Multiple Sclerosis

About Multiple Sclerosis

Multiple Sclerosis MS is an autoimmune demyelinating disease of the central nervous system affecting approximately 2.8 million people worldwide. Jean Martin Charcot first described the disease in 1868. MS involves immune mediated destruction of myelin the protective covering of nerve fibers, disrupting nerve signal conduction. The disease is more common in women 3 1 ratio, typically diagnosed between ages 20 and 40, and more common at higher latitudes. Approximately 85 percent have relapsing remitting MS RRMS with clearly defined attacks followed by periods of remission. Secondary progressive MS SPMS develops in most RRMS patients over time. Primary progressive MS PPMS affects approximately 15 percent with gradual decline from onset. Symptoms vary widely depending on affected CNS regions and include vision loss optic neuritis, weakness, numbness, tingling, fatigue, balance problems, bladder dysfunction, cognitive impairment, and heat sensitivity Uhthoff sign. Diagnosis requires dissemination of lesions in space and time, using MRI McDonald criteria. Cerebrospinal fluid analysis shows oligoclonal bands in 95 percent. Disease modifying therapies DMTs have transformed MS treatment. Injectable therapies interferon beta, glatiramer acetate, oral therapies fingolimod, dimethyl fumarate, siponimod, and monoclonal antibodies natalizumab Tysabri, ocrelizumab Ocrevus, ofatumumab Kesimpta significantly reduce relapse rate and MRI activity. Early treatment is associated with better long term outcomes.