Global InformationMultiple sclerosis information
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| Multiple sclerosis | |
|---|---|
| Other names | Multiple cerebral sclerosis, multiple cerebro-spinal sclerosis, disseminated sclerosis, encephalomyelitis disseminata |
 | |
| CD68-stained tissue shows several macrophages in the area of a demyelinated lesion caused by MS. | |
| Specialty | Neurology |
| Symptoms | Variable, including almost any neurological symptom or sign, with autonomic, visual, motor, and sensory problems being the most common.[1] |
| Usual onset | Age 20–50[2] |
| Duration | Long term[3] |
| Causes | Unknown[4] |
| Diagnostic method | Based on symptoms and medical tests[5] |
| Treatment | Disease-modifying therapies[6]
Physiotherapy[7] Occupational therapy[7] |
| Frequency | 0.032% (world) |
Multiple sclerosis (MS) is an autoimmune disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.[3] This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems.[1][8][9] Specific symptoms can include double vision, vision loss, eye pain, muscle weakness, and loss of sensation or coordination.[3][10][11] MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms).[12][13] In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances.[13] In the progressive forms of MS, bodily function slowly deteriorates and disability worsens once symptoms manifest and will steadily continue to do so if the disease is left untreated.[14]
While the cause is unclear, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells.[4] Proposed causes for this include immune dysregulation, genetics, and environmental factors, such as viral infections.[15][16][8][17] MS is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests.[5]
No cure for multiple sclerosis is known.[18] Current treatments are aimed at mitigating inflammation and resulting symptoms from acute flares and prevention of further attacks with disease-modifying medications.[8][19] Physical therapy[7] and occupational therapy,[20] along with patient-centered symptom management, can help with people's ability to function. The long-term outcome is difficult to predict; better outcomes are more often seen in women, those who develop the disease early in life, those with a relapsing course, and those who initially experienced few attacks.[21]
Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system.[22] Nearly one million people in the United States had MS in 2022,[23] and in 2020, about 2.8 million people were affected globally, with rates varying widely in different regions and among different populations.[24] The disease usually begins between the ages of 20 and 50 and is twice as common in women as in men.[2] MS was first described in 1868 by French neurologist Jean-Martin Charcot.[25]
The name "multiple sclerosis" is short for multiple cerebro-spinal sclerosis, which refers to the numerous glial scars (or sclerae – essentially plaques or lesions) that develop on the white matter of the brain and spinal cord.[25]
- ^ a b Compston A, Coles A (October 2008). "Multiple sclerosis". Lancet. 372 (9648): 1502–1517. doi:10.1016/S0140-6736(08)61620-7. PMID 18970977. S2CID 195686659.
- ^ a b Milo R, Kahana E (March 2010). "Multiple sclerosis: geoepidemiology, genetics and the environment". Autoimmunity Reviews. 9 (5): A387-94. doi:10.1016/j.autrev.2009.11.010. PMID 19932200.
- ^ a b c "NINDS Multiple Sclerosis Information Page". National Institute of Neurological Disorders and Stroke. 19 November 2015. Archived from the original on 13 February 2016. Retrieved 6 March 2016.
- ^ a b Nakahara J, Maeda M, Aiso S, et al. (February 2012). "Current concepts in multiple sclerosis: autoimmunity versus oligodendrogliopathy". Clinical Reviews in Allergy & Immunology. 42 (1): 26–34. doi:10.1007/s12016-011-8287-6. PMID 22189514. S2CID 21058811.
- ^ a b Tsang BK, Macdonell R (December 2011). "Multiple sclerosis- diagnosis, management and prognosis". Australian Family Physician. 40 (12): 948–955. PMID 22146321. Archived from the original on 5 October 2021. Retrieved 28 December 2023.
- ^ Liu Z, Liao Q, Wen H, et al. (June 2021). "Disease modifying therapies in relapsing-remitting multiple sclerosis: A systematic review and network meta-analysis". Autoimmunity Reviews. 20 (6): 102826. doi:10.1016/j.autrev.2021.102826. PMID 33878488. S2CID 233325057.
- ^ a b c Alphonsus KB, Su Y, D'Arcy C (April 2019). "The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis". Complementary Therapies in Medicine. 43: 188–195. doi:10.1016/j.ctim.2019.02.010. PMID 30935529. S2CID 86669723.
- ^ a b c Compston A, Coles A (April 2002). "Multiple sclerosis". Lancet. 359 (9313): 1221–1231. doi:10.1016/S0140-6736(02)08220-X. PMID 11955556. S2CID 14207583.
- ^ Murray ED, Buttner EA, Price BH (2012). "Depression and Psychosis in Neurological Practice". In Daroff R, Fenichel G, Jankovic J, Mazziotta J (eds.). Bradley's neurology in clinical practice (6th ed.). Philadelphia, PA: Elsevier/Saunders. ISBN 978-1-4377-0434-1.
- ^ Piryonesi SM, Rostampour S, Piryonesi SA (April 2021). "Predicting falls and injuries in people with multiple sclerosis using machine learning algorithms". Multiple Sclerosis and Related Disorders. 49: 102740. doi:10.1016/j.msard.2021.102740. PMID 33450500. S2CID 231624230.
- ^ Mazumder R, Murchison C, Bourdette D, et al. (25 September 2014). "Falls in people with multiple sclerosis compared with falls in healthy controls". PLOS ONE. 9 (9): e107620. Bibcode:2014PLoSO...9j7620M. doi:10.1371/journal.pone.0107620. PMC 4177842. PMID 25254633.
- ^ Baecher-Allan C, Kaskow BJ, Weiner HL (February 2018). "Multiple Sclerosis: Mechanisms and Immunotherapy". Neuron. 97 (4): 742–768. doi:10.1016/j.neuron.2018.01.021. PMID 29470968. S2CID 3499974.
- ^ a b [medical citation needed]Lublin FD, Reingold SC (April 1996). "Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis". Neurology. 46 (4): 907–911. doi:10.1212/WNL.46.4.907. PMID 8780061. S2CID 40213123.
- ^ Loma I, Heyman R (September 2011). "Multiple sclerosis: pathogenesis and treatment". Current Neuropharmacology. 9 (3): 409–416. doi:10.2174/157015911796557911. PMC 3151595. PMID 22379455.
- ^ Ward M, Goldman MD (August 2022). "Epidemiology and Pathophysiology of Multiple Sclerosis". Continuum. 28 (4): 988–1005. doi:10.1212/CON.0000000000001136. PMID 35938654. S2CID 251375096.
- ^ Aloisi F, Cross AH (October 2022). "MINI-review of Epstein-Barr virus involvement in multiple sclerosis etiology and pathogenesis". Journal of Neuroimmunology. 371: 577935. doi:10.1016/j.jneuroim.2022.577935. PMID 35931008. S2CID 251152784.
- ^ Ascherio A, Munger KL (April 2007). "Environmental risk factors for multiple sclerosis. Part I: the role of infection". Annals of Neurology. 61 (4): 288–299. doi:10.1002/ana.21117. PMID 17444504. S2CID 7682774.
- ^ "NINDS Multiple Sclerosis Information Page". National Institute of Neurological Disorders and Stroke. 19 November 2015. Archived from the original on 13 February 2016. Retrieved 6 March 2016.
- ^ McGinley MP, Goldschmidt CH, Rae-Grant AD (February 2021). "Diagnosis and Treatment of Multiple Sclerosis: A Review". JAMA. 325 (8): 765–779. doi:10.1001/jama.2020.26858. PMID 33620411. S2CID 232019589.
- ^ Quinn É, Hynes SM (July 2021). "Occupational therapy interventions for multiple sclerosis: A scoping review". Scandinavian Journal of Occupational Therapy. 28 (5): 399–414. doi:10.1080/11038128.2020.1786160. hdl:10379/16066. PMID 32643486. S2CID 220436640.
- ^ Weinshenker BG (1994). "Natural history of multiple sclerosis". Annals of Neurology. 36 (Suppl): S6-11. doi:10.1002/ana.410360704. PMID 8017890. S2CID 7140070.
- ^ Berer K, Krishnamoorthy G (November 2014). "Microbial view of central nervous system autoimmunity". FEBS Letters. 588 (22): 4207–13. doi:10.1016/j.febslet.2014.04.007. PMID 24746689. S2CID 2772656.
- ^ McGinley MP, Goldschmidt CH, Rae-Grant AD (February 2021). "Diagnosis and Treatment of Multiple Sclerosis: A Review". JAMA. 325 (8): 765–779. doi:10.1001/jama.2020.26858. PMID 33620411. S2CID 232019589.
- ^ Lane J, Ng HS, Poyser C, et al. (July 2022). "Multiple sclerosis incidence: A systematic review of change over time by geographical region". Mult Scler Relat Disord. 63: 103932. doi:10.1016/j.msard.2022.103932. PMID 35667315. S2CID 249188137.
- ^ a b Clanet M (June 2008). "Jean-Martin Charcot. 1825 to 1893". International MS Journal. 15 (2): 59–61. PMID 18782501. Archived from the original (PDF) on 30 March 2019. Retrieved 21 October 2010.
* Charcot J (1868). "Histologie de la sclerose en plaques". Gazette des Hopitaux, Paris. 41: 554–5.