Prognosis

When multiple sclerosis is diagnosed, it is hardly possible to make a definitive prognosis due to the very different individual course of the disease. Although this uncertainty can be distressing, the large proportion of positive progressions should be the focus of patient education. The severity of the initial symptoms can be used to estimate a tendency that usually proves to be correct.

Even if it cannot be completely relied upon, a good prognosis can be assumed if the initial clinical picture is moderate. Life expectancy is hardly limited with good long-term and relapse therapy. Multiple sclerosis is by no means a death sentence, but the diagnosis must be handled responsibly – on the part of the doctor as well as the patient.

Multiple sclerosis (MS) is not a fatal disease in principle. Many patients live to be over 70 years old despite MS. Death can occur due to the consequences of the symptoms. It can happen that MS patients lose the ability to move efficiently at an advanced age.

As a result, they often become bedridden, which can also be the case with other diseases in old age. Bedriddenness is associated with an increased risk of pneumonia, which can kill older and immunocompromised patients. The suffering caused by the restrictions, which may build up over the course of many years, can cause psychological damage to the patient.

A resulting depression and life crisis could possibly drive the patient to suicide. Psychological support also plays an important role in the treatment of chronically ill patients. The majority of all MS patients therefore die a natural death or other illness.

In very rare cases, a lesion in the brain caused by MS is responsible for the onset of death. The damage must be relatively large and must be located in an area of the brain from which vital processes are controlled. Since no treatment method exists yet that would cure multiple sclerosis completely, the therapeutic options are mainly focused on slowing down or even stopping the progression.

Within the framework of this therapeutic goal, various drugs have been developed that both reduce the rate of relapses and slow down the progression of the disease. Three examples are listed below. Glatiramer acetate: This is a compound composed of four natural amino acids.

Daily injections under the skin (for example, into fatty tissue on the abdomen, such as insulin spikes) result in fewer relapses of inflammatory events. With permanent treatment, after 6 years of disease progression, a quarter of the treated patients are completely free of relapses. If long-term therapy is continued, no new permanent symptoms occur in 75% of patients.Beta-Interferon: This is a protein compound that can also be produced by the body’s own cells.

Interferons are mediators of the immune system and control various processes. For example, they also bring inflammation in MS under control, thereby prolonging the symptom-free phases between the much rarer attacks of the disease. Beta-interferon is injected once to three times a week under the skin or into the muscle (as with a vaccination).

Natalizumab: This drug is a so-called monoclonal antibody. This is an antibody developed in the laboratory, similar to those produced by the body’s own immune system. Instead of attacking certain pathogens or foreign substances, it binds to cells of the immune system.

This prevents these cells from migrating into the central nervous system and causing inflammation. The rate of relapse is thus reduced by 60 – 70 %. Natalizumab is a very strong drug with quite dangerous side effects. For this reason, it is only used in particularly severe MS courses.