Multiple Sclerosis

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Overview

Multiple sclerosis (MS) is an inflammatory, chronic, degenerative disorder that affects nerves in the brain and spinal cord. Myelin, the fatty substance that surrounds and insulates nerves and facilitates the conduction of nerve impulses is the initial target of inflammatory destruction in multiple sclerosis.

MS is characterized by intermittent damage to myelin , called demyelination. Demyelination causes scarring and hardening (sclerosis) of nerve tissue in the spinal cord, brain, and optic nerves. Demyelination slows conduction of nerve impulses, which results in weakness, numbness, pain, and vision loss.

Because different nerves are affected at different times, MS symptoms often worsen (exacerbate), improve, and develop in different areas of the body. Early symptoms of the disorder may include vision changes (e.g., blurred vision, blind spots), numbness, dizziness, and muscle weakness.

MS can progress steadily or cause acute attacks (exacerbations) followed by partial or complete reduction in symptoms (remission). Most patients with the disease have a normal lifespan.

Types

Multiple sclerosis is classified according to frequency and severity of neurological symptoms, the ability of the CNS to recover, and the accumulation of damage.

Primary progressive MS causes steady progression of symptoms with few periods of remission.

Relapsing-Remitting MS causes worsening of symptoms (exacerbations) that occur with increasing frequency, along with periods of reduced symptoms (remission).

Secondary progressive MS is initially similar to relapsing-remitting MS but eventually follows a progressive course without remissions.

Relapsing-Progressive MS causes cumulative damage during exacerbations and remissions.

Incidence and Prevalence

MS is the most common neurological cause of debilitation in young people and affects about 500,000 people in the United States. Worldwide, the incidence is approximately 0.1%. Northern Europe and the northern United States have the highest prevalence, with more than 30 cases per 100,000 people.

MS is more common in women and in Caucasians. The average age of onset is between 18 and 35, but the disorder may develop at any age. Children of parents with MS have a higher rate of incidence (30–50%).

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