Multiple Sclerosis or MS for short is a previously incurable inflammatory and chronic disease. This leads to a destruction of nerve fibers in the central nervous system, ie in the brain or spinal cord. Typical of the disease are the relapses with their complaints, which leads in the long term to motor and emotional disorders.

What is multiple sclerosis?

Infogram on the symptoms and diagnosis of multiple sclerosis.

Multiple sclerosis, MS for short, is a disease of the central nervous system. This leads to chronic inflammation in the spinal cord and brain, in which parts of the nerve fibers (medullary sheaths) are destroyed. In addition, it comes to damage of the body's own defense cells, which normally fight foreign body pathogens. Therefore, multiple sclerosis is also known as an autoimmune disease.

Strangely enough, multiple sclerosis is more common in areas and countries farther from the equator. But even within different countries there are striking distribution patterns of the incidence of multiple sclerosis. After epilepsy, MS is the most common chronic inflammatory disease of the human nervous system. In Germany, about 0.15 percent of the population suffer from multiple sclerosis. Women in their younger years are more affected than men.

Due to the destruction of the nerve fibers, sufferers almost always suffer from motor problems or disorders of physical activity. In addition, the physical sensations are severely attacked.

causes

For the causes of multiple sclerosis so far come three main reasons. The first cause can be an autoimmune disease. The immune system attacks the body's own tissue. As a result, antibodies are formed that can trigger chronic diseases in the blood and are directed against one's own cells. In multiple sclerosis, these antibodies target the nerve tissue of the brain and spinal cord.

The second cause of multiple sclerosis relies on genetic or hereditary causes. Thus, people whose close relatives suffer from this disease are exposed to a higher risk of MS. Nevertheless, multiple sclerosis is not considered a hereditary disease. Environmental factors can also cause genetic changes in humans, which can then also lead to the disease in the same way.

As a last known cause infections for multiple sclerosis come into question. In particular, pathogens such as chlamydia, herpes viruses and Epstein-Barr virus are considered as possible causes of inflammation of the nerve fibers. If a patient already has multiple sclerosis, various other influences can lead to the known relapses of the disease. Especially stress, hormonal imbalances, infections, vaccinations and medications are considered triggers.

Symptoms, complaints & signs

Multiple sclerosis is associated with many different symptoms. Also, the disease progresses at different rates and the order of symptoms is not fixed. However, in the beginning, walking difficulties, feeling in the legs, problems with bowel movements, sight problems in one or both eyes and severe tiredness are particularly common.

However, there are many other symptoms - such as facial paralysis and poor sensation in the arms - that can occur in the beginning. The symptoms of multiple sclerosis usually occur suddenly and show little signs. The other symptoms usually show up during the course of the disease.

So it comes in 90 percent of cases to spasticity in the legs or lack of strength in them. Most sufferers are unsure when walking or can not anymore. Other common symptoms (occurring in at least two-thirds of those affected) include bladder dysfunction, concentration problems and blurred vision.

In about half of the cases, there are mental illnesses (such as depression or psychosis), speech problems and difficulty grasping or pointing. In one third of cases facial paralysis occurs. In general, it can cause pain and tingling sensations on the body. In rare cases paralysis of the cranial nerves occurs.

disease

The course of multiple sclerosis depends on early detection and treatment by a physician. Unfortunately, you can not completely heal MS yet. Since the disease course of multiple sclerosis can be very individual and different, a general description is not readily possible.

Nevertheless, one can often make out three major forms of progression. The first typical phase is the recurrent and relapsing MS. Here, the symptoms or complaints occur several days in a row. In between, sometimes several years can go without further complications. The longer a thrust lasts the higher the likelihood that residual damage to the nerve fibers will be left behind,

The second phase or progression is called progressive and chronic. Here, the symptoms usually appear creeping but persistent. Relapses, as in the recurrent phase do not occur. The third form is equally progressive and chronic. Here, the thrusts are less and less, although the disorders of the nervous system remain the same. In summary, multiple sclerosis can take a benign course, in which the person affected has various complaints, but does not die. In rare cases, however, there is also a severe form of MS, which unfortunately ends in death, as the nerve fibers of the brain have been damaged too much.

complications

A chronic urinary tract infection caused by neurogenic bladder dysfunction is one of the most common complications of multiple sclerosis. Recurring infections of the bladder, which are not or not sufficiently treated, can spread to the kidneys and in the worst case lead to blood poisoning (urosepsis). Gait uncertainties due to the disease are often the cause of falls that result in broken bones.

Bedridden or wheelchair-dependent patients with multiple sclerosis often suffer from pressure ulcers, joint stiffness and cramping of the musculature due to limited mobility, and the risk of thrombosis is also increased. Osteoporosis and respiratory diseases such as bronchitis or pneumonia are in many cases also the result of multiple sclerosis-related inactivity.

Constipation, urinary and fecal incontinence can also occur as further complications of the disease. A diminished ability to concentrate, memory disorders and depressive moods often result in a change in the personality, which also has an effect on social behavior. The drugs needed to treat multiple sclerosis may weaken the immune system and make the organism susceptible to infection by viruses, fungi or bacteria.

Therapy with interferon is often associated with flu-like symptoms, even allergic reactions are possible. Sleep disorders and problems in sex life can occur as a result of the disease itself or drug treatment.

When should you go to the doctor?

Multiple sclerosis is a disease that, due to its chronic nature and the course in spurts, can repeatedly require a visit to the doctor. The first visits to the doctor, however, serve to ensure the diagnosis and to exclude other possible causes in case of signs such as weakness, tingling sensation or discomfort as well as paralysis. The first point of contact in this context is the family doctor, who will issue the necessary referrals to a neurologist or radiologist. After the diagnosis and a possibly medicinal setting, visits to the doctor are not absolutely necessary.

The thrust indicates a sudden change in the course of multiple sclerosis, which can remain stable for a long time and then attract attention with new symptoms. Here it makes sense to visit the doctor in order to cope with occurring symptoms as well as possible. This often succeeds in cooperation with medical disciplines such as speech therapy, occupational therapy or physiotherapy.

Mental problems can also make it necessary to go to the doctor or psychotherapist. If sufferers get along badly with multiple sclerosis, a professional contact person from the medical sector is also useful here. He can catch the sufferer in his psychic constitutions and give valuable action tips for the psychological coping with the disease on the way. Caring relatives can also be included here.

Treatment & Therapy

If multiple sclerosis is diagnosed during a doctor's examination, treatment should be started as soon as possible. Since a MS is currently not curable, the goal of the treatment is to slow down or halt the destruction of nerve fibers in the brain and spinal cord. The therapy of multiple sclerosis depends on its course.

Thrust Therapy:

In the Schubtherapie especially the symptoms or symptoms in the spurts of MS are to be fought. It uses medicines that strengthen the immune system and try to attack non-body cells. Furthermore, anti-inflammatory drugs or cortisone are also administered. Side effects here are often: sleep disorders, internal restlessness, palpitations and cravings.

Basic therapy:

The basic therapy is intended to slow down the progression of the body motor and the senses and to mitigate or prevent emerging thrusts. In addition, the quality of life should be maintained by treating the symptoms of the complaint. Medications here are glatiramer acetate or interferon beta, which slow down the duration and frequency of multiple sclerosis relapses.

Therapy of symptoms:

In addition to the basic therapy and push therapy, concomitant symptoms or complaints are also treated in order to reduce the suffering of those affected and to enable a livable life. Physiotherapy, massages, pelvic floor exercises and relaxation methods are very successful. Typical symptoms such as dizziness, trembling, frequent urination and potency problems can be treated sustainably both with medication and with the above measures and often lead to an improvement in the quality of life of multiple sclerosis patients.

aftercare

Many people with multiple sclerosis suffer from the heteronomy that the disease entails. Often every boost leaves one or more restrictions in daily life. The focus of aftercare is therefore on the instruction, training and advice. People should be able to do everything they can, and only get support when needed.

In the area of ​​washing and dressing, relatives or carers can therefore work resource-oriented. This means, for example, to take over the preparation and follow-up of the daily morning hygiene or to give help with a spasticity-induced movement deficit. If sufferers have polyneuropathy, relatives should inspect their feet and exposed areas for skin damage to detect and treat decubitus ulcers or injuries early.

Families only provide support when eating and drinking, when limited coordination, tremor or spasticity limit their mobility so much that it would not be possible to eat. Special crockery or cutlery make it easier for people affected to eat and drink independently.

When people with multiple sclerosis suffer from incontinence, therapists make a valuable contribution to bladder training or self-catheterization guidance. Due to the adequate incontinence care, infections can be avoided and the quality of life increased.

Limited mobility eliminates carpets, door sills or other potential sources of stumbling in the living space. Prior to any mobilization, it is recommended to use a muscle-relaxing massage and moving the joints to maintain mobility and normalize the tone.

Outlook & Forecast

The prognosis in multiple sclerosis is very individual and accordingly only general statements can be made and naming favoring factors. First of all, the disease causes severe disability in approximately one-third of those affected. Another third suffer from neurological limitations, which are partially compatible with a working life and also largely maintain independence. The last third can spend the whole life without major restrictions, but various minor disabilities or other suffering are possible. However, the independence of this last group is preserved in every case.

Furthermore, people with multiple sclerosis who only experience a relapsing course always have a better prognosis regarding the development of further restrictions. In the case of the chronic progressive course, serious restrictions occur far more frequently and hardly ever develop again.

It has also been shown that female persons have a better prognosis for a good life expectancy. This also applies to people who become ill before their 40th birthday and to people with relapsing forms with a few relapses.

For the quality of life of those affected modern therapies, the preservation of possible independence as well as a mental health care and a stable environment are crucial. The life expectancy is often hardly lower than for non-sick people.

You can do that yourself

Although multiple sclerosis is not curable, the disease can be positively influenced. In addition to long-term medical treatment, sufferers have other options to alleviate the symptoms and avoid complications.

The doctor will first recommend a lifestyle change. Exercise and a balanced and healthy diet support the immune system and other organs that have a significant impact on the course of multiple sclerosis. Also important is the support from friends and family members. Social support can contribute significantly to well-being and thus to health.

A healthy life also protects against concomitant diseases of the cardiovascular system. The everyday complaints can be reduced by some basic recommendations. It is important to take regular medication, because only a consistent treatment brings the desired success. If side effects occur or for other reasons the desire to change the medication, must be discussed with the responsible physician.

Basically, regular visits to the doctor are indicated, so that a possible deterioration in health can be recognized quickly. Measures such as physiotherapy and exercise also help against the typical symptoms. Patients should also drink a lot and avoid or reduce any overweight. Accompanying this, a visit to a self-help group can make sense.

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