Neuroimmunology

Multiple sclerosis is a common chronic disease of the central nervous system (CNS) in Germany. The CNS comprises the brain and spinal cord. In multiple sclerosis, the sheath layers of the nerve cells and also nerve cells are attacked and local inflammation occurs. Depending on the localization, different symptoms can occur. Our work focuses on providing advice after diagnosis on treatment options and therapy changes during the course of the disease.

Studies

We carry out studies to test new drugs in the treatment of multiple sclerosis. At present, new monoclonal antibodies in particular are being administered as infusions for patients with relapsing forms of the disease. Interested parties can contact us by email.

Links to networks

Multiple Sclerosis Competence Network

www.kompetenznetz-multiplesklerose.de/

German Multiple Sclerosis Society Federal Association

www.dmsg.de

German Multiple Sclerosis Society Lower Saxony Regional Association e.V.

http://www.dmsg-niedersachsen.de/

Neuromyelitis optica spectrum diseases (NMOSD) are diseases in which the nerve sheath layer and projections of the nerve cells of the optic nerves, the spinal cord and also the brain (especially the brain stem) are damaged. Similar to multiple sclerosis, the clinical symptoms vary depending on the site of damage and occur in episodes. In contrast to multiple sclerosis, certain antibodies are often detectable (aquaporin-4 antibodies, MOG antibodies). Our special outpatient clinic is one of the network centers in Germany and specializes in confirming the diagnosis and advising on treatment options.

Studies

We carry out various observational studies in which patients are regularly examined, certain symptoms are asked about and the course of the disease is systematically recorded. Interested parties can contact us by email.

Links to networks

NMO study group

www.nemos-net.de

In autoimmune-mediated encephalitis, antibodies are formed against structures in the brain, which lead to inflammation. Each of these antibodies is directed against different structures of the brain and therefore causes different symptom complexes. The best-known antibody is the NMDA receptor antibody. Psychiatric symptoms, personality changes and seizures often develop within a short period of time. In severe cases, treatment in an intensive care unit may be necessary. Interdisciplinary treatment between neurology and psychiatry is particularly important in certain cases. There is cooperation between the neuroimmunology and psychiatry outpatient clinics.

Links to networks

German network for research into autoimmune encephalitis

https://generate-net.de

In immune-mediated neuropathies, peripheral nerves are damaged by a systemic process. If motor nerves are affected, this leads to muscle weakness or even paralysis with muscle wasting. These are often caused by autoimmune diseases such as collagenoses or vasculitis, but there are also independent diseases whose cause is not known with certainty (CIDP, MMN).

In myasthenia gravis, antibody bindings at the transmission site between nerve and muscle lead to exercise-induced muscle weakness. In principle, this can affect all muscles in the body and can be exacerbated by numerous medications, but also by infections. Our focus is on therapy evaluation and optimization.

Sarcoidosis is a multisystemic disease that causes a granulomatous inflammatory reaction with nodule formation in the organs. The lungs are most frequently affected, but any other organ can also be involved. The cause is not known. However, there is a disturbance of T-cell function and increased B-cell activity as an expression of an immune reaction. The most common neurological manifestations include facial paralysis, meningitis, spinal cord inflammation or nodules in muscles, nerves and skin. Neurosarcoidosis is often chronic and requires medical treatment.

In paraneoplastic syndromes, antibodies are formed - usually in association with an underlying tumor disease - that are directed against the body's own structures. Depending on the target structure of the antibodies, this can lead to central nervous, psychiatric, peripheral neurological or epileptic syndromes, as well as muscle weakness. Examples include encephalitis and/or polyneuropathies due to antineuronal antibodies (e.g. Hu-, Yo-, Ri-, GAD-, Tr-, Cv2-, amphiphysin-, Ma1-, Ma2-, Sox1-, Zic4-AK), as well as Lambert-Eaton syndrome.

Sjögren's syndrome is a disease that is partly associated with rheumatoid arthritis or collagenoses. Clinically, patients suffer from dry eyes and mouth. In some patients, the nervous system is involved, often in the form of polyneuropathies or spinal cord inflammation.

Systemic lupus erythematosus is an autoimmune disease that belongs to the group of collagenoses. In principle, all organs of the body can be attacked, so that the symptoms can be very variable. In 50-70% of cases, the nervous system is involved in the form of damage to nerves, the brain, eyes and spinal cord or muscle involvement.

Vasculitides are mostly autoimmune vascular inflammations that can lead to damage and thus neurological symptoms as part of a systemic collagenosis (e.g. SLE, Sjögren's syndrome), but also in isolation in the nervous system (e.g. PACNS). A precise differential diagnosis with even rarer pathogen-induced vasculitis and other chronic inflammatory neurological diseases is required in order to develop a suitable treatment strategy.