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Multiple sclerosis - Overview

Alternative Names

MS; Demyelinating disease

Definition of Multiple sclerosis:

Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system).

Causes, incidence, and risk factors:

Multiple sclerosis (MS) affects women more than men. The disorder is most commonly diagnosed between ages 20 and 40, but can be seen at any age.

MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped.

The nerve damage is caused by inflammation. Inflammation occurs when the body's own immune cells attack the nervous system. Repeated episodes of inflammation can occur along any area of the brain, optic nerve, and spinal cord.

Researchers are not sure what triggers the inflammation. The most common theories point to a virus or genetic defect, or a combination of both. Geographic studies indicate there may be an environmental factor involved.

People with a family history of MS and those who live in a geographical area where MS is more common have a slightly higher risk of the disease.

Multiple sclerosis

MRI of the brain

Nerve supply to the pelvis

Central nervous system

Myelin and nerve structure

Reviewed last on: 8/5/2010
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. Previously reviewed by Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital.

References

Calabresi P. Multiple sclerosis and demyelinating conditions of the central nervous system. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 436.

Carroll WM. Oral therapy for multiple sclerosis--sea change or incremental step? N Engl J Med. 2010 Feb 4;362(5):456-8. Epub 2010 Jan 20.

Goodin DS, Cohen BA, O'Connor P, et al. Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Assessment: the use of natalizumab (Tysabri) for the treatment of multiple sclerosis (an evidence-based review): report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2008:71(10):766-73.

Farinotti M, Simi S, Di Pietrantonj C, McDowell N, Brait L, Lupo D, Filippini G. Dietary interventions for multiple sclerosis. Cochrane Database Syst Rev. 2007 Jan 24;(1):CD004192.

Kappos L, Freedman MS, Polman CH, et al. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet. 2007:370(9585):389-97.

Miller DH, Leary SM. Primary-progressive multiple sclerosis. Lancet Neurol. 2007;6:903-912.

Marriott JJ, Miyasaki JM, Gronseth G, O'Connor PW; Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Evidence Report: The efficacy and safety of mitoxantrone (Novantrone) in the treatment of multiple sclerosis: Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2010 May 4;74(18):1463-70.

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