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Multiple sclerosis

Sclerosis multiplex · Roztroušená skleróza

What it is

The immune system strips myelin from central nerves in scattered patches.

Symptoms & signs

  • Optic neuritis
  • numbness and tingling
  • weakness
  • double vision
  • fatigue
  • bladder urgency
  • heat sensitivity (Uhthoff)

🚩 Get help if…

  • call 112 / 911 now Trouble breathing or swallowing
  • call 112 / 911 now Sudden weakness or numbness of both legs with loss of bladder control
  • see a doctor soon New symptoms lasting over 24 hours — a possible relapse
  • see a doctor soon Painful blurred vision in one eye

Where it strikes

Medical treatment

  • Ocrelizumab, natalizumab, cladribine, fingolimod
  • steroids for relapses
  • baclofen for spasticity
  • amantadine or modafinil for fatigue

Natural & lifestyle

  • Vitamin D 2000–4000 IU
  • smoking cessation
  • exercise and cooling vests
  • Mediterranean diet
  • physiotherapy

Emerging & experimental

  • Autologous haematopoietic stem-cell transplant
  • BTK inhibitors (tolebrutinib)
  • remyelination agents (clemastine)
  • Epstein-Barr-targeted T-cell therapy

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Cannabis extract (nabiximols) — approved for spasticity in many countries after trials trials support
  • Wahls and Swank diets — small trials show less fatigue; no proven effect on relapses mixed evidence
  • Low-dose naltrexone — small trials, better quality of life early / small studies
  • High-dose biotin — the large SPI2 trial found no benefit not confirmed in trials
  • The Coimbra protocol (very high-dose vitamin D) — anecdotal; risk of dangerous calcium levels anecdotal / traditional

ICD codes