Despite intensive research, scientists still do not know what actually causes multiple sclerosis (MS). A whole bundle of causes is suspected. In contrast, considerable progress has been made in the treatment of the autoimmune disease over the last two decades. The German Multiple Sclerosis Society (DMSG) certified the Department of Neurology at Vivantes Neukölln Hospital as an "MS Specialized Center“. Senior physician Dr. Dieter Bähr heads the MS outpatient clinic; he reports on the treatment options.
Dr. Bähr, what happens in the body with an MS disease?
You have to think of it like this: The immune system triggers an overreaction in which antibodies and other messenger substances are directed against the body's own substances and tissues. The nerve fibers are attacked and become inflamed, which can lead to various symptoms, such as paralysis, visual, sensory, balance and speech disorders, as well as bladder dysfunction.
How does the disease progress?
In rare cases, the disease progresses gradually, but often in episodes. These occur especially at the beginning of the disease, when the inflammatory reaction in the central nervous system is particularly active.
How do you treat your patients at the Vivantes MS Outpatient Clinic?
The disease activity is decisive for the treatment. We therefore take a lot of time to find out: How strong and how fast is the MS developing? Magnetic resonance imaging (MRI) has developed into an important component of comprehensive diagnostics. By means of imaging, it is now possible to detect MS at an early stage. Foci of inflammation and the extent of tissue and brain atrophy are visible, and the activity and progression of the disease can also be better assessed. This means that MS can be treated correctly at an early stage. Although it cannot yet be cured, in many cases it can be controlled so well that no new attacks of the disease occur and one can concentrate on alleviating the symptoms.
What can medication do?
We carefully consider when, how and at what intensity we treat with medication. Cortisone used for relapses treats the current symptoms. In particularly severe cases, for example when impaired vision could lead to blindness, we wash out the immune reaction from the bloodstream (plasmapheresis). In the long term, we use drugs that intervene to varying degrees in the immune system. The possibilities have multiplied in recent years! If the inflammatory activity is rather low or becomes lower in the course of the disease, we concentrate on symptomatic treatment. This is enormously important for the quality of life of our patients: we can influence movement disorders, pain and bladder dysfunction. In addition, our patients are regularly examined and their laboratory values are checked in order to verify the effectiveness of our measures, to recognize new symptoms in time and to counteract possible side effects of the medication.
What are the special features of the Vivantes MS Center of Excellence?
We treat more than 400 patients a year. Therefore, our team is very familiar with the disease MS and has developed a competence that offers excellent conditions for an individual and successful treatment. In addition, we are closely networked with other Vivantes experts, for example the Institute for Neuroradiology, the Clinic for Ophthalmology, Urology and the Pelvic Floor Center, as well as external partners, such as the German Multiple Sclerosis Society. These cooperations make interdisciplinary coordination easy and ensure a high quality of care for our patients. Our special services also include neuropediatrics: Here, examinations of children are possible in whom the diagnosis is particularly complex. We are currently participating in two interesting studies: One is investigating the extent to which the lifestyle of MS patients, i.e. diet, sport, stress and habits, affects the development of the disease without the influence of medication. Another study focuses on how patients deal with relapses and symptoms: they are trained to better understand their own bodies and to be aware of warning signals so that they do not have to treat all symptoms immediately with medication.