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Multiple Sclerosis

Multiple Sclerosis is a topic covered in the 5-Minute Emergency Consult.

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  • 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 US)
  • Increased prevalence is seen moving away from equator

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Rosen, Peter, et al., editors. "Multiple Sclerosis." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis.
Multiple Sclerosis. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis. Accessed April 25, 2019.
Multiple Sclerosis. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis
Multiple Sclerosis [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 25]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Multiple Sclerosis ID - 307560 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307560/all/Multiple_Sclerosis PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -