rehabilitation measure, for example equipment or balance training, which can be much fun for you. Adapt nutrition
You can adjust your diet to your disease: There is no special MS diet, but there are many recommendations, for example a vegan diet, an anti-inflammatory diet or a diet with as little carbohydrates (low carb) as possible, but with a lot of proteins. Vitamin D – so say the experts – should always be part of your diet, possibly also as a supplement if your doctor thinks it makes sense.

High-dose vitamin D may reduce MS flare-ups, i.e., slow MS activity somewhat. (8) Vitamin D is made by the body as soon as it gets sunlight. So exercise in the fresh air has more than one health-promoting aspect!

MS: Help& Self-help

There are now many MS support groups for people with MS. The MS self-help gives support to affected persons. Enables sharing with each other. This increases the quality of life immensely. Relatives can also get help in MS self-help groups.

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