Multiple Sclerosis (MS)Those who develop multiple sclerosis are initially confronted with a variety of questions and fears. It is therefore particularly important to know that for MS, despite its progressive course very good treatment options are available. In most cases, patients can now lead a largely symptom-free, independent life with long-term preservation of their ability to work.
What exactly is multiple sclerosis?
Multiple sclerosis is a chronic, inflammatory disease of the brain and spinal cord. Since it is currently not curable, patients have many questions and fears after diagnosis. It is therefore important to know that there are very effective treatment options that can have a favorable influence on the course of the disease or even almost stop it. Medical research is working at full speed on the causes of the disease and on new therapies. The goal is to enable patients to live a symptom-free and independent life.
How the disease develops? The origin of the disease is not yet fully understood. Further subject of numerous examinations.
It is amed that a genetic predisposition and various environmental factors can trigger a malfunction of the immune system. This autoimmunological process involves various cells, lymphocytes, and other components of the immune system. Thereby it comes to inflammation of the brain and spinal cord. These disturb the functionality of the nerve fibers by attacking their sheathing layer (myelin) and thus hindering the smooth transmission of impulses.
What are the symptoms of multiple sclerosis??
Multiple sclerosis is not Cardinal symptom dominates. Rather, it is characterized by the occurrence of very different limitations, which may occur in isolation or in combination. In common parlance, therefore, the disease is called "Disease of 1000 faces denotes.
The following physical symptoms are u. a. in different degrees of severity:
– Visual disturbances with blurred vision in the context of optic neuritis – Paralysis symptoms, sometimes associated with increased muscle tension (spasticity) – Sensory symptoms with numbness and insensitivity – Dizziness and balance disorders – Disturbances in bladder control with urge to urinate or incontinence
Not all symptoms are obvious. Patients can also be affected by excessive fatigue, concentration and attention deficits, and depressive moods.
What is the course of multiple sclerosis?
The course of the disease with the appearance of the various symptoms up to a physical disability can hardly be predicted in the individual case. Mild courses, which hardly lead to any restrictions in lifestyle, are frequent.
3 forms of progression can be distinguished.
– The primary relapsing multiple sclerosis is the most common. It is predominant at the onset of the disease and is characterized by disease episodes with the sudden appearance of new symptoms. These regress completely or incompletely (remission) in the course of days to weeks. There may be weeks, months or years of symptom-free intervals between disease episodes.
– This form of progression can turn into a secondary chronic-progressive course go over. The symptoms of the disease then slowly increase, independent of relapsing deteriorations. Restrictions do not regress.
– To be distinguished from this primary chronic-progressive form of progression in ca. 10 % of cases. In this case, the disease progresses slowly from the beginning, without relapses being distinguishable.
How is the diagnosis made?
Essential for the diagnosis are a careful taking of medical history and the physical examination.
This is followed by a Magnetic resonance imaging (MRI) of the brain and spinal cord in which inflammatory foci can be detected. With a lumbar puncture, cerebrospinal fluid (CSF) can be taken from the spinal canal to look for typical changes in the cell appearance and protein components (oligoclonal bands). In this way, important Differential diagnoses (diseases with similar symptoms) are excluded. stimulus conduction in brain. spinal cord is examined. All of these examinations are appreciated in their entirety. To establish the diagnosis, the generally applicable diagnostic criteria (McDonald criteria) are then applied.
What treatment options are available?
The treatment of multiple sclerosis is based on several pillars. The acute disease relapse is treated with an Cortisone shock therapy treats. This promotes the regression of the symptoms of the disease (remission). Long-term immunotherapy influences the long-term course of the disease by reducing the number and severity of relapses. A large number of drugs are now available, which patients can inject themselves, take as tablets or have administered at very different intervals by infusion into the vein. The occurrence of impairments due to the disease should be slowed down or even prevented. The disease is not curable.
Symptomatic medication has no effect on the course of the disease. They serve Relief of symptoms such as z. B. painful sensations, increased muscle tension (spasticity) or depressive moods. The treatment is supported by non-drug therapies such as physiotherapy, occupational therapy or speech therapy. These measures can alleviate symptoms. Improve or maintain functional ability in everyday life. These therapies can take place intensively and individually within the framework of a multimodal inpatient rehabilitation.
Inpatient rehabilitation for multiple sclerosis
Patients make use of inpatient rehabilitation measures after initial diagnosis, after acute relapses or also because of chronically progressing deteriorations with very different degrees of severity of the disease. Participation in social. Securing social life. The preservation of the ability to work is in the foreground for patients who are usually young at the onset of the disease. This can be impaired by motor symptoms, especially the ability to walk, or non-motor symptoms such as excessive fatigue. For patients in advanced stages of the disease, maintaining independent living is paramount.
What is the multimodal treatment concept of rehabilitation??
Since multiple sclerosis is a chronic disease that usually begins in younger adulthood, patients of all ages, with very different life circumstances and degrees of severity of the disease are represented in the rehabilitation program.
The rehabilitation goal is as individual as the individual patient. This must be worked out by doctors and therapists together with the patient at the beginning of rehabilitation and is the basis for the individual therapy plan. Multimodal is then the therapy offer.