Multiple Sclerosis

Relapsing-remitting MS:

In this type, the most common one, neurological symptoms flare up before fading away again partially or completely after a few weeks. Over the years, most patients find that the condition increasingly affects their bodily functions. Approximately one fifth of patients have a mild form of the disease with little or no functional impairments.
 

Secondary-progressive MS:

This form of the disease starts out as relapsing-remitting MS, before symptoms start to steadily deteriorate 10 to 20 years after the onset of the disease. Sometimes it becomes impossible to tell when acute relapses start and finish. Some patients will experience additional relapses, however, not all do.

Primary-progressive MS:

This type of multiple sclerosis usually commences late in life and patients do not experience the relapses typical for other types of the disease. Symptoms gradually worsen over time and there are no symptom-free phases.

Clinically isolated syndrome: (CIS)

CIS is the term used when a patient displays symptoms typical for MS but the disease cannot yet be diagnosed. This may be the case, for instance, if a patient has experienced a first acute episode of symptoms, but these have faded away again entirely, making it difficult to find sufficient direct evidence of the disease. CIS may develop into MS over time, allowing the condition to be diagnosed after the second relapse.


 

The causes of the disease are not yet fully understood. It is thought that there are several contributing factors. The immune system has a major role to play. Immune cells malfunction and start to attack the body’s own tissue. T-lymphocytes and B-cells find their way into the central nervous system and cause inflammation. The malfunctioning cells predominantly damage nerve cells and nerve fibres, as well as myelin, a membrane which acts as a protective sheath for nerve fibres in the brain and spinal cord.

Intensive research is still being carried out into the contribution genetic factors, environmental influences and infections make towards triggering the onset of the disease. Researchers are also keen to discover why women are more often affected than men by a remitting-relapsing form of the disease.

 

Vision problems, sensory problems, coordination problems or paralysis are typical symptoms of multiple sclerosis. When the disease first appears, patients often notice vision problems or unusual sensations in their arms, torso or legs, such as numbness or tingling. Minor affective disorders may also occur, for example euphoria, feelings of depression or emotional instability.

The first symptoms usually appear during an initial episode between the ages of 15 and 40. Whilst patients often recover entirely from relapses at the beginning if they receive suitable treatment, lasting neurological deficits often remain after relapses in the later stages of the disease, and may get steadily worse over time. Problems with gait and bladder function are typical for later stages of the disease.

The disease takes many different forms. Patients experience a wide range of different symptoms. Depending on which part of the central nervous system is affected, the following symptoms may arise:

- Sensory problems (may only affect certain patches)
- Weak muscles and paralysis
- Movement disorders
- Fatigue

Although the autoimmune disease cannot be cured, there are various treatment options. As well as symptomatic approaches aimed at easing symptoms and preventing possible complications, patients at the DZI can benefit from a wide range of possible options involving immunotherapy.

Immunotherapy generally refers to all methods which use the body’s own immune system to regulate disease. Various different approaches are available. The two main approaches for multiple sclerosis focus on treatment aimed at impeding inflammatory reactions during relapses, and disease modifying treatment aimed at preventing new relapses.

Immunotherapy has been used to treat multiple sclerosis for years now. In addition, clinicians from the Department of Neurology are working at the DZI to continually improve immunotherapy treatments. This ensures that our patients can benefit from cutting-edge treatment at all times.

Studies are also being carried out into new innovative treatments. These include innovative antibody treatments that modulate the immune system, treatments using small molecules or treatments using substances connected to the human microbiome.

The Department of Neurology is currently involved in various studies investigating different targeted approaches for using immunotherapy to treat MS, and patients are given the chance to participate. We have powerful cutting-edge equipment at our disposal for examinations, including optical coherence tomography for specific cases. As an MS centre recognised by the Deutsche Multiple Sklerose Gesellschaft (German Multiple Sclerosis Society, DMSG), and an associate member in the Klinischen Kompetenznetz Multiple Sklerose (Competence Network Multiple Sclerosis, KKNMS) and the Zentrum der Neuroemyeliitis optica Studiengruppe (Neuromyelitis optica study group, NEMOS), we can offer comprehensive patient care from the initial medical examination through all stages of treatment.

Do you have any questions on the treatment of multiple sclerosis? Please feel free to get in touch with us by phone, e-mail or via our contact form.