Multiple sclerosis (MS) is an autoimmune disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.[3] Being a demyelinating disease, MS 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] Symptoms 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 relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances.[13] In progressive forms of MS, bodily function slowly deteriorates once symptoms manifest and will steadily worsen if left untreated.[14]
While its 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]
^ abNakahara J, Maeda M, Aiso S, Suzuki N (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. PMID22189514. S2CID21058811.
^ abTsang BK, Macdonell R (December 2011). "Multiple sclerosis- diagnosis, management and prognosis". Australian Family Physician. 40 (12): 948–955. PMID22146321.
^Liu Z, Liao Q, Wen H, Zhang Y (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. PMID33878488. S2CID233325057.
^ abcAlphonsus 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. PMID30935529. S2CID86669723.
^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. ISBN978-1-4377-0434-1.
^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. PMID33450500. S2CID231624230.
^ ab[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. PMID8780061. S2CID40213123.
^ abClanet M (June 2008). "Jean-Martin Charcot. 1825 to 1893". International MS Journal. 15 (2): 59–61. PMID18782501. * Charcot J (1868). "Histologie de la sclerose en plaques". Gazette des Hopitaux, Paris. 41: 554–5.