Multiple sclerosis (MS, disseminated sclerosis, encephalomyelitis disseminata) is a demyelinating disease.

Patient information

What is multiple sclerosis? Are there lots of sclerosis ?
That's actually sort of correct . Sclerosis are scars, and that's exactly what you get. The question is where. And the answer is in white matter of the brain and spinal cord.

Why do you say that multiple sclerosis is demyelinating then?
Myelin is the cover of white matter, that makes conduction quicker. So if there's scarring, it's going to replace this myelin. That's called "demyelination".

• Myelin sheaths (i.e. insulating covers of neurons) in the brain and spinal cord are damaged
• The damage disrupts the ability of parts of the nervous system to communicate, causing a range of Sx
• The underlying mechanism is thought to be autoimmune, or failure of the myelin-producing cells
• Causes include genetics, and environmental factors e.g. infections
• Multiple sclerosis refers to scars (better konwn as plaques/lesions in particular in the white matter of the brain and spinal cord 

• Physical
• Mental
• Psychiatric problems, sometimes
• Between attacks, Sx may disappear completely, however, permanent neurological problems often occur especially as the disease advances

• Relapsing, involving isolated attacks on and off
• Progressing, involving Sx building up over time, continuous worsening

• Genetics
• Environmental factors, such as infections

• Sx
• Results of medical tests

• No known cure
• For acute attacks, High dose IV corticosteroids
• Disease modification, using immunosuppressants, including:
  • Interferon beta-1a
  • Interferon beta-1b
  • Glatiramer acetate
  • Mitoxantrone
  • Natalizumab
  • Fingolimod
  • Teriflunomide
  • Dimethyl fumarate

• Tx whilst modestly effective, can have adverse effects, and be poorly tolerated
• Long term outcome is difficult to predict
• Good outcomes are more often seen in women, those who develop the disease early in life, those w /a relapsing course, and those who initially experienced few attacks
• Life expectancy is 8 years lower than that of an unaffected population

• Alternative Tx are commonly pursued, despite a lack of evidence
• The most common autoimmune disorder affecting the CNS
• 2.3m people are affected globally annually with wide variation in different regions in the world, and amongst different populations
• 20k Pt's per year die, up from 12k in the 1990
• Disease usually begins between 20-50yo, and is twice as common in women as in men