Multiple Sclerosis: Pathophysiology, Clinical Features, Diagnosis, and Management Publisher



Maghzi AH^{1, 2, 3} ; Borazanci A⁴ ; Mcgee J⁴ ; Steven Alexander J⁵ ; Gonzaleztoledo E^{4, 6} ; Minagar A⁴ Show Affiliations
Source: Neuroinflammation Published:2011

Abstract

Multiple sclerosis (MS) is an immune-mediated neurodegenerative disease of the central nervous system (CNS), which largely affects young adults with certain genetic backgrounds, often following exposure to several as yet unidentified environmental antigen(s). Based on the clinical disease pattern, four types of MS are recognized: relapsing-remitting MS (RRMS), secondary progressive MS (SPMS), primary progressive MS (PPMS), and progressive relapsing MS (PRMS). Interestingly, it appears that these four different forms of MS have dissimilar underlying neuropathologies, which, in turn, indicates that MS may represent a heterogeneous group of related diseases. The most common form of MS, RRMS, begins with a single unifocal or multifocal demyelinating attack (known as clinically isolated syndrome [CIS]), with a complete or partial resolution of the attack. This form of MS with its dominant neuroinflammatory sequelae is clinically recognized by relapses and development of new lesions on magnetic resonance imaging (MRI) studied by CNS neuroimaging. The clinical course of RRMS is characterized by clear disease relapses with development of new neurologic deficits or worsening of older symptoms that last more than 24 hours; each relapse is typically separated from the last attack by at least 1 month of stability. Patients with relapse of MS, either with treatment with corticosteroids or spontaneously, may return to their baseline neurologic status or may recover partially, with residual neurologic deficits. © 2011 Elsevier Inc. All rights reserved.