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Multiple sclerosis is an autoimmune-mediated, chronic inflammatory disease of the central nervous system, the causes of which are still not fully understood. It leads to foci of inflammation in the brain and spinal cord and damage to the affected nerve cells. The inflammations result from a misdirected activity of the patient's own immune system. Different symptoms and complaints arise depending on the localization of the inflammatory foci.

There are relapsing and progressive forms of the disease. In the relapsing-remitting form, new symptoms appear intermittently and partially or completely disappear after some time. The majority of those affected have this relapsing-remitting form at the beginning of the disease, which can progress to the progressive form.

Progressive forms are characterized by a continuous, slow increase in symptoms, e.g. a gradual deterioration in the ability to walk.

At the beginning of MS, symptoms such as visual disturbances, sensory disturbances, clumsiness, weakness and increased fatigue often occur. The course of multiple sclerosis varies greatly from person to person. As the disease progresses, existing symptoms may worsen and new symptoms may develop.

If you have symptoms that could be caused by multiple sclerosis, you will first have a detailed consultation with a neurologist followed by a comprehensive physical examination. We will then discuss with you whether further diagnostic examinations are useful and necessary. We offer all diagnostic examinations on an outpatient or inpatient basis and promptly at our MS Center.

Following a detailed medical history interview, a standardized neurological examination is performed. The optimization of this standardized examination for worldwide use in clinics and studies is an important task of our center.

In addition to the medical history and physical examination, magnetic resonance imaging (MRI) is another important diagnostic component in the diagnosis of MS. MRI of the head and spinal cord can very sensitively show the inflammatory foci typical of MS.

A lumbar puncture is often necessary for further clarification.

During a lumbar puncture, cerebrospinal fluid (CSF) is obtained from the spinal canal. With the help of the subsequent examination of the cerebrospinal fluid, other inflammatory processes of the central nervous system can be ruled out or confirmed or the findings typical of MS can be found. Lumbar puncture is generally low-risk and is usually performed on an outpatient basis.

You can find a detailed article on the diagnosis of MS here.

In the context of evoked potentials (EP), electrical stimulation or other stimuli (visual or acoustic) trigger impulses in the nerve fiber system. The time it takes for these impulses to reach the cerebral cortex or a muscle can provide information about the integrity of the examined nerve pathways.

Compared to MRI, which provides information about the condition of the central nervous system, the EP examination checks the conduction velocity of the nerve fibers. It therefore provides the treating neurologist with additional information about the integrity of the nervous system.

Once the diagnosis has been confirmed, a detailed consultation will take place. During this consultation, the available treatment options are discussed with you and the therapeutic procedure is determined individually with you.

As a rule, a three-day therapy with high doses of cortisone is indicated to treat relapse symptoms. The treatment is carried out in order to achieve the fastest possible reduction in acute relapse symptoms.

The aim of immunomodulating therapy is to prevent the occurrence of new relapses and foci of inflammation in the brain and to reduce the risk of permanent disability in the long term. This is a prophylactic treatment with medication that influences the immune system in different ways and prevents misdirected and harmful activity of the immune system. The immunomodulating drugs are administered either as an infusion or in the form of tablets or injections (subcutaneous or intramuscular).

In the case of existing symptoms that have not completely regressed, it makes sense to pursue consistent symptomatic therapy early on in the course of the disease. Depending on the symptoms, this may include physiotherapy, hippotherapy, psychotherapy, cognitive training and drug therapy approaches.

The Eye Clinic at the University Hospital Basel has been treating patients from the region, Switzerland and all over the world for over 150 years.

An important part of this are neuroophthalmology patients who suffer from a disorder of the visual pathway or eye mobility. We work closely with the Department of Neurology and the Center for Multiple Sclerosis and offer patients with MS ophthalmological diagnostics and therapy as part of the specialized consultation hours of Prof. Konstantin Gugleta and Prof. Anja Palmowski.

Your attending physician at the MS Center can arrange an appointment at the eye clinic in consultation with you.

Eye Clinic

In the course of the disease, multiple sclerosis can lead to problems with urination and sexuality in some patients.

The urological causes of these symptoms can vary greatly. Comprehensive diagnostic clarification in conjunction with suitable treatment can help to reduce existing restrictions in quality of life.

For the diagnosis and treatment of urological complaints in patients with multiple sclerosis, the Department of Urology at the University Hospital in Basel offers a neuro-urological consultation.

Your attending physician at the MS Center can arrange an appointment in the urology department in consultation with you.

Urology

Rheumatology offers joint interdisciplinary special consultation hours with neurology in the area of inflammatory and non-inflammatory rheumatological diseases.

Inflammatory diseases of the CNS or the peripheral nervous system are regularly found in systemic rheumatologic diseases. Ideally, these diseases are clarified on an interdisciplinary basis.

Differentiation from MS can be complex in individual cases and knowledge of the rheumatological differential diagnoses is helpful in such cases. Rheumatology can provide differential diagnostic support and, thanks to its many years of broad experience with immunosuppressive strategies, can advise on MS therapy.

Your attending physician at the MS Center can arrange an appointment with the rheumatology department in consultation with you.

Rheumatology

Experience shows that patients with MS often also have neuropsychiatric symptoms that require specific treatment. Close interdisciplinary cooperation between somatic and psychiatric practitioners is of particular importance in order to ensure a precise diagnosis and optimal treatment.

Your attending physician at the MS Center can arrange an appointment at the University Psychiatric Clinic in consultation with you.

University Psychiatric Clinic

People with MS have very different symptoms that affect their physical and cognitive performance and therefore their quality of life.

To improve or maintain motor skills, we offer outpatient physiotherapy, occupational therapy and speech therapy for patients with neurological diseases. In order to precisely analyze and treat the interrelationships of symptoms and their effects on sensorimotor function and movement patterns, all of our trained MS therapists have many years of professional experience with the disease, in addition to their specific expertise, so that therapy can be planned and adapted to the patient's specific situation.

Cognitive and fine motor skills should be assessed by occupational therapy. The objectives of functional treatment are derived from this. Occupational therapy also offers advice on and testing of assistive devices.

In order to maintain and improve speech and speech motor skills, a precise speech therapy assessment and individual planning of speech therapy is necessary. The MS Center has built up a network of registered speech therapists.

The frequency and duration of therapy are individually defined and supplemented by instructed self-training. Our wide range of therapies also includes Hippotherapy-K® (HTK), which we carry out in Binningen.

In consultation with you, your attending physician at the MS Center will issue a prescription for therapies at the University Hospital Basel as well as follow-up prescriptions.

Therapies

The appearance of multiple sclerosis is very diverse. Each person affected shows very individual symptoms and courses. Treatment is therefore complex and must be multidisciplinary.

REHAB Basel has the multidisciplinary team and the infrastructure to address specific issues. Consultations, assessments and therapies are offered individually on an outpatient basis, in our day clinic or as an inpatient.

A key focus of neurorehabilitative treatment is to make everyday life easier. This should help to improve the quality of life of patients and their relatives through

• learning compensation strategies
• the comprehensive provision of assistive devices, including workplace visits
• neuropsychological therapy and advice, including on maintaining the ability to work
• Advice on any conversion measures
• Advice on wheelchairs
• the use of symptomatic therapies

In addition to the extensive range of therapies, we offer special consultation hours for

• the treatment of spasticity (incl. botulinum toxin, intrathecal baclofen therapy/baclofen pumps)
• Bladder, bowel and sexual dysfunctions
• Swallowing disorders (including FEES diagnostics, videofluoroscopy)
• Pain (including invasive pain therapy such as infiltration therapy, neural therapy)
• Wound treatment
• Specific neuro-orthopaedic issues (incl. gait analysis, complex splinting of the lower extremities)

Your attending physician at the MS Center can arrange an appointment at REHAB in consultation with you.

REHAB Basel

As an independent specialist group and part of the interdisciplinary treatment team at the hospital, we provide advice on the following topics, among others:

• Outpatient support services
• Gainful employment in connection with illness/disability
• Social insurance
• Discharge planning and rehabilitation
• Financial problems and debt situation
• Housing situation

If you would like to talk to the social services, please contact your attending physician at the MS Center or contact us directly. We will be happy to assist you with our professional expertise.

University Hospital Basel
Hebelstrasse 2
4031 Basel
E-mail: sozialdienst.medizin@usb.ch
Phone: +41 61 328 74 90

In addition to the hospital's own social services, the Swiss MS Society also offers consultation hours on social issues at the MS Center. Ms. Ruch's consultation hours take place every second Friday on the premises of the MS Center.

If you would like a consultation with the social services of the Swiss MS Society, please contact your attending physician at the MS Center or contact Ms. Ruch directly on 0844 674 636.

Social counseling of the Swiss Multiple Sclerosis Society

In cooperation with the Department of Psychosomatics, the MS Center offers those affected an annual course on improving quality of life through mindfulness.

Mindfulness promotes inner peace, acceptance and serenity. It leads to a broader perspective that can open up new creative possibilities for action. It can help - alongside medical and psychotherapeutic treatment - to cope better with the challenges of the illness. It is a very effective means of reducing stress and promoting well-being. Studies have proven its effectiveness for MS.

The course consists of 8 evening sessions and one in-depth day. You can find more details and the next dates on the Psychosomatics homepage.
If you are interested, please contact:

Franziska Weeren
Tel. +41 61 265 20 59
franziska.weeren@usb.ch

The Swiss MS Society offers those affected a wide range of information, courses and advice on many relevant topics relating to MS.

Here you will find the services offered by the Swiss Multiple Sclerosis Society.