An estimated half a million people in Germany suffer from the insidious multiple sclerosis (MS) disease. The course of the disease can vary dramatically from patient to patient; In addition, the form of progression may sometimes change significantly over time. The incalculable course of this chronic disease is associated with a considerable psychological burden on patients.
Distribution of MS
The spread of MS is similar to that of an infectious disease, which is found mainly in temperate climates. Mostly middle-aged women (35 to 40 years) are affected by the disease, they get two to three times more likely than men. In other parts of the world (for example, Southeast Asia), MS is almost unknown.
Causes and triggers
Multiple sclerosis is an inflammatory disease of the central nervous system, the triggers of which are still unknown. However, harmless infectious diseases such as rubella or measles as MS causes are hotly debated - the prevalence of disease cases in Central Europe may indicate this. Whatever the trigger, the consequences are grave: the cells of the immune system mistakenly attack, damage and destroy the body's own tissues; In this context, one speaks of an autoimmune disease.
More specifically, the fatty sheaths of the nerve cells of the brain (the so-called myelin sheaths) are damaged and destroyed. The myelin sheaths form an insulating layer around the long extensions of the nerve cells; their task is the rapid conduction of stimuli within the brain. If myelin sheaths are destroyed, motor and sensor failures are the result - depending on where in the brain the infectious focus is located.
The course of the disease varies from patient to patient and can not be predicted. Thus, the course can change several times within a few months or years - from standstill to progressive disability in the progressive case.
In around 85 percent of patients, relapsing-like worsening of the clinical picture occurs; Frequency of recurrence depends on the age of the patient and is more common in recent years. The health condition of the patient is mostly significantly improved one to two months after the end of the episode. The regression of the acute symptoms, however, depends on the course of the disease, which is difficult to predict.
About two-thirds of the patients show a transition to a so-called secondary-progressive course, in which a progressive deterioration can be demonstrated. Only five percent of patients suffer from severe disabilities.
Symptoms and diagnosis
The more typical initial symptoms include visual disturbances such as seeing double vision and bladder weakness. For example, the more unspecific MS symptoms must be differentiated from the common tick-borne borreliosis as part of the diagnosis; Damage to the central nervous system can be detected in both diseases. But also cerebral and spinal tumors and autoimmune diseases must be excluded.
Treatment and therapy
Unfortunately, there is currently no causative MS therapy. Since multiple sclerosis is not curable, the symptomatic treatment of MS is of great importance. With the drugs available on the market, the immune defense is generally weakened and thus slows down the erroneous destruction of the body's own myelin sheaths. The drug treatment of the various symptoms relieves the symptoms and thereby increases the quality of life. For the MS therapy, a step therapy has proven:
1. Basic therapy: Intramuscularly or intracutaneously injected immunomodulators (interferon-beta or glatiramine acetate) reduce the rate of recurrence and also the severity of the relapses.
2. Cytostatic agents: If the disease progresses nevertheless, low-dose cytostatics are used, as they are also used in cancer therapy.
3. Treatment of acute relapses: In case of an acute episode (worsening of the state of health over 24 hours) intravenous high-dose glucocorticoids (cortisone) are administered. This reduces the severity of the thrust and shortens the overall thrust. Depending on the condition of the patient, physiotherapy and exercise therapy are further cornerstones of the treatment. The physiotherapy exercises help to avoid complications and to improve the quality of life of the patients.