Multiple sclerosis

What is multiple sclerosis?

Multiple sclerosis is an autoimmune disease. The body’s own immune system attacks the protective sheath of the nerves in the brain and in the spinal cord, which causes chronic inflammation of the nerves. It is unclear why this autoimmune reaction occurs. 

When can the illness present?

MS can principally occur at any age; however, it is most common between the age of 20 and 40. MS rarely presents in children. Women develop multiple sclerosis twice as frequently as men.

Progression of multiple sclerosis

There are three different types of multiple sclerosis. 

• Primary chronic progressive MS proceeds chronically from the onset and gets increasingly worse. This non-relapsing form of MS often starts after the age of 40. 
• Relapsing-remitting MS progresses in episodes with an abatement of symptoms between episodes.   
• Secondary chronic progressive MS changes to an episodic course in a chronic form after a certain time, and the symptoms get increasingly worse.

Symptoms of MS

The symptoms and impact of MS can vary markedly from patient to patient.

Early symptoms in the early stages of MS are: 

• Spasmodic paralysis symptoms
• Impaired sensitivity in the arms and legs (numb feeling)
• Motor disorders (reduced mobility)
• Lethargy and fatigue

MS usually presents in episodes. Good and bad phases alternate in episodes over the course of the disease. 

The most frequent symptoms of MS include : 

• Visual impairment     
• Difficulty speaking and swallowing     
• Memory and concentration problems     
• Muscle weakness     
• Muscle tremors     
• Mood changes     
• Pain and loss of sensation

Diagnosing multiple sclerosis

Multiple sclerosis is not easy to diagnose and requires different examinations. They include neurological examinations and eye, muscle, coordination and sensation tests.     

A neurology specialist will make the diagnosis and is also usually the subsequent point of contact for MS patients.  When treating the illness, the neurologist will be supported by other specialities including, among others, general medicine, ophthalmology, psychotherapy.

In addition to that, specialists in the fields of physiotherapy, occupational therapy and speech therapy may provide support in the treatment of symptoms. 

Examinations to diagnose MS

If there is suspected MS, the patient will undergo MRI examinations of the brain and a lumbar puncture are also carried out to examine the cerebrospinal fluid.

Life expectancy with MS

Life expectancy is minimally or barely affected by MS. It is not significantly lower than that of healthy people. Only a very rare, malignant form of multiple sclerosis can result in death after only a few months. 

Treating multiple sclerosis

Multiple sclerosis cannot be cured; treatment can only slow the progression of the disease. The treatment depends on the form of the disease, the severity and the impact on the individual patient.

The treatment of MS patients usually involves a step-by-step therapy which is tailored to the individual patient situation. It is normally a combination of medical treatment with physiotherapeutic, ergotherapeutic and psychotherapeutic support.

The goal of MS treatment is to reduce the inflammatory response and minimise the symptoms and thus improve the quality of life of MS patients. 

There are three forms of treatment for MS: 

• Acute treatment: Acute treatment is provided in the event of an acute episode. In the event of an acute episode, the patient receives cortisone medications over the course of several days which stem the inflammatory response. 
• Course-modified treatment: Course-modified treatment is a drug therapy and is oriented on the progression of the patient's MS. 
• Symptomatic treatment: Symptomatic treatment treats the MS patient’s symptoms as they arise. Since MS symptoms vary widely from person-to-person, the treatment measures vary as well. Physiotherapy and occupational therapy are also utilised to support the drug therapy.