In multiple sclerosis, patches of myelin and underlying nerve fibers in the eyes, brain, and spinal cord are damaged or destroyed.
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The cause is unknown but may involve an attack by the immune system against the body’s own tissues (autoimmune reaction).
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Usually, periods of relatively good health alternate with episodes of worsening symptoms.
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People may have vision problems and abnormal sensations, and movements may be weak and clumsy.
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Usually, doctors base the diagnosis on symptoms and results of a physical examination and magnetic resonance imaging (MRI).
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Treatment includes corticosteroids, drugs that help keep the immune system from attacking the body, and drugs to relieve symptoms.
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Often, the disorder slowly worsens, disabling some people, but life span is unaffected unless the disorder is very severe.
The term “multiple sclerosis” refers to the many areas of scarring (sclerosis) that result from destruction of the tissues that wrap around nerves (myelin sheath). This destruction is called demyelination. Sometimes the nerve fibers that send messages (axons) are also damaged. Over time, the brain may shrink in size because axons are destroyed.
In the United States, about 400,000 people, mostly young adults, have multiple sclerosis. Most commonly, it begins between the ages of 20 and 40. It is more common among women. Most people have periods of relatively good health (remissions) alternating with periods of worsening symptoms (flare-ups or relapses). Relapses can be mild or debilitating. Recovery during remission is good but incomplete. Thus, the disorder worsens slowly over time.
Causes
The cause unknown, but a likely explanation is that people are exposed early in life to a virus (possibly a herpesvirus or retrovirus) or some unknown substance that somehow triggers the immune system to attack the body’s own tissues (autoimmune reaction—see Autoimmune Disorders).The autoimmune reaction results in inflammation, destruction of myelin, and damage to the myelin sheath and the underlying nerve fiber.
Heredity seems to have a role in multiple sclerosis. About 5% of people with the disorder have a brother or sister who is affected, and about 15% have a close relative who is affected. Also, multiple sclerosis is more likely to develop in people with certain genetic markers on the surface of their cells called human leukocyte antigens (see Biology of the Immune System: Recognition). These markers help the body to distinguish self from nonself and thus know which substances to attack.
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