Multiple sclerosis, or MS for short, is a previously incurable inflammatory and chronic disease. This leads to destruction of nerve fibers in the central nervous system, i.e. in the brain or spinal cord. Typical of the disease are flare-ups with their symptoms, which lead to motor and sensory disorders in the long term.
What is multiple sclerosis?
Multiple sclerosis, MS for short, is a disease of the central nervous system. This leads to chronic inflammation in the spinal cord and brain, in which parts of the nerve fibers (marrow sheaths) are destroyed. In addition, the body’s own defense cells, which normally fight foreign pathogens, are damaged. Therefore, multiple sclerosis is also known as an autoimmune disease. See foodezine for Everything about Cancer.
Oddly enough, multiple sclerosis is more common in areas and countries farther from the equator. But there are also distinctive patterns of distribution of the frequency of multiple sclerosis within different countries. After epilepsy, MS is the most common chronic inflammatory disease of the human nervous system. In Germany, around 0.15 percent of the population suffers from multiple sclerosis. Younger women are affected more often than men.
Due to the destruction of the nerve fibers, those affected almost always suffer from motor problems or disorders of physical movement. In addition, the physical sensations are severely affected.
Causes
There are currently three main reasons for multiple sclerosis . The first cause can be an autoimmune disease. The immune system attacks the body’s own tissue. As a result, antibodies are formed that can trigger chronic diseases in the blood and are directed against the body’s own cells. In multiple sclerosis, these antibodies turn against the nerve tissue of the brain and spinal cord.
The second cause of multiple sclerosis is based on genetic or hereditary causes. For example, people whose close relatives have the disease are at a higher risk of MS. Nevertheless, multiple sclerosis is not considered a hereditary disease. Environmental factors can also bring about genetic changes in humans, which can then also lead to this disease as a result.
The last known cause is infections for multiple sclerosis. In this context, pathogens such as chlamydia, herpes viruses and the Epstein-Barr virus are considered possible causes of inflammation of the nerve fibers. If a patient is already suffering from multiple sclerosis, various other influences can also lead to the well-known flare-ups of the disease. Above all, stress, hormone disorders, infections, vaccinations and medication are then considered triggers.
Symptoms, Ailments & Signs
Multiple sclerosis is associated with many different symptoms. The disease also progresses at different speeds and the order in which symptoms appear is not fixed. However, at the beginning, walking difficulties, sensory disturbances in the legs, problems with bowel movements, visual difficulties in one or both eyes and severe tiredness are particularly common.
However, there are many other symptoms – such as facial paralysis and dysesthesias in the arms – that can occur initially. The symptoms of multiple sclerosis usually appear suddenly and show hardly any signs. The other symptoms usually appear during the course of the disease.
So it comes in 90 percent of the cases to spasms in the legs or lack of strength in them. Most of those affected are unsteady when walking or can no longer walk. Other common symptoms (occurring in at least two-thirds of those affected) include difficulty emptying the bladder, problems concentrating and blurred vision.
In about half of the cases, there are mental illnesses (e.g. depression or psychosis), speech disorders and difficulties in grasping or pointing. Facial paralysis occurs in a third of cases. In general, there may be pain and tingling sensations in the body. In rare cases, the cranial nerves become paralyzed.
Course of the disease
The course of multiple sclerosis depends on early detection and treatment by a doctor. Unfortunately, there is no complete cure for MS. Since the course of multiple sclerosis can be very individual and varied, a general description is not easily possible.
Nevertheless, one can often identify three major forms of progression. The first typical phase is relapsing and relapsing MS. The symptoms or complaints occur for several days in a row. In between, sometimes several years can pass without further complications. The longer an attack lasts, the higher the probability that residual damage to the nerve fibers will remain.
The second phase or progression is referred to as progressive and chronic. The symptoms usually appear slowly but persistently. Relapses, as in the recurring phase, do not occur. The third form is also progressive and chronic. The relapses become fewer and fewer, although the disorders of the nervous system remain the same. In summary, multiple sclerosis can take a benign course in which the affected person has various symptoms, but does not die from it. In rare cases, however, there is also a severe form of MS, which unfortunately ends in death because the nerve fibers in the brain have been damaged too much.
Complications
A chronic urinary tract infection caused by neurogenic bladder emptying disorders is one of the most common complications of multiple sclerosis. Recurring infections of the urinary bladder that are not treated or not treated adequately can spread to the kidneys and, in the worst case, lead to blood poisoning (urosepsis). Unsteady gait caused by the disease is often the cause of falls that result in broken bones.
Patients with multiple sclerosis who are bedridden or dependent on a wheelchair often suffer from pressure sores, joint stiffness and muscle cramps due to restricted mobility, and the risk of thrombosis is also increased. Osteoporosis and diseases of the airways such as bronchitis or pneumonia are in many cases also the result of inactivity caused by multiple sclerosis.
Other complications of the disease can include constipation, urinary and fecal incontinence. A reduced ability to concentrate, memory disorders and depressive moods often result in a change in personality, which also affects social behavior. The drugs needed to treat multiple sclerosis may weaken the immune system and make the body susceptible to viral, fungal or bacterial infections.
Therapy with interferon is often accompanied by flu-like symptoms, and allergic reactions are also possible. Sleep disturbances and problems in sex life can occur as a result of the disease itself or drug treatment.
When should you go to the doctor?
Multiple sclerosis is a disease that, due to its chronic nature and progression in flares, can repeatedly require a trip to the doctor. However, the first visits to the doctor serve to secure the diagnosis and to rule out other possible causes in the event of signs such as weakness, tingling or paralysis as well as paralysis. The first point of contact in this context is the family doctor, who will issue the necessary referrals to a neurologist or radiologist. After the diagnosis and, if necessary, medication adjustment, visits to the doctor are not absolutely necessary.
Flare-up marks a sudden change in the course of multiple sclerosis, which can remain stable for a long time and then manifest itself with new symptoms. Here it makes sense to see a doctor in order to be able to cope with the symptoms as best as possible. This often succeeds in cooperation with medical disciplines such as speech therapy, ergotherapy or physiotherapy.
Psychological problems can also make it necessary to go to the doctor or psychotherapist. If those affected do not cope well with multiple sclerosis, a professional contact person from the medical field is also useful here. He can catch the affected person in his mental state and give valuable tips for dealing with the mental illness. Caregiving relatives can also be involved here.
Treatment & Therapy
If multiple sclerosis is diagnosed during an examination by a doctor, therapy should be started as soon as possible. Because there is currently no cure for MS, the goal of treatment is to slow or stop the destruction of nerve fibers in the brain and spinal cord. The therapy of multiple sclerosis depends on its progression.
relapse therapy:
In the case of flare-up therapy, the main aim is to combat the complaints or symptoms associated with the flare-ups of MS. Drugs are used that strengthen the immune system and try not to attack the body’s own cells. Anti-inflammatory drugs or cortisone are also administered. Side effects here are often: sleep disorders, inner restlessness, palpitations and cravings.
basic therapy:
The basic therapy is intended to slow down the progression of physical motor skills and the senses and to weaken or prevent emerging flare-ups. In addition, the quality of life should be maintained by treating the symptoms. Medications include glatiramer acetate or interferon beta, which slow down the duration and frequency of multiple sclerosis flare-ups.
Therapy of the symptoms:
In addition to the basic therapy and relapse therapy, accompanying symptoms and complaints are also treated in order to reduce the suffering of those affected and to enable a life worth living. Physiotherapy, massages, pelvic floor training and relaxation methods are particularly successful here. Typical symptoms such as dizziness, tremors, frequent urination and erectile dysfunction can be treated sustainably with medication as well as with the measures mentioned above and often lead to an improvement in the quality of life of multiple sclerosis patients.
Aftercare
Many people with multiple sclerosis suffer from the heteronomy that the disease brings with it. Because often every push leaves behind one or more restrictions in everyday life. The focus of aftercare is therefore on guidance, training and counseling. People should be able to do whatever they can for themselves and only receive support when it is necessary.
In the area of washing and dressing, relatives or nursing staff can therefore work in a resource-oriented manner. This means, for example, taking over the preparation and follow-up of daily morning hygiene or providing help with movement deficits caused by spasticity. If those affected suffer from polyneuropathy, relatives should inspect the feet and pressure-exposed areas for skin damage in order to be able to identify and treat decubitus ulcers or injuries at an early stage.
Even with eating and drinking, relatives only give support if mobility is so severely restricted due to limited coordination, tremor or spasticity that eating would not be possible. Special dishes or cutlery make it easier for those affected to eat and drink independently.
When people with multiple sclerosis suffer from incontinence, therapists make a valuable contribution to bladder training or self-catheterization instructions. Adequate incontinence care can prevent infections and improve quality of life.
Due to the restricted mobility, carpets, doorsteps or other potential sources of tripping in the living space must be removed. Before each mobilization, we recommend a muscle-relaxing massage and moving the joints to maintain mobility and normalize tone.
Outlook & Forecast
The prognosis for multiple sclerosis is very individual and accordingly only general statements can be made and favorable factors named. The first thing to note is that the disease leads to severe disabilities in about a third of those affected. Another third suffer from neurological limitations, some of which are still compatible with a professional life and also largely preserve independence. The last third can spend their whole life without major restrictions, but various minor disabilities or other ailments are possible. In any case, this last group retains its independence.
Furthermore, people with multiple sclerosis who only suffer from a relapsing course always have a better prognosis with regard to the development of further restrictions. In the chronically progressive course, serious limitations occur far more frequently and also almost never recede.
It has also been shown that females have a better prognosis for a good life expectancy. This also applies to people who become ill before their 40th birthday as well as to people with a relapsing form with few relapses.
Modern therapies, the preservation of possible independence as well as psychological care and a stable environment are decisive for the quality of life of those affected. Life expectancy is often hardly lower than that of people who are not ill.
You can do that yourself
Although multiple sclerosis cannot be cured, the course of the disease can be positively influenced. In addition to long-term drug treatment, sufferers have other options for relieving symptoms and avoiding complications.
The doctor will first recommend a lifestyle change. Exercise and a balanced and healthy diet support the immune system and other organs that have a significant impact on the course of multiple sclerosis. Support from friends and family members is also important. Social support can contribute significantly to well-being and thus to health.
A healthy life also protects against accompanying diseases of the cardiovascular system. Everyday discomfort can be reduced by following a few basic recommendations. It is important to take medication regularly, because only consistent treatment will bring the desired success. If side effects occur or if you wish to change your medication for other reasons, you must speak to the responsible doctor.
In principle, regular visits to the doctor are indicated so that any deterioration in health can be recognized quickly. Measures such as physiotherapy and sport also help against the typical symptoms. Patients should also drink a lot and avoid or reduce any excess weight. Attending a self-help group can also be useful.
