Multiple sclerosis (MS) is a disease in which the substance myelin, which insulates and protects the nerve cells of the brain and spinal cord, is damaged.
Although the exact cause is unclear, MS is thought to be an autoimmune disease.
Myelin, which protects the nerve fibers of the central nervous system, helps messages move quickly and smoothly between the brain and the rest of the body. In MS, the immune system, which fights infections, mistakes myelin for a foreign body and attacks it. This damages it and removes it from the nerve fibres, partially or completely, leaving scars known as lesions or plaques.
The damage disrupts communication between the nervous system and the rest of the body. In addition to the loss of myelin, there can sometimes be damage to the nerve fibres themselves, leading to increased disability that can occur over time.
Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system. The cause of MS is unknown, but probably involves a combination of genetic and other triggering factors. About 2.5 million people worldwide have been diagnosed with MS. The disease usually begins between the ages of 20 and 40 and is twice as common in women as in men. The average age of diagnosis for the condition is about 30 years.
There are three forms of multiple sclerosis. The way the disease changes and worsens is different for each of them:
Signs and symptoms of MS vary widely and depend on the amount of neurological damage and the nerves that are affected.
Physical, mental and sometimes psychological problems may occur. Specific symptoms may include double vision, blindness in one eye, muscle weakness and spasms, impaired sensation, problems with coordination and movement, fatigue, memory and thinking problems. Some people with severe MS may lose their ability to walk independently or at all, while others may experience long periods of remission without any new symptoms.
In most cases, the disease progresses with relapses and subsequent periods of remission, with short episodes of neurological difficulties that resolve completely or almost completely. A small number of patients experience steady progressive deterioration.
Diagnosis is based on clinical symptomatology and exclusion of other diseases with similar course. There is no specific test for MS. As the process of myelin breakdown occurs, areas of inflammation and subsequent damage can be identified. These areas are called lesions or plaques and are easily detectable on MRI.
The most important goal in treating MS is to delay and reduce the patient's disability in the long term. Treatment differs according to the form of course and whether the disease is in flare or in remission. It is divided into seizure treatment, course-modifying treatment and symptomatic treatment.
