Ms.

Multiple Sclerosis (MS)

Multiple Sclerosis (MS) is a chronic, often disabling disease that attacks the central nervous system (CNS), which is composed of the brain, spinal cord, and optic nerves. The progress, severity, and specific symptoms of MS are unpredictable and vary from one person to another.

Pathophysiology

MS is characterized by the immune system attacking the protective sheath (myelin) that covers nerve fibers, causing communication problems between the brain and the rest of the body. Eventually, the disease can cause the nerves themselves to deteriorate or become permanently damaged.

Demyelination

Demyelination is the process by which the myelin sheath is damaged. In MS, this is caused by an autoimmune response where the body's immune system mistakenly attacks its own tissues. This leads to the formation of scar tissue (sclerosis) in multiple areas of the CNS.

Axonal Damage

In addition to demyelination, MS can also cause damage to the axons themselves. This axonal damage is a major contributor to the permanent disability seen in MS patients.

Symptoms

The symptoms of MS vary widely and depend on the amount of nerve damage and which nerves are affected. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.

Common Symptoms

• Fatigue
• Difficulty walking
• Numbness or tingling
• Muscle weakness
• Vision problems
• Dizziness and vertigo
• Bladder and bowel dysfunction
• Cognitive changes

Diagnosis

Diagnosing MS can be challenging because its signs and symptoms can be similar to those of other medical problems. There is no single test for MS. Instead, a diagnosis often relies on ruling out other conditions that might produce similar signs and symptoms.

Diagnostic Criteria

The McDonald criteria are used to diagnose MS. These criteria include evidence of damage in at least two separate areas of the CNS, evidence that the damage occurred at different points in time, and ruling out all other possible diagnoses.

Tests

• Magnetic Resonance Imaging (MRI)
• Lumbar puncture (spinal tap)
• Evoked potential tests

Treatment

There is no cure for MS, but treatments can help speed recovery from attacks, modify the course of the disease, and manage symptoms.

Disease-Modifying Therapies

These therapies can reduce the frequency and severity of relapses and may slow the progression of disability.

Symptomatic Treatments

Medications and therapies to manage symptoms such as muscle spasms, fatigue, and bladder problems.

Epidemiology

MS is more common in women than in men, and it is usually diagnosed between the ages of 20 and 50. The prevalence of MS varies widely around the world, with higher rates in northern Europe and North America.

Research

Ongoing research is focused on understanding the causes of MS, developing new treatments, and finding a cure. Areas of research include the role of genetics, the environment, and the immune system in the development of MS.

Also see

• Central nervous system
• Autoimmune disease
• Demyelinating disease
• Neurology