Multiple sclerosis

We treat your disease comprehensively

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. Predominantly younger people are affected, women twice as often as men. MS can lead to temporary or permanent disabilities that affect family, partnership, work and one’s own mental state. There are as yet no known cure options. However, many drugs can have a beneficial effect on the course of the disease. In addition, there are proven treatment methods to alleviate symptoms and improve quality of life. Self-help groups and associations such as the German Multiple Sclerosis Society (DMSG) offer further help. 

At Schoen Clinic, we specialise in the diagnosis and treatment of multiple sclerosis. Our aim is to positively influence the course of the disease and to treat your symptoms with a view to achieving better quality of life.

Causes & symptoms

What is multiple sclerosis?

The disease process is at least partly caused by inflammation. The misguided immune system attacks its own nerve cells in the brain and spinal cord. This is also referred to as an autoimmune disease. 

MS usually occurs with a sudden symptom, such as paralysis, impaired vision or loss of sensitivity of a part of the body. This rapid onset is called a “relapse”. The impairments after a relapse can recede completely or only partially.

A typical feature of MS is that the inflammation can reoccur at different intervals in other parts of the nervous system. The name “multiple sclerosis” is derived from the fact that many (multiple) sites in the brain and spinal cord develop hardened scarring (sclerosis).

For 85 per cent of all persons affected, the illness is characterised by relapses with the regression of different symptoms and remission in-between. However, half of these patients experience a gradual deterioration after several years, called “secondary progressive” multiple sclerosis. 15 per cent have a gradual progression without any noticeable relapses from the beginning. 

Causes: How does multiple sclerosis develop?

It is assumed that the disease is triggered by the interaction of various factors:

It is known that multiple sclerosis is genetically caused and can therefore occur more frequently in a family. For example, if a monozygotic twin suffers from multiple sclerosis, the probability is 30 per cent that his twin will also develop MS. 

Certain environmental influences and geographical conditions can also influence the risk of MS. The closer to the equator a person grows up, the lower the risk of MS. Further south and north, the risk increases. Northern Europe and North America have the highest disease rates. Solar radiation may also play a role in a certain phase of the immune system’s development. 

In addition, there are signs that long-term contact with certain viruses can induce the immune system to display self-aggressive behaviour and thus indirectly increase the risk of MS. However, it is very unlikely that multiple sclerosis can be caused directly by a certain pathogen. 

Symptoms: Frequent indications of multiple sclerosis

MS symptoms are very varied. They can develop within hours or days and disappear partially or completely. They can also develop gradually over weeks or months.

 Frequent symptoms include:

  • Paralysis of the face, extremities or one side of the body, often associated with muscle cramps
  • Visual disturbances, such as blurred vision or significant impairment of vision, sometimes associated with pain behind the eyes
  • Sensory disturbances in different parts of the body (pins and needles, tingling, numbness), electrifying sensations in the extremities during neck flexion 
  • Unsteady gait, dizziness, balance or coordination problems with difficulty in grasping or writing
  • Bladder and bowel control problems with the sudden urge to urinate, incontinence or constipation
  • Eye movement disorders, such as double vision or involuntary jerky eye movements 
  • Speech disorders with unclear, blurred speech
  • Swallowing disorders

Symptoms: Nonspecific signals

  • Fatigue (increased exhaustion, fatigue, weakness, lack of concentration, lack of a recuperative effect)
  • Depression (lack of drive, listlessness, sleep disturbance, loss of interest, melancholy, suicidal thoughts)
  • Cognitive disorders (concentration and attention problems, memory disorders, slower reactions)
  • Pain (sometimes difficult to localize, diffuse, burning, tearing, crampy, occasionally suddenly shooting or electrifying)

Diagnostics

Diagnosis: We work according to international MS diagnostic criteria

The recording of the patient’s medical history and a physical and neurological examination take place first. There are also further examinations according to internationally defined criteria, such as magnetic resonance imaging.

Magnetic resonance imaging (MRI)

Magnetic resonance imaging allows for a very accurate and early diagnosis. A strong magnetic field picks up signals from different tissues in the brain and spinal cord and converts them into layered images with a very high resolution. This makes it possible, for example, to depict inflammatory focal points or damaged nerve cells.

Lumbar puncture (CSF analysis)

The brain and spinal cord are surrounded by cerebrospinal fluid. Lumbar puncture is a routine neurological examination of this cerebrospinal fluid. It is used to detect inflammation of the nervous system. The procedure is performed under local anaesthetic.

Evoked potentials

Certain inputs into the nervous system can be stimulated by minimal electrical, acoustic or visual stimuli. The reactions can be derived using surface electrodes and can give information about the condition of the nerve conduction in the central nervous system.