Which organs are affected by multiple sclerosis

Multiple Sclerosis: Disease with 1,000 Faces

Status: 01/20/2020 1:06 p.m. | archive

Multiple Sclerosis (MS) is also known as the "Disease with the 1,000 Faces". The disease can develop so differently from patient to patient that general statements can only be made to a limited extent. In Germany at least 130,000 people are affected by this chronic inflammatory disease of the nervous system, women about three times as often as men. Most people are diagnosed with MS in early adulthood.

The cause of multiple sclerosis is still unclear

In multiple sclerosis, misdirected immune cells attack the nerves - this leads to inflammation and pain. The causes of the malfunction have not yet been clearly clarified. Research suggests that there is a connection between the composition of the intestinal flora and diseases of the brain - called the "gut-brain axis". Researchers assume that the central trigger is an initially harmless viral infection in childhood or adolescence that disrupts the activity of the immune system.

MS is not contagious. It is also not a hereditary disease in the classic sense, even if it can occur in families.

Different disorders first Symptom of MS

Conspicuous signs of multiple sclerosis are neurological disorders that can last for hours or days in different parts of the body. The following symptoms may occur individually or in combination:

  • Visual disturbances (double vision)
  • Leg pain
  • Paralysis
  • Bladder and bowel disorders
  • Balance and coordination disorders
  • Speech disorders
  • Tingling sensation and other sensory disorders
  • chronic fatigue
  • sexual disorders

At first the disturbances disappear again or only minor complaints remain. Over time, new ones are added, some of which are permanent. Typical of the course of MS: The severity of the symptoms increases with the course of the disease, but some disorders are temporary. One speaks of thrusts.

The Diagnosing multiple sclerosis is not easy

MS is often difficult to diagnose, even for experienced general practitioners, because of its different manifestations.

First of all, a careful survey of the medical history, the anamnesis, is required. Typically, this is followed by a neurological examination of the musculoskeletal system, coordination, balance and sensory organs. Magnetic resonance imaging (MRI) is also used to create images of the brain and spinal cord. A so-called lumbar puncture (the removal of nerve water with a hollow needle from the spinal cord at the level of the lumbar spine) provides information about inflammatory cells and certain suspicious proteins. A blood test may not be able to detect MS, but it is still important to rule out other diseases with similar symptoms.

The clinical appearance must be compared with the previous course of the disease, the neurological examination results and the findings from the additional examinations are then to be viewed in an overall view. According to the so-called McDonald criteria, the diagnosis of MS can under certain circumstances be considered confirmed after the first attack.

Strengthen the immune system through nutrition

So far, MS is not curable, but treatable. It's about slowing down the course of the disease and maintaining the quality of life as much as possible. With diet, people with MS can try to strengthen their immune defenses and minimize inflammation. The diet should therefore primarily consist of vegetables, high-quality oils, nuts and seeds. The anti-inflammatory omega-3 fatty acids have a particularly positive effect. Carbohydrates (such as bread, pasta, sugary foods), on the other hand, should be avoided.

"Ketogenic nutrition" is one approach: Instead of glucose (blood sugar), so-called ketone bodies are supposed to cover the energy needs of organs and the brain. Ketone bodies are created when there is a lack of carbohydrates - the liver then converts fatty acids into energy suppliers. High-fat sources of protein such as fish, poultry, eggs, and high-fat milk and milk products should be consumed daily.

Another approach is to ensure more good intestinal bacteria: with probiotics and prebiotics. Because intestinal bacteria produce valuable short-chain fatty acids such as butyrate and propionate from foods rich in fiber. They are used to repair nerve cells.

According to recent studies, propionic acid can boost the immune system. Propionic salt is available as a dietary supplement.

Anti-inflammatory drugs

In acute attacks, patients receive high-dose anti-inflammatory drugs, mostly steroid hormones (corticosteroids). Immunostimulating interferons and immunosuppressants - i.e. drugs that dampen the immune system - will be postponed to so-called basic and escalation treatment. They are designed to stop the progression of this chronic disease.

Accompanying treatment approaches for multiple sclerosis

In addition, there are physical and occupational therapy measures, speech therapy help and - very importantly - psychotherapeutic support. Acupuncture, homeopathic or anthroposophic healing methods (such as artistic therapy, wraps and pads) can complement the therapy. They should definitely be discussed with the attending physician.

Stem cell transplantation for the most severe cases

When drugs have little or no effect and the MS progresses rapidly and aggressively, a new, healthy immune system can develop from your own stem cells. The stem cells migrate from the bone marrow into the bloodstream through a drug and are removed with a kind of blood wash. These precursor cells can later develop into healthy immune cells that no longer attack the nervous system. With a high dose of chemotherapy, the sick immune system is first destroyed. This can be life-threatening because the patient has no white blood cells for about ten days. Since there is a high risk of infection, he has to spend this time in the isolation ward. Then he gets his own, previously removed stem cells back. They should grow in the bone marrow and build up the fresh immune system.

Problem of assumption of costs

Stem cell transplant is more potent than drugs it has been compared to. A meaningful study has shown: MS progressed with stem cells in only three out of 52 cases, in the drug group in 30 out of 50. Many transplant recipients have had no more MS relapses - sometimes for ten years. However, the health insurance companies usually refuse to cover the costs of stem cell therapy.

Experts on the subject

Prof. Dr. Christoph Heesen, senior physician and head of the MS outpatient department
Multiple sclerosis day clinic
Institute for Neuroimmunology and Multiple Sclerosis
Department of Neurology
University Medical Center Hamburg-Eppendorf
Martinistrasse 52
20246 Hamburg
www.uke.de

Prof. Dr. Heinz Wiendl, director
Clinic for Neurology with Institute for Translational Neurology
University Hospital Münster
Albert Schweitzer Campus 1
48149 Munster
www.ukm.de

Prof. Dr. Nicolaus Kröger, director
Stem Cell Transplant Clinic
University Medical Center Hamburg-Eppendorf
Martinistrasse 52
20246 Hamburg
(040) 74 10-558 64
www.uke.de

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