Multiple Sclerosis


Multiple Sclerosis is an autoimmune disorder involving the degeneration of central nervous system myelin sheath.  The peripheral nervous system is NOT involved. 

Multiple Sclerosis (MS) is a progressive and diffuse demyelinating central nervous system disorder that affects white and gray matter in the brain. 


Prevalence

Approximately 400,000 people in the U.S. and 2.5 million people worldwide are affected.  The incidence rate is highest among whites, although MS occurs in all races. 

The onset of MS usually occurs between 20 and 40 years of age and affects about twice as many females as males.  The disease does not normally affect the lifespan and may extend over a period of 30 years. 

Factors including environmental and genetics are implicated in disease onset.  About 15% of persons with MS have an affected relative. 

Source: Pathophysiology; The Biologic Basis for Disease in Adults and Children, 6th Edition, Mosby Elsevier


Pathophysiology

MS occurs following a viral insult to a genetically MS-susceptible individual in combination with a subsequent abnormal and insufficient immune response.  Progressive inflammation and irreversible tissue damage occur early on - due to various mechanisms - and continue throughout the course of the disease.  

Early inflammation and myelin destruction lead to fragile axons and even further damage and scarring (sclerosis).  Permanent disability results when axons can no longer repair themselves and become demylinated.       


Precipitating factors which serve as precursors to the initial onset or to exacerbations include trauma, infections, or pregnancy.  Clinical manifestations include brain atrophy resulting in disability and progressive MS, damage to oligodendrocytes that manufacture myelin, optic neuritis or blindness, spastic ataxia, hypotonia, bladder and bowel symptoms, and more.   


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