What is Multiple Sclerosis?
Multiple Sclerosis (MS) is an autoimmune central nervous system disease characterised by inflammation, demyelination, and axonal damage. Myelin sheaths, oligodendrocytes, axons, and nerve cells are affected to a lesser extent.
The disease commonly appears in young adults. Its prevalence varies geographically, ranging from 2 to 200 per 100,000.
MS was first reported by Jean-Martin Charcot in 1868. It is a chronic disease that can either present with relapses or progress from the onset or later stages.
What Are the Symptoms of Multiple Sclerosis?
In patients with Multiple Sclerosis (MS), all symptoms and signs related to central nervous system damage can manifest. However, some are very common, while others are rare enough to be considered red flags. Common symptoms include weakness in extremities, sensory symptoms, ataxia, bladder problems, fatigue, diplopia, visual disturbances like blurred vision, dysarthria, and cognitive issues such as memory, concentration, and attention problems. Conversely, less common symptoms include movement disorders, epileptic seizures, headaches, severe cognitive decline to the level of dementia, cortical symptoms, hearing loss, and amyotrophy.
What Are the Clinical Course Types of Multiple Sclerosis?
The clinical course is defined under four categories:
Relapsing-Remitting MS (RRMS): Characterized by acute attacks followed by complete or near-complete recovery periods. No progression of the disease is observed between attacks.
Secondary Progressive MS (SPMS): occurs after an average of 5-6 years of the early phase. Following a period of relapses and recoveries, the frequency of relapses decreases, recovery is minimal, and disability increases.
Progressive-Relapsing MS (PRMS): Involves continuous progression from the onset, with relapses occurring intermittently.
Primary Progressive MS (PPMS): Characterized by a steady progression of the disease from the onset, usually without significant recovery periods.
The course can be rapid or slow. Benign MS is a diagnosis made retrospectively, characterised by infrequent attacks without severe sequelae and a low lesion load on MRI. Patients with EDSS scores ≤ 3 fifteen years after the onset of the disease are considered to have benign MS.
Source: MS Diagnosis and Treatment Guidelines, 2018
