Multiple Sclerosis | Specialists and Information

MS is a chronic disease of the nervous system. Most nerve fibers are surrounded by a layer called myelin. This layer insulates the nerve fiber from the surrounding tissue. It ensures that information flows through the nervous system smoothly and at high speed, much like in electrical cables.

Inflammatory processes damage and destroy the myelin sheath. As a result, nerve impulses are no longer transmitted optimally. Depending on which area is affected by the disease, various symptoms may appear—ranging from visual disturbances to muscle weakness.

Multiple sclerosis is more common among young adults in Western industrialized nations. A 2009 study by Charité found the highest incidence rates in Europe, North America, and Australia. In these regions, at least 30 out of every 100,000 residents suffer from multiple sclerosis. There are approximately 120,000 people with MS living in Germany. The disease is not contagious.

The earliest records of the progression of multiple sclerosis date back to the 19th century. A grandson of George III described the symptoms of MS in his diary.

Despite intensive research efforts, it has not yet been possible to identify clear triggers for the disease.

Currently, the medical community assumes that multiple sclerosis is triggered by a combination of several factors:

• genetic predisposition
• Childhood obesity
• Environmental toxins, such as cigarette smoke
• Infectious diseases caused by herpes or measles viruses

In addition, researchers are discussing the following hypotheses:

• Hormone hypothesis: Women are more likely to develop the disease than men
• Hygiene hypothesis: Children with multiple siblings are less likely to develop the disease than only children; their immune systems learn from the very beginning to cope with a wide variety of pathogens.
• Vitamin D metabolism hypothesis: The risk of developing multiple sclerosis decreases with proximity to the equator.

This video explains the development of multiple sclerosis

The disease typically develops between the ages of 20 and 40. The initial symptoms lead patients to see their primary care physician, who then refers them to a neurologist.

People with the following symptoms typically visit their primary care physician:

• Vision problems
• Balance problems
• Paresis, or signs of paralysis
• Sensory disturbances
• Fatigue: tiredness or exhaustion syndrome

A twitching eyelid is very rarely associated with MS.

Conventional medicine also refers to multiple sclerosis as encephalomyelitis disseminata (ED). The World Health Organization’s current classification system, ICD-10-2016, codes MS under code G35.

During a detailed consultation—the medical history—the physician assesses the patient’s symptoms. He or she gains an understanding of the patient’s living situation and medical history and asks about any cases of multiple sclerosis in the patient’s family. In addition, the doctor assesses basic neurological functions such as balance, coordination, mobility, and sensory function.

There is no blood test that definitively diagnoses multiple sclerosis. Nevertheless, a comprehensive blood test is important to rule out other conditions. For example, HIV, Lyme disease, and some metabolic disorders can cause similar symptoms.

MRI scans and lumbar punctures provide very important clues for diagnosis. Using magnetic resonance imaging (MRI), the neurologist creates an image of the brain. The image resembles an X-ray. However, the patient is not exposed to any dangerous radiation. MRI uses powerful magnets.

During a lumbar puncture, a specialist inserts a hollow needle into the lumbar spine. Through the needle, the specialist collects cerebrospinal fluid, which is then tested in the lab for specific proteins. MS is associated with elevated levels of these proteins.

If the test results confirm a diagnosis of MS, the patient must come to terms with an incurable disease. It primarily manifests in three different courses.

Relapsing-remitting course

In this case, multiple sclerosis manifests in clearly distinguishable relapses. The symptoms subsequently subside partially or even completely. Forty percent of those affected experience MS in this way.

Chronic-progressive course

Another 40 percent of MS patients experience individual relapses without the symptoms subsiding between them.

Primary progressive course

Only about ten percent of those affected have to live with this form of multiple sclerosis. The symptoms no longer subside and continue to worsen.

According to Charité, people with MS typically die about thirty years after the first onset of the disease. In countries with good medical care, life expectancy has been rising steadily for years.

Multiple sclerosis is a serious disease; it turns the lives of patients and their families upside down. It is not uncommon for a person with MS to develop depression that requires treatment.

For this reason, treatment is ideally supported by a team of neurologists, psychologists, nursing staff, and social workers. The focus is on administering various medications:

• Acute relapses: primarily corticosteroids
• Long-term treatment: for example, interferons or dimethyl fumarate
• highly active disease courses: for example, natalizumab or mitoxantrone

In addition, occupational and physical therapy help alleviate motor symptoms. If speech difficulties arise, speech-language pathologists offer their assistance.

If you experience the symptoms listed above, a neurologist is the right person to consult. This specialist in the nervous system focuses on the diagnosis and treatment of neurological disorders. Anyone wishing to become a neurologist must first study medicine. This is followed by a five-year residency to become a board-certified neurologist.

Neurologists frequently collaborate with experts from other disciplines, particularly in the symptomatic treatment of multiple sclerosis. For example, physical therapists can use physical therapy to alleviate pain and spasticity. In cases of swallowing and speech disorders, the neurologist may consult a speech-language pathologist.

Multiple sclerosis is a severe blow to those affected. However, the high-quality medical care available in Central Europe gives patients and their families every reason to work toward a future worth living.