Multiple sclerosis

Multiple sclerosis (MS), also known as encephalomyelitis disseminata, is a demyelinating disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.[1] 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.[7][10][11] Specific symptoms can include double vision, blindness in one eye, muscle weakness, and trouble with sensation or coordination.[1][12][13] MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms).[14][15] Between attacks, symptoms may disappear completely, although permanent neurological problems often remain, especially as the disease advances.[15]

Multiple sclerosis
Other namesDisseminated sclerosis, encephalomyelitis disseminata
CD68-stained tissue shows several macrophages in the area of a demyelinated lesion caused by MS.
SpecialtyNeurology
SymptomsBladder overactivity, bowel (constipation, bowel incontinence), cognition problems (anxiety, depression, limited critical thinking, learning, and planning), fatigue, hearing impairment or loss, mobility problems (dizzinessvertigo, lightheadedness, coordination issues, tremor), muscle problems (spasms, stiffness, and/or weakness), numbness and/or tingling, pain (stabbing pains in the face, feeling of burning, pins and needles, hugging or squeezing in the trunk and limbs), sexual problems (erectile dysfunction, ejaculation issues, decrease in vaginal lubrication and sensation), speech and/or swallowing difficulties, sensation problems, vision problems (double vision, blindness in one eye) [1] [2]


Note: symptoms may not present all at once, may come and go, and range from mild to severe.[3]
Usual onsetAge 20–50[4]
DurationLong term[1]
CausesUnknown[5]
Diagnostic methodBased on symptoms and medical tests[6]
TreatmentMedications, physical therapy[1]
Prognosis5–10 year shorter life expectancy[7]
Frequency2 million (2015)[8]
Deaths18,900 (2015)[9]

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.[5] Proposed causes for this include genetics and environmental factors being triggered by a viral infection.[10][16] MS is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests.[6]

There is no known cure for multiple sclerosis.[1] Treatments attempt to improve function after an attack and prevent new attacks.[10] Medications used to treat MS, while modestly effective, can have side effects and be poorly tolerated.[1] Physical therapy can help with people's ability to function.[1] Many people pursue alternative treatments, despite a lack of evidence of benefit.[17] The long-term outcome is difficult to predict; good 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.[18] Life expectancy is five to ten years lower than that of the unaffected population.[7]

Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system.[19] In 2015, about 2.3 million people were affected globally, with rates varying widely in different regions and among different populations.[8][20] In that year, about 18,900 people died from MS, up from 12,000 in 1990.[9][21] The disease usually begins between the ages of twenty and fifty and is twice as common in women as in men.[4] MS was first described in 1868 by French neurologist Jean-Martin Charcot.[22] The name multiple sclerosis refers to the numerous glial scars (or sclerae – essentially plaques or lesions) that develop on the white matter of the brain and spinal cord.[22] A number of new treatments and diagnostic methods are under development.[23]