Mandatory medical device diagnostics. Eye examination – if optic neuritis is suspected. Slit lamp examination (slit lamp microscope; viewing of the eyeball under appropriate illumination and high magnification; in this case: Viewing of the anterior and middle segments of the eye). Ophthalmoscopy (ocular fundus examination; examination of the central fundus) – to diagnose optic neuritis … Multiple Sclerosis: Diagnostic Tests
An at-risk group points to the possibility that the disease may be associated with the risk of vital substance (micronutrient) deficiency. Multiple sclerosis (MS) complaint indicates vital nutrient (macro- and micronutrient) deficiency for: Vitamin B12 Omega-3 fatty acid docosahexaenoic acid Omega-3 fatty acid eicosapentaenoic acid Amino acid tryptophan Within the framework of micronutrient medicine (vital … Multiple Sclerosis: Micronutrient Therapy
To prevent multiple sclerosis, attention must be paid to reducing risk factors. Behavioral risk factors Diet Consumption of animal fats and meat High intake of saturated fatty acids (SFA). High salt intake – (co)factor in the development of autoimmunity; is controversial. Micronutrient deficiency (vital substances) – see prevention with micronutrients. Consumption of stimulants Tobacco (smoking, … Multiple Sclerosis: Prevention
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Vascular malformations – vascular malformations. Eyes and eye appendages (H00-H59). Anterior ischemic optic neuropathy – acute occlusion of an ophthalmic artery supplying the optic nerve in the tin Haller vascular cortex; also called ocular infarction. Blood, blood-forming organs – immune system (D50-D90). Antiphospholipid syndrome (APS; antiphospholipid antibody syndrome); … Multiple Sclerosis: Or something else? Differential Diagnosis
The following are the major diseases or complications that may be contributed to by multiple sclerosis (MS): Respiratory system (J00-J99) Pneumonia (pneumonia) Eyes and eye appendages (H00-H59). Visual impairment Mouth, esophagus (food pipe), stomach and intestines (K00-K67; K90-K93). Constipation (constipation) – due to degenerative processes of the enteric nervous system (ENS; “abdominal brain”): The myenteric … Multiple Sclerosis: Complications
Stages and courses of multiple sclerosis (MS): Clinically isolated syndrome (CLS) – initial stage of clinical presentation. There is an initial symptom suggestive of multiple sclerosis. The diagnosis is not yet confirmed; however, a second episode occurs in 30% of patients with HIS within one year. Relapsing-remitting (“RRMS”) form of progression. Sudden onset of disease … Multiple Sclerosis: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Gait [ataxia (gait disorders)] Tremor [tremor] Extremities Auscultation (listening) of the heart Auscultation of the lungs Palpation (palpation) of the abdomen (abdomen), etc. Ophthalmological examination … Multiple Sclerosis: Examination
1st-order laboratory parameters-obligatory laboratory tests. Small blood count Differential blood count* Inflammatory parameters – CRP (C-reactive protein) or ESR* (erythrocyte sedimentation rate). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance). Electrolytes … Multiple Sclerosis: Test and Diagnosis
Therapy goals Early detection (“ascertainment”) of disease activity. Improvement of symptomatology and modification of the course of the disease. Freedom from measurable disease activity (“No evidence of disease activity”, NEDA). Long-term disability progression Therapy recommendations Optic neuritis: 500-1,000 mg methylprednisolone/day, i.v., for 3-5 days; during steroid therapy for ulcer prophylaxis, a proton pump inhibitor Therapy … Multiple Sclerosis: Drug Therapy
The following symptoms and complaints may indicate multiple sclerosis (MS): Early symptoms Optic neuritis (inflammation of the optic nerve; synonyms: Neuritis nervi optici; retrobulbar neuritis; usually unilateral/only 0.4% of patients develop disease in both eyes simultaneously; most common symptom of a relapse of MS; approximately 50% of patients with typical optic neuritis develop multiple sclerosis … Multiple Sclerosis: Symptoms, Complaints, Signs
Pathogenesis (disease development) The exact mechanism of the development of multiple sclerosis (MS) is not yet fully understood. What seems certain is that the body’s immune system overreacts, targeting the myelin sheath and autoaggressively destroying (destroying) it. Myelin is a lipid-rich biomembrane that spirally surrounds and electrically insulates the axons (axial processes) of nerve cells. … Multiple Sclerosis: Causes
General measures Fall prevention (see below “Fall propensity/prevention/measures for fall prevention”). Nicotine restriction (refraining from tobacco use). Improves the prognosis in terms of the degree of disability. Has an impact on the time to transition to secondary chronic progression (SPMS): each additional year of smoking after diagnosis accelerates time to SPMS conversion by 4.7 Avoidance … Multiple Sclerosis: Therapy
