Multiple Sclerosis: Symptoms, Diagnosis, Therapy | NDR.de – Guide

Multiple Sclerosis: Symptoms, Diagnosis, Therapy |  NDR.de – Guide

Status: 05/02/2022 10:56

Multiple sclerosis is an autoimmune disease that progresses in phases. If the drugs don’t work, a stem cell transplant can help. But health insurance companies rarely pay for the therapy – a study on this has now been completed.

Multiple sclerosis (MS) is also known as the “disease with a thousand faces”. It can take such different courses 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 more often than men. Most affected individuals are diagnosed with MS in early adulthood.

causenot for autoimmune disease still unclear

In multiple sclerosis, misdirected immune cells attack nerves, causing inflammation and pain. The causes of the faulty order have not yet been clearly clarified. Research suggests there is a link between gut flora composition and brain disease – called the “gut-brain axis”. Researchers speculate that the central trigger is an initially harmless viral infection in childhood or adolescence that disrupts immune system activity.

MS is not contagious. It is also not a hereditary disease in the classic sense of the word, although it can be hereditary.

Different glitches like first MS symptoms

Significant signs of multiple sclerosis are neurological disorders, especially deficits that last for hours to 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 and other sensory disturbances
  • chronic exhaustion (fatigue)
  • sexual disorders

At first, the disorders disappear again or only minor symptoms remain. Over time new ones will be added, some of which are permanent. Typical of the course of MS: The severity of symptoms increases as the disease progresses, but some disorders appear only temporarily. We are talking about flare-ups.

Further information

Multiple Sclerosis: Symptoms, Diagnosis, Therapy |  NDR.de – Guide

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Diagnosis with MRI, lumbar puncture and blood test

Due to the different manifestations, MS is often difficult to diagnose, even for experienced doctors.

The first step is a careful investigation of the medical history, anamnesis. This is usually followed by a neurological examination of the musculoskeletal system, coordination, balance and sensory organs. Images of the brain and spinal cord are also created using magnetic resonance imaging (MRI). A so-called lumbar puncture (removal of cerebrospinal fluid with a hollow needle from the spinal cord at the level of the lumbar spine) provides information on inflammatory cells and certain suspicious proteins. Although a blood test cannot detect MS, it is still important to rule out other conditions with similar symptoms.

The clinical aspect is to be compared with the previous evolution of the disease, the result of the neurological examination and the results of the complementary examinations are then to be considered in an overall view. According to the so-called According to the McDonald criteria, the diagnosis of MS can already be considered certain after the first episode.

Strengthen the immune system through nutrition

MS is not yet curable, but treatable. The objective is to slow the progression of the disease and to preserve the quality of life as much as possible. Along with a diet, people with MS can try to boost their immune system and minimize the inflammatory process. The diet should therefore consist mainly of vegetables, high-quality oils, nuts and seeds. The anti-inflammatory omega-3 fatty acids in particular have a positive effect. Carbohydrates (eg bread, pasta, sugary foods), on the other hand, should be avoided.

Another approach is to provide more good gut bacteria: with pro- and prebiotics. Because gut bacteria produce valuable short-chain fatty acids such as butyrate and propionate from fiber-rich foods. They are needed to repair nerve cells.

According to recent studies, propionic acid can strengthen the immune system. Propionate is available as a dietary supplement.

anti-inflammatory drugs

In the event of acute flare-ups, patients are given high doses of anti-inflammatories, mainly steroid hormones (corticosteroids). Immunostimulating interferons and immunosuppressants – that is, drugs that weaken the immune system – are prescribed for the so-called basic and escalation therapy. They are designed to stop the progression of this chronic disease.

Concomitant treatment approaches for multiple sclerosis

In addition, there are physiotherapeutic and occupational therapy measures, speech therapy assistance and – very important – psychotherapeutic support. Acupuncture or anthroposophical healing methods (such as art therapy, wraps, and tampons) can complement the therapy. They must absolutely be discussed with the doctor treating you.

Stem cell transplant for the most serious cases

If medications have little or no effect and MS progresses rapidly and aggressively, a healthy new immune system can develop from your own stem cells. A drug causes stem cells from the bone marrow to migrate into the bloodstream and are flushed out by a kind of blood wash. These progenitor cells can then develop into healthy immune cells that no longer attack the nervous system. High-dose chemotherapy destroys the diseased immune system. This can be life-threatening because the patient has no white blood cells for about ten days. As there is a high risk of infection, he must spend this time in the isolation room. Then he retrieves his own stem cells, which he had previously removed. They should grow in the bone marrow and strengthen the new immune system.

Stem cell therapy: no reimbursement despite high efficiency

Stem cell transplantation is more effective than the drugs it has been compared to. A significant A study showed: With stem cells, MS only progressed in three out of 52 cases, in the drug group in 30 out of 50 cases. some cases for ten years.

Another study was launched in Germany in order to obtain a health insurance license – and thus the assumption of the costs by the health insurance companies. Although many participants have shown that stem cell transplantation is an effective method of influencing the immune system and controlling previously incurable MS, health insurance companies continue to refuse to cover the costs.

The study had to be stopped for financial reasons. For those affected, the termination means they have to fight with their health insurance company to get the costs approved. As a rule, health insurance companies refuse to cover the costs of stem cell therapy. It is now possible in this country to pay for stem cell therapy oneself, or the persons concerned must have the treatment carried out abroad – cost: 45,000 to 50,000 euros.

subject specialists

Senior Physician and Head of the MS Outpatient Clinic
Multiple Sclerosis Day Clinic
Clinic and polyclinic of neurology
Chief and Neurocentre
Hamburg-Eppendorf University Hospital
Martinistraße 52
20246 Hamburg
www.uke.de

Further information

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