Multiple sclerosis (MS): symptoms, course and therapyMultiple sclerosis, often abbreviated as MS, is a serious disease with many facets. The symptoms are not only diverse, they can also vary greatly from patient to patient. Even though research has been looking into multiple sclerosis for a long time, there are still many things we don't know, first and foremost a cure. However, this does not mean that you are completely helpless as an MS sufferer. On the contrary, nowadays it is possible to successfully influence the course of the disease with the right medication. Sanubi explains everything you need to know about multiple sclerosis in this overview article. It is concretized what multiple sclerosis, resp. MS, is what symptoms occur, what the causes are, and what treatment options come into question.
What is multiple sclerosis?
Multiple sclerosis is an autoimmune, chronic inflammatory neurological disease that can progress differently in different people. Sanubi has prepared a detailed definition for you:
"Multiple sclerosis, abbreviated to MS, also known in neurology as encephalomyelitis disseminata, or ED, is an autoimmune neurological disease of the central nervous system. Both the nerves in the brain and those in the spinal cord are affected by scattered, chronic inflammatory lesions."
Multiple sclerosis is thus a demyelinating disease in which many, i.e. multiple, inflammatory demyelinating foci, all of which are located in the brain and spinal cord, ensure that the myelin sheaths of the nerve cell processes are attacked by the body's own immune cells. All kinds of neurological symptoms can occur as part of this process, which affects the nerve fibers. Each patient has an individual course of the disease. Contrary to popular belief, however, this does not mean that someone who suffers from multiple sclerosis automatically has to contend with severe disabilities. Often the relapses that make MS worse can be delayed for a long time, or at least the consequences can be treated in such a way that affected persons have a similarly high life expectancy as all other people.
Many people who suffer from multiple sclerosis are entitled to a degree of care. Sanubi advises, if not already done, to apply for a care degree. However, one should be well prepared for the care degree assessment. Once the care degree, from care degree 1, care degree 2, care degree 3, care degree 4 to care degree 5, is granted, one is entitled to care aids for consumption, worth 40 euros per month.
Multiple sclerosis: symptoms
As mentioned so far, MS is accompanied by a wide variety of symptoms. Nevertheless, there are certain similarities. First and foremost is the fact that the symptoms occur in so-called relapses. These usually heal completely, especially at the beginning of the disease. The first episode usually occurs between the ages of 15 and 40. Is usually characterized by visual disturbances or other sensory disturbances. In the further course of the disease, a variety of other symptoms can be added. This includes motor disorders, limb pain and speech disorders. Such a wide spectrum of symptoms means that most patients have different experiences and are exposed to different conditions accordingly.
Specifically, multiple sclerosis can cause, among other things, the following impairments:
– Sensory hypersensitivity – numbness of the skin – double perception – blurred vision – foggy vision – blurred vision – fatigue – dullness – pain in the eye – muscle pain – nerve pain – joint pain – headache – weakness – paralysis – spasticity – tremors – stiffness and heaviness in the arms and legs – slurred speech, respectively. Swallowing disorders – Personality changes – Psychological impairments
Joint pain can also indicate osteoarthritis or polyarthritis.
Multiple Sclerosis: Diagnosis
The diagnosis of multiple sclerosis is nowadays made according to uniform diagnostic criteria. One of the main criteria is a spatial and temporal dispersion, called dissemination in technical language, of the occurrence of the inflammatory foci. More precisely, this means on the one hand that the inflammations occur at different locations and on the other hand that time intervals between them can be identified. A second important rule in diagnosis is that the diagnosis of multiple sclerosis should only be made if there are no alternative diagnoses that better explain the patient's symptoms. In the course of diagnosis, various examinations are performed, ranging from imaging and laboratory chemistry to neurophysiological examinations. The McDonald criteria, last updated in 2017, form the basis for the diagnosis.
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The causes of multiple sclerosis
The cause, also called etiology, of MS is not clear at this time. There are a number of theories in circulation and basically research indicates that there are several factors that are responsible for multiple sclerosis together. A mixture of genetic traits and external influences is suspected. Sanubi lists the most important hypotheses in the following course, resp. factors that could be possible causes.
1. Genetic predisposition
While it is clear that multiple sclerosis is not a genetic disease, as of October 2013, 110 genetic variations have been identified that are more common in people with MS than in the rest of the population. It is therefore quite possible that these genetic traits contribute to a predisposition to multiple sclerosis. Many of these gene variants are directly related to other autoimmune diseases, such as Crohn's disease or type 1 diabetes. Furthermore, it has been found that ethnicity also plays a role, as American studies have found that people of African-American or Latin-American origin are less likely to develop MS. Identical twins of people with MS have a 35 percent risk of developing the disease themselves, while siblings have a risk of only about. 4 percent. First-degree relatives have a 3 percent chance of developing the disease, while second- and third-degree relatives have a 1 percent and 0.9 percent chance, respectively. For comparison, the risk of the general population can be used, where the probability of developing multiple sclerosis is about 0.1 percent.
Infections were also considered as a possible cause early on. An amption which is still close today, but which has not yet been proven. Although research suggests that contracting an infection whose causative agent has cross-reactivity, i.e., a similar effect on the sites in the nervous system that are also affected by multiple sclerosis, increases the risk of developing the disease. However, it is not clear exactly which disease is involved. In addition, numerous viruses, such as the Epstein-Barr virus, may be associated with MS. In addition, there are a number of bacterial pathogens that can be found in the medical history of patients with multiple sclerosis. However, for all the factors mentioned, the evidence is very thin and often the amptions are only supported by data showing an increased rate of MS in patients affected by the infections.
3. Vitamin D
The fact is that multiple sclerosis is less common around the equatorial zone than elsewhere. One of the central theories that has been put forward to explain this circumstance is that this anomaly is due to the better supply of vitamin D in these areas. After all, vitamin D is produced in the human body mainly through exposure to sunlight. However, as with most other possible causes, the link to multiple sclerosis is only suspected and has not yet been proven. Nevertheless, several studies suggest that vitamin D supplementation may reduce the risk of developing MS.
After many years of research, it can be clearly stated at the present time that smoking increases the risk of developing MS. However, it has not yet been clarified how much higher the chance of multiple sclerosis is in smokers. There are different studies that indicate as many different factors by which the risk is increased by cigarettes, ranging from 1.2 to 1.8. In addition, the progression of multiple sclerosis has been found to be accelerated in smokers. However, it has not yet been possible to find out exactly which changes caused by cigarette smoke in the body are relevant in this context.
Obesity also appears to be a factor that increases the risk of developing MS. In particular, people who were overweight in childhood are more likely to develop multiple sclerosis. The reason for this and why exactly this is the case could not be explained, despite intensive research efforts.