Therapy of Multiple Sclerosis and Other Inflammatory Diseases in Munich
Multiple sclerosis (MS) is a chronic disease of the nervous system, which is caused by the body’s own immune system (mistakenly). It destroys parts of the nerve fibers and nerve cells. This type of disease is called “autoimmune” i.e. inflammation by the patient’s own immune system. The nerve fibers are significantly involved in the transmission of impulses. With MS this transmission is disturbed. Depending on the location of the inflammation in the nervous system, the patient may experience various symptoms (e.g. visual disturbances, sensory disturbances, paralysis, coordination disorders, bladder disorders). The disease usually occurs initially in relapses, and the progression can vary greatly. Sometimes MS changes into a chronic progressive course or does not progress as much or at all in relapses.
How Diagnosing “MS”?
The most important thing is to perform an MRI of the brain and, if necessary, of the spine. Measurement of the sensory pathways (SEP) and visual pathways (VEP) is also important. If the MRI shows inflammatory lesions, a nerve fluid examination should be performed. As a rule, this is easily done on an outpatient basis. Here, certain parameters are examined (inflammatory cells, protein, immunoglobulins). On this basis the diagnosis of multiple sclerosis may be confirmed and other inflammations (i.e., infections with Borrelia, for example) may be excluded.
Subsequently, all findings and diagnoses should be discussed together with your physician. If you suffer from multiple sclerosis, the selection of a medication that helps your immune system to suppress this false reaction will take place.
The development of drugs against this false immune reaction is progressing rapidly, and in recent years, fortunately, quite a few drugs have been approved to reduce this reaction, so that the neurologist can individually select the best medication for the patient with multiple sclerosis. Early and appropriate medication significantly influences the progress of the disease. In later phases (i.e., in a purely progressive course), the medication options are fewer.
Additional Complaints in Multiple Sclerosis
In addition to the “failure symptoms” of the nervous system described above, other disorders often occur, such as memory/attention and concentration problems, sleep disorders, or pain. A so-called “fatigue” syndrome is a syndrome of exhaustion and fatigue that often causes patients to slow down and makes them exceptionally tired. Likewise, depression or other psychological problems can occur as a result of the disease.
These complaints should also be noted and investigated (e.g., neurologically, neuropsychologically, and possibly psychiatrically). Special forms of therapy for multiple sclerosis patients such as neuropsychological training, antidepressant medication, and physical activation are required here. If necessary, the initiation of rehabilitation may also be useful. At home, they should receive regular physiotherapy and, if necessary, occupational therapy and neuropsychological therapy (at least if they have permanent deficits).
What can a MS patient do himself to get a positive effect on course of the disease?
In the past, multiple sclerosis patients were advised not to engage in sports, but today we know that regular exercise and an active life have a significant positive impact on the course of the disease and the patients’ wellbeing. So you can make a significant contribution to your overall wellbeing and disease progression by staying active, challenging yourself mentally, and exercising regularly. However, this is often easier said than done with severe symptoms, particularly fatigue. Possible temporary deterioration through exercise can be unsettling for multiple sclerosis patients.
Together, we look at the current neurological and general physical fitness status. Then we work out a training program together. Our professional staff is specially trained in neurology and will be happy to assist you.
Exercise not only increases their general wellbeing, it reduces complaints such as fatigue, depression, cognitive complaints and contributes positively to the course of the disease. We are also happy to advise you on nutrition in MS. A special “diet” to cure MS unfortunately does not exist on a scientifically researched level. Nevertheless, there are some things you may consider regarding diet to influence your disease positively. Please feel free to make an appointment for nutritional counseling for this.
Q: How does multiple sclerosis (MS) manifest itself?
A: Multiple sclerosis can manifest itself in many complaints, depending on which brain region in the patient is affected by the inflammation. For example, an episode may manifest itself in sensory disturbances (tingling, numbness, etc.), paralysis, gait disturbances, coordination and speech disorders, or visual disturbances. In addition, fatigue symptoms, bladder disorders and memory and concentration disorders may occur in the course of the disease. Such neurological complaints should always be clarified.
Q: At what age does MS occur?
A: The first occurrence of MS happens mostly in young to middle aged people (between 20-40 years), there are proportionally more women than men affected overall. However, there are also cases that occur in adolescence or older, but these are not as common.
Q: What forms of multiple sclerosis are there? How do they progress?
A: There are very different courses of MS, so it is also impossible to predict how the disease will progress in an individual when it first appears. The most common form is so-called relapsing-remitting MS, that means relapses occur with varying frequency and the symptoms usually improve significantly again or disappear (even with cortisone therapy). Some patients have a very mild course and remain stable with now and then appearing relapses. In other patients, these episodes can be more severe and symptoms may persist permanently. In some patients, this form changes into a “secondary chronic progressive” course. Here, after a phase of relapses, there is a continuous deterioration of brain functions, i.e., there may be progressive gait disturbance, sensory disturbances, and cognitive complaints. Another, but rare form of MS is “primary progressive MS”, i.e. the symptoms do not occur in relapses, but deteriorate continuously from the beginning.
Q: What are the treatment options for people with multiple sclerosis?
A: Fortunately, there is a lot of research going on in multiple sclerosis, and there are a number of drugs that are now routinely in use. In principle, for the relapsing forms, there are now good and effective drugs in use, because the active inflammation in the brain can be well controlled (e.g., interferons, dimethyl fumarate, fingolimod, natalizumab, etc.). However, for the chronic form of progression, there are still few options, as this is also a brain degradation that can be poorly addressed by anti-inflammation. The following applies: an early and effective therapy improves the further course and the degree of disability in the following years. In a relapse, regardless of the basic therapy, a quick presentation to the doctor should always be made in order to carry out a very effective cortisone shock therapy. In addition to drug therapy, regular exercise and sports are an important part of therapy, as well as occupational therapy, neuropsychological therapy and physiotherapy, depending on the symptoms.