| Abstract [eng] |
Multiple Sclerosis is a chronic, heterogenous neurological disorder characterized by immune- mediated injury to the central nervous system and remains a condition without a definitive cure. [1] Multiple sclerosis is the most common non-traumatic neurological condition causing long-term disability among individuals in early to mid-adulthood, with a global prevalence exceeding 2.3 million. [2] It is a challenging disease not only for the patient but also for the treating physician. A combination of medical treatment as well as physical and psychological support is required with the goal of preventing progression and exacerbations of the condition, while also slowing the advancement of functional impairment. [1] A timely diagnosis and adequate treatment are the first step in the long-term management and adaptation to achieve a life worth living despite the shattering diagnosis of multiple sclerosis. It is yet to learn a lot about the pathogenesis of this disease, but it is expected to be a multifactorial highly complex genesis, with a lot of influential factors. Neuromyelitis optica (NMO) previously termed Devic ́s disease, is a chronic autoimmune inflammatory disorder of the central nervous system, primarily defined by episodic acute optic neuritis (ON) and transverse myelitis (TM). [3] NMO was considered for a long time to be a particularly aggressive variant of multiple sclerosis, following the identification of Aquaporin-4 (AQP4) targeting IgG antibody, a differentiation of NMO from MS is possible and thus the classification of neuromyelitis optica spectrum disorder (NMOSD) has been established since 2007. [4] Over the last years and decades, the treatment changed drastically especially for MS and a completely new path of treatment was established for NMOSD as it is finally possible to have a specific tailored treatment for NMOSD instead of treating it as a severe sub form of MS. During this thesis we will figure out how to establish a diagnosis, what kind of lab work is essential as well as the imaging techniques needed to conclude a diagnosis and to follow up the patient. We will discover the different medications which are best suited for the treatment of MS as well as NMOSD and which ones are no longer recommended. |
