Multiple sclerosis is an inflammatory disease of the nervous system that affects more than 200,000 people in Germany and can have very different courses. Still, despite intensive research, the exact mechanisms of the development of MS are unclear. All information about causes, symptoms, diagnosis, therapy and course of this disease.
What is multiple sclerosis?
How long multiple sclerosis (MS) – a chronic inflammatory disease of the nervous system – has existed is unknown. Probably the first appropriate description of the symptoms of MS dates from 1395, and the German poet Heinrich Heine also suffered from symptoms that could be attributed to MS. Multiple sclerosis, also called encephalomyelitis disseminata (ED), is often equated with rapid disability and wheelchair disability. But fortunately, multiple sclerosis often has a less dramatic course. The course varies widely, which is why multiple sclerosis is also called the disease with 1,000 faces. For example, initially there may be only a few symptoms that hardly worsen, the disease may progress continuously, or it may worsen again and again in the form of individual disease episodes. The spread of MS increases with the distance from the equator, so the disease occurs mainly in temperate climates. Worldwide, about 2.5 million people are affected. Women contract the disease about twice as often as men; the first signs usually appear between the ages of 20 and 40.
Causes of multiple sclerosis
In MS, the fatty sheaths of the nerve cells of the brain and spinal cord (called myelin sheaths) are damaged and destroyed by inflammatory processes (demyelination). The myelin sheaths act as an insulating layer around the long extensions of the nerve cells; their function is the rapid conduction of impulses within the brain. If the myelin sheaths are destroyed, motor and sensory function failures are the result – depending on where exactly in the brain the infectious focus is located. As a result, the transmission of information suffers there and the areas otherwise supplied with information by these nerves – for example the eyes or the skin – fail. According to current knowledge, multiple sclerosis is based on several factors that interact in this disease. At the heart of MS is the immune system, in which some of the immune cells mistakenly target the body’s own tissue – the protective sheaths (myelin sheaths) of the nerve fibers – and trigger an inflammatory reaction there. However, what causes this misdirected immune response (autoimmune disease) is unclear.
MS triggered by viral infection?
As early as the end of the 19th century, scientists suspected that an infection might be the cause of the inflammation in multiple sclerosis. Even today, infections with viruses in childhood in particular are suspected as triggers, such as the causative agents of rubella and measles, herpes, or the Epstein-Barr virus. Other environmental influences such as a lack of sunlight and vitamin D are also discussed as possible causes. In addition, there is probably a genetic component, with at least a tendency for multiple sclerosis being inherited.
Symptoms in MS
Symptoms in multiple sclerosis vary widely, ranging from minor signs to a full-blown MS flare. The symptoms that occur depend on which areas of the nervous system are affected by the inflammation. Possible signs include visual disturbances such as double vision, bladder weakness, tingling in fingers and toes; dizziness is also common. Read more about symptoms and signs in MS here.
Diagnosis and progression in MS
The frequency and severity of a relapse in MS varies widely, and the course is difficult to predict because the disease can present in very different ways. In some sufferers, relapses occur infrequently, in about two-thirds of those affected, bodily functions deteriorate over the years, and in five percent, multiple sclerosis results in permanent severe disability. The diagnosis of multiple sclerosis is not easy due to the wide range of symptoms. The medical history (anamnesis) and the results of physical and technical examinations are taken into account. Typically, the following examinations are performed:
- Magnetic resonance imaging (MRI)
- Evoked potentials (to test nerve function and conductivity).
- Examination of the cerebrospinal fluid (CSF puncture).
- Blood and urine tests
This can be used to diagnose multiple sclerosis and rule out other causes of symptoms.
What is the therapy for multiple sclerosis?
Multiple sclerosis is not yet curable, so therapy mainly treats the symptoms. The goal of therapy is to relieve the symptoms of those affected. This includes making signs of a relapse disappear, slowing the progression of the disease, and preventing complications and long-term limitations. Various drug therapies are available. Read more about therapies for MS here.
Can multiple sclerosis be prevented?
Because causes are unknown, multiple sclerosis cannot be prevented. However, it is known that some factors can negatively affect the course or trigger a relapse. These factors include major physical and emotional stress, such as surgery (OP), a febrile illness, or infection. Staying in warm climates also seems to have an unfavorable effect on multiple sclerosis. Hormonal changes, such as after pregnancy, can also trigger a relapse.
Immune system and MS
It is important for affected individuals to know: Actions that affect the immune system can worsen multiple sclerosis. These include hyposensitization for allergy, vaccinations, and agents that stimulate the immune system (including herbal medicines). The Robert Koch Institute recommends that people with MS receive the scheduled vaccinations because there is no scientific evidence against them, but a viral infection has been shown to worsen the disease.
Living with MS
Living with multiple sclerosis initially means coming to terms with the fact that you have a chronic disease. Although there is a rule of thumb that states that the expression of disability five years after the onset of multiple sclerosis is about three-quarters of the disability that will be reached after 10 to 15 years, the individual MS course cannot be predicted. MS progression is more likely to be favorable in:
- Women
- First illness under 40 years of age and with initially only one MS symptom
- Complete regression of symptoms after the first MS episode
It is important to recognize and avoid the individual relapse triggers, to seek a competent doctor and to be in close contact with him. To what extent multiple sclerosis has an impact on the exercise of the profession or limits physical performance varies. Working with MS is possible, but varies from person to person. Support and exchange of experiences with multiple sclerosis are offered by self-help groups, for example by the German Multiple Sclerosis Society. Read more about nutrition, sports, and working with multiple sclerosis here.
