Multiple Sclerosis

Basics

Pathophysiology: Recurrent episodes of CNS demyelination:
- Signs and symptoms depend on location of lesions and timing of demyelination
Multiple sclerosis (MS) occurs in distinct patterns:
- Relapsing recurring MS: 2 or more episodes lasting ≥24 hr separated by ≥1 mo
- Primary progressive MS: Slow or stepwise progression over at least 6 mo
- Secondary progressive MS: Initial exacerbations and remissions followed by slow progression over at least 6 mo
- Stable MS: No progression (without treatment) over at least 18 mo

MS is a chronic demyelinating disease of CNS:
- Etiology is not well understood
Presumed to be T cell–mediated autoimmune disease
There is evidence for a viral trigger
Plaques in white matter:
- Characterized by infiltrate of T cells and macrophages
Persons of northern European origin most often affected (in the U.S.)
Increased prevalence is seen moving away from equator

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