Causes

The cause of multiple sclerosis encephalitis disseminata is controversially discussed because it has not yet been sufficiently researched. Various possibilities are under discussion: Which pathological (diseased) mechanisms characterize the disease, on the other hand, is well described: The nerve cords, which consist of many thin nerve fibers, are usually surrounded by a protein envelope. This serves to protect the nerves, but it also increases the conduction speed.

Thanks to this sheath of proteins (myelin), the so-called myelin sheath, signals can be transmitted very quickly. This transport of information occurs in two directions. On the one hand, commands are transmitted from the brain to the muscles, for example, in order to execute a voluntary movement.

On the other hand, sensations (sharp, blunt) or temperature (cold, warm) can also be directed in the other direction to the brain to be consciously perceived here. In the clinical picture of multiple sclerosis, a demyelination takes place for reasons as yet unexplained: The protein shell around the nerves slowly dissolves – in the brain, the white brain matter perishes. This demyelination occurs in patches.

The myelin-forming cells are replaced by nerve fibers.These areas are considered scarred (sclerosed). Once the protein sheaths of the nerves have degenerated, the speed of nerve conduction is greatly reduced. Due to the very long nerve tracts (e.g. to the foot), this can also mean a complete loss of function.

Particularly frequently affected are In the spinal cord, nerve tracts that play an important role in voluntary muscle movement are affected.

Cerebellum
Brainstem
Optic nerve and
The spinal cord.
It is an autoimmune disease. The body fights its own nerve sheath proteins.
A genetic component may also play a role.
The fact that in about 10 percent of cases there is a familial clustering is indicative.
A viral infection, which slowly leads to the development of MS, is also being considered. The viruses could be measles -, rabies – (rabies) or paramyxo – viruses.

To diagnose MS (multiple sclerosis), a medical history, physical examinations, possibly a lumbar puncture and an MRI are necessary. In some cases, the neurological examination may reveal an extinguished abdominal skin reflex.

In the past, computed tomography of the head (cCT) was one of the routine examinations for suspected multiple sclerosis. MRI of the brain is the examination method of first choice for diagnosing multiple sclerosis. The inflammatory foci are usually better visible here than in CT (computed tomography).

The MRT (magnetic resonance imaging) can be performed in different sequences. On the resulting images of some of them, old lesions, i.e. scars, can be better recognized. These are typically located next to the cavities (ventricles) of the brain, which are filled with liquor.

Other typical locations in multiple sclerosis are near the cerebral cortex or in the connecting structure between the two halves of the brain (the so-called bar). The most valuable diagnostic imaging tool in multiple sclerosis is the MRI of the head. MRI of the brain can reliably identify inflammatory foci in the brain or spinal cord.

By administering a contrast medium, the radiologist can differentiate between fresh lesions (e.g. in acute attacks) and old lesions (e.g. scars) in the nerve tissue. Improvements in MRI techniques have made the diagnosis much better, especially in the follow-up examinations.

The other technique, MRI (magnetic resonance imaging) of the head, mainly shows the new lesions with additional administration of contrast medium. They absorb the contrast medium injected into the patient through the vein and depict inflammatory processes. In order to test the functionality of the brain and its individual parts, functional tests can be performed on various sensory systems.

Here it can be tested whether visual or auditory impressions still reach the brain or how it reacts to them. Sensitivity (feeling touch and/or pain) and motor skills (movement of limbs by magnetic stimulation of brain regions) can also be tested. As expected, the potentials obtained are delayed.

The following are some of the characteristic findings of the extraction of cerebrospinal fluid (med. : liquor) within the scope of the so-called liquor diagnostics: clear fluid, many white blood cells, a lot of protein and an increased cell count. In the presence of MS, an independent production of antibodies in the cerebrospinal fluid is expected.

These can then also be detected. You can find out more about cerebrospinal fluid extraction under our topic: CSF diagnostics. The diagnosis MS is clear if: If only two of the three criteria mentioned are present, multiple sclerosis is still likely. After only one episode experienced so far, the grid shifts from “definite” to “probable”.

At least 2 demyelination foci located at a distance from each other can be detected in CCT (computed tomography of the skull) MRI (magnetic resonance imaging) and
A characteristic cerebrospinal fluid finding of CSF diagnostics is present AND
At least 2 relapses or progressive complaints for at least one year