Multiple Sclerosis (MS, Encephalomyelitis Disseminata)

What Is MS?

Multiple sclerosis, also called encephalomyelitis disseminata, is a chronic inflammatory disease of the central nervous system. There are focal inflammatory spots (lesions) in the brain and spinal cord.

It affects 2.5 million people worldwide, with more than twice as many women as men. The disease is characterized by loss of the myelin sheaths of the nerve fibers. To date, the cause of the disease is unknown.

MS shows high variability in its expression. Depending on the location of the lesions, various neurological symptoms are possible. Also, different courses of this disease can be found. It can either be relapsing or progressively worsening.

A few years ago, the diagnosis was made purely based on clinical symptoms. In the meantime, laboratory findings and MRI images of the central nervous system have been added as proof. Unfortunately, there is currently no cure for MS However, immunosuppressive and immunomodulatory drugs can positively influence the course of the disease.

What Causes MS?

The cause of multiple sclerosis is unknown. However, an autoreactive response of the body to an antigen is suspected, which leads to a false attack of the own immune system against the myelin sheaths of the nerve fibers. Viral infections are discussed as possible antigens; among others, the Eppstein-Barr virus, which triggers Pfeiffer's glandular fever, is suspected of starting multiple sclerosis.

What Are Signs and Symptoms of Multiple Sclerosis?

The symptoms of M.S. disease are highly variable and individual. In most cases, M.S. begins relapsing with one clinical sign. This condition is also called "clinically isolated syndrome." A clinically isolated syndrome is a preliminary stage of MS. 80% of the patients develop another clinical syndrome, so it is referred to as multiple sclerosis. However, 20% of the patients do not suffer a second attack up to 20 years after the clinically isolated syndrome and do not develop MS. The most common symptoms reported by affected individuals are:

• Visual disturbances
• Sensory disturbances
• Permanent fatigue

Symptoms often resolve incompletely or completely within days or weeks. As the disease progresses, further episodes occur with the same signs or new-onset symptoms such as:

• Disturbance in motor skills
• Disturbances in bladder emptying
• Sexual dysfunction
• Tremor on movement
• Daytime sleepiness
• Depressiveness
• Memory disorders
• Concentration disorders

Diagnosis: Multiple Sclerosis Test

The diagnosis of MS is made in three steps. First, based on the medical history, the physician can already express the suspicion of an inflammatory disease of the central nervous system. Second, laboratory tests and MRI images are used to exclude other diseases, so-called differential diagnoses. Third, the so-called "spatial and temporal dissemination" is determined, meaning at least two lesions have occurred at different times or places in the body. Only then can multiple sclerosis be diagnosed.

Multiple Sclerosis Progression

There are three different courses of multiple sclerosis.

Relapsing-remitting MS describes how patients experience relapses of clinical symptoms, but these (almost) completely resolve within days to weeks. There is no increase in disease between relapses. It is the most common form, affecting 85% of all MS patients.

Secondary progressive MS develops in more than half of the patients, where the disability continues to increase; relapses can also occur in between.

In contrast, primary progressive MS occurs in about 15% of patients. This form has the worst prognosis and describes an ever-worsening disability without relapses.

Multiple Sclerosis Therapy

Unfortunately, no therapy treats the cause of multiple sclerosis yet, because it is still unknown. The treatment consists of three pillars:

• Relapse therapy
• Course modifying therapy
• Symptomatic therapy

In an acute episode, high doses of cortisol are given for 3-5 days. Progression-modifying therapy uses immunosuppressive and immunomodulatory drugs to prolong relapse intervals and reduce disease activity. Physical therapy, occupational therapy, psychotherapy, and similar are used as supportive measures to alleviate symptoms and improve the patients' quality of life.

Rehab for MS

The goal of rehabilitation, in general, is to maintain the patient's ability to perform, independence, and thus participation in social life. In multiple sclerosis patients, the focus is on symptom relief from spasticity, pain, and bladder and bowel problems. In addition, the patients' motor skills and cognitive abilities are to be maintained.

The rehabilitation measures can be carried out either in outpatient settings or, in severe cases, as in inpatient settings. In special neuro-rehabilitation clinics, the staff is trained, among others, on MS patients and can support them particularly well.

Which Doctors and Clinics Are Specialized in MS?

Multiple sclerosis belongs to the field of neurology. These physicians work closely with neuroradiologists in large clinics to diagnose and treat MS patients.

We will help you find an expert for your disease. All listed physicians and clinics have been reviewed by us for their outstanding specialization in multiple sclerosis and are awaiting your inquiry or request for treatment.

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