Multiple sclerosis

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Multiple sclerosis
Other names	Multiple cerebral sclerosis, multiple cerebro-spinal sclerosis, disseminated sclerosis, encephalomyelitis disseminata
CD68-stained tissue shows several macrophages in the area of a demyelinated lesion caused by MS.
Specialty	Neurology
Symptoms	Involving autonomic, visual, motor, and sensory systems, almost any central or peripheral neurological symptom.[1]
Usual onset	Age 20–50[2]
Duration	Long term[3]
Causes	Unknown[4]
Diagnostic method	Based on symptoms and medical tests[5]
Treatment	Disease-modifying therapies[6] Physiotherapy[7] Occupational therapy[7]
Frequency	0.032% (world)

Multiple sclerosis (MS) is an autoimmune disease resulting in damage to the insulating covers of nerve cells in the brain and spinal cord.^[3] As a demyelinating disease, MS disrupts the nervous system's ability 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 symptoms may disappear completely between attacks, 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 due to either destruction by the immune system or inactivation of myelin-producing cells.^[4] Proposed causes for this include immune dysregulation, genetics, and environmental factors, such as viral infections.^{[15][16][8][17]} The McDonald criteria are a frequently updated set of guidelines used to establish an MS diagnosis.^[18]

There is no cure for MS.^[19] Current treatments aim to mitigate inflammation and resulting symptoms from acute flares and prevent further attacks with disease-modifying medications.^[8][20] Physical therapy^[7] and occupational therapy,^[21] 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.^[22]

MS is the most common immune-mediated disorder affecting the central nervous system (CNS).^[23] In 2020, about 2.8 million people were affected by MS 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]