[Therapy of multiple sclerosis]

Multiple sclerosis (MS) is one of the most frequent neuroimmunological disorders of the central nervous system. It is a multifactorial disease with possible causes including genetic and environmental factors. MS is characterized in essence by an autoimmune inflammation in the central nervous system, resulting in the damage of the myelin sheath and the axons. There are four pathological subtypes of the disease. Its clinical course can either be of the relapsing-remitting or primary and secondary progressive type. All structures of the central nervous system may be involved, but the longest tracts are affected the most often. According to the revised McDonald criteria, the diagnosis of MS is based on the clinical course and the MRI findings. Its therapy can be divided into the acute treatment of relapses, symptomatic relief and long-term immunomodulatory treatment. With respect to differential diagnosis, it is of special concern to distinguish between MS and neuromyelitis optica, as early diagnosis and appropriate treatment of the latter may prevent the development of severe residual symptoms associated with this disease.