multiple sclerosis

multiple sclerosis or short MS is a previously incurable inflammatory and chronic disease. This leads to the destruction of nerve fibers in the central nervous system, i.e. in the brain or spinal cord. The relapses with their symptoms are typical of the disease and lead to motor and emotional disorders in the long term.

What is 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 (myelin sheaths) are destroyed. In addition, there is damage to the body's own defense cells, which normally fight foreign pathogens. Therefore, multiple sclerosis is also known as an autoimmune disease.

Oddly enough, multiple sclerosis is more common in areas and countries farther from the equator. But there are also distinctive distribution patterns of the frequency of multiple sclerosis within different countries. After epilepsy, MS is the most common chronic inflammatory disease of the human nervous system. In Germany approx. 0.15 percent of the population suffer from multiple sclerosis. Younger women are more likely to be affected than men.

As a result of the destruction of the nerve fibers, those affected almost always suffer from motor problems or disorders of physical movement. In addition, the physical sensations are severely affected.

causes

For the causes of a multiple sclerosis So far there are three main reasons. The first cause can be an autoimmune disease. Here 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 is based on genetic or hereditary causes. People whose close relatives have this condition are at higher risk of MS. Nevertheless, multiple sclerosis is not considered a hereditary disease. Environmental factors can also bring about genetic changes in humans, which can then also lead to this disease.

The last known cause is also infections for multiple sclerosis. Pathogens such as chlamydia, herpes viruses and Epstein-Barr virus are considered to be possible causes of inflammation of the nerve fibers. If a patient has already contracted multiple sclerosis, various other influences can lead to the known attacks of the disease. Above all, stress, hormonal imbalances, infections, vaccinations and medication are then considered to be triggers.

Symptoms, ailments & signs

Multiple sclerosis has many different symptoms. The disease also progresses at different speeds and the sequence of the symptoms is not fixed. However, at the beginning it is particularly common to have difficulty walking, sensory disturbances in the legs, problems with bowel movements, visual difficulties in one or both eyes and severe fatigue.

However, there are many other symptoms - facial paralysis and poor sensation in the arms, for example - that can appear at the beginning. The symptoms of multiple sclerosis usually appear suddenly and show hardly any signs. The other symptoms usually show up during the course of the disease.

In 90 percent of the cases there is spasticity in the legs or weakness in them. Most people are unsure or unable to walk. Other common symptoms (occurring in at least two-thirds of those affected) include urination disorders, concentration problems, and visual disturbances.

In about half of the cases there are mental illnesses (such as depression or psychosis), speech disorders and difficulty reaching or pointing. Facial paralysis occurs in a third of the cases. In general, there may be pain and tingling sensations on the body. In rare cases, the cranial nerves are paralyzed.

Course of disease

The course of a multiple sclerosis depends on early detection and treatment by a doctor. Unfortunately, MS cannot yet be completely cured. Since the course of multiple sclerosis can be very individual and different, a general description is not easily possible.

Nevertheless, one can often make out three major progressive forms. The first typical phase is relapsing and relapsing MS. Here the symptoms or complaints appear several days in a row. In between, several years can pass without further complications. The longer a thrust lasts, the higher the probability that residual damage to the nerve fibers will remain,

The second phase or form of progression is called progressive and chronic. The symptoms usually appear gradually but persistently. Relapses like those in the recurring phase do not occur. The third form is also progressive and chronic. The attacks become 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 affected person has various complaints, but does not die from them. In rare cases, however, there is also a severe form of MS, which unfortunately ends in death because the nerve fibers of the brain have been damaged too much.

Complications

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

Bedridden or wheelchair-bound patients with multiple sclerosis often suffer from pressure ulcers, joint stiffness and muscle spasms due to their restricted mobility, and the risk of thrombosis is also increased. Osteoporosis and diseases of the respiratory tract such as bronchitis or pneumonia are in many cases also the result of inactivity caused by multiple sclerosis.

Constipation and urinary and fecal incontinence can also occur as further complications of the disease. A reduced ability to concentrate, memory disorders and depressive moods often lead to a change in personality, which also affects social behavior. The drugs required to treat multiple sclerosis may weaken the immune system and make the organism susceptible to infections from viruses, fungi or bacteria.

Therapy with interferon is often associated with flu-like symptoms, and allergic reactions are also 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 progression in episodes, can repeatedly require going to the doctor. The first visits to the doctor, however, serve to confirm the diagnosis and to rule out other possible causes in the event of signs such as weakness, tingling or abnormal sensations as well as paralysis.The first point of contact in this context is the family doctor, who will issue the necessary referrals to the neurologist or radiologist. Visits to the doctor are not absolutely necessary after the diagnosis and, if necessary, drug adjustment.

The episode marks a sudden change in the course of multiple sclerosis, which can remain stable for a long time and then draw attention to itself with new symptoms. Here it makes sense to see a doctor in order to be able to cope with any symptoms as well as possible. This is often achieved in cooperation with medical disciplines such as speech therapy, occupational therapy or physiotherapy.

Psychological problems can also make it necessary to go to a doctor or psychotherapist. If those affected with multiple sclerosis have problems coping with it, a professional contact person from the medical field makes sense here too. He can support the affected person in his or her psychological state and give valuable tips on how to deal with the illness psychologically. Caregiving relatives can also be included here.

Treatment & Therapy

Is a multiple sclerosis is diagnosed, therapy should be started as soon as possible. Since there is currently no cure for MS, the goal of treatment is to slow down or stop the destruction of nerve fibers in the brain and spinal cord. The therapy of multiple sclerosis depends on its form.

Relapse therapy:

The main aim of relapse therapy is to combat the complaints or symptoms associated with relapses in MS. Medicines are used that strengthen the immune system and try to prevent the body's own cells from being attacked. Anti-inflammatory drugs or cortisone are also administered. Side effects here are often: sleep disorders, inner restlessness, palpitations and cravings.

Basic therapy:

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

Therapy of the symptoms:

In addition to basic therapy and relapse therapy, accompanying symptoms or complaints are also treated in order to reduce the suffering of those affected and enable a life worth living. Physiotherapy, massages, pelvic floor training and relaxation methods are particularly successful here. Typical symptoms such as dizziness, tremors, frequent urination and potency problems can be treated sustainably both with medication and with the measures mentioned above and often lead to an improvement in the quality of life of multiple sclerosis patients.

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Aftercare

Many people with multiple sclerosis suffer from the heteronomy that the disease brings with it. Because often every episode leaves one or more restrictions in daily life. The focus of aftercare is therefore on instruction, training and advice. People should be able to do everything they can and only receive support when necessary.

Relatives or caregivers can therefore work in a resource-oriented manner in the area of ​​washing and clothing. This means, for example, taking on the preparation and follow-up of daily morning hygiene or providing help with a lack of movement due to spasticity. If people suffer from polyneuropathy, relatives should inspect the feet and areas exposed to pressure for skin damage in order to identify pressure ulcers or injuries at an early stage and treat them.

When it comes to eating and drinking, relatives only provide support if mobility is so limited due to restricted coordination, tremors or spasticity that it would not be possible to eat. Special crockery or cutlery make it easier for those affected to eat and drink independently.

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

Due to the restricted mobility, carpets, doorsteps or other potential sources of tripping must be removed in the living space. Before each mobilization, a muscle-relaxing massage and movement of the joints is recommended in order to maintain mobility and normalize the tone.

Outlook & forecast

The prognosis for multiple sclerosis is very individual and accordingly only general statements can be made and favorable factors can be named. First of all, it should be noted that the disease leads to severe disabilities in around a third of those affected. Another third suffer from neurological limitations, some of which are still compatible with a professional life and also largely maintain independence. The last third can spend the whole life without major restrictions, but various minor disabilities or other ailments are possible. The independence of this last group remains in any case.

Furthermore, people with multiple sclerosis who only suffer from a relapsing course always have a better prognosis with regard to the development of further restrictions. In the chronically progressive course, severe limitations occur far more frequently and almost never regress.

It has also been shown that women have a better prognosis for a good life expectancy. This also applies to people who fall ill before their 40th birthday as well as to people with relapsing progression with a few relapses.

For the quality of life of those affected, modern therapies, the preservation of possible independence as well as psychological support and a stable environment are decisive. In many cases, life expectancy is hardly less than that of people who are not sick.

You can do that yourself

Multiple sclerosis is not curable, but the course of the disease can be positively influenced. In addition to long-term drug treatment, patients have other options for alleviating the symptoms and avoiding 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 influence on the course of multiple sclerosis. Support from friends and family members is also important. Social support can make a significant contribution to wellbeing and thus health.

A healthy life also protects against accompanying diseases of the cardiovascular system. The everyday complaints can be reduced with a few basic recommendations. It is important to take medication regularly, because only consistent treatment will bring the desired success. If side effects occur or if you wish to change your medication for other reasons, you must speak to the responsible doctor.

In principle, regular visits to the doctor are indicated so that a possible deterioration in health can be recognized quickly. Measures such as physiotherapy and sport also help against the typical symptoms. Sick people should also drink a lot and avoid or reduce any excess weight. Attending a self-help group can also be useful.