MS is a central demyelinating disease that involves the myelin sheaths (covering) surrounding the nerve axonal fibers in the brain or the spinal cord. It is classified as an autoimmune disease where the autoimmune system produces antibodies that attack the nerve fibers. Typically, it is more common in females, and more common in the northern hemispheric population. The typical presentation for MS is dependent on the area of the brain or the spinal cord that is affected and last more than 24 hours and include a numbness and tingling sensation of one side of the body or one limb, weakness, double vision, painful loss of vision (optic neuritis) and if it involves the spinal cord, it can affect the urination and both sides of the body.
There are several types of MS including relapsing remitting (most common), primary progressive and secondary progressive. The difference between these types is the presentation and the progression. Treatment can also vary.
The diagnosis of MS is done with MRI of the brain and/or spinal cord with contrast, lumbar puncture to check for specific markers in the CSF and occasionally evoked visual and/or auditory potential.
Treatment of MS is two fold; acute and maintenance therapies. Treatment of acute attacks involves the use of intravenous steroids. The maintenance treatment involves the use of immune-modulators such as Betaseron, Avenox, Rebif, and Copaxone. Newer treatments include Gilenya (fingolimod) and infusions with Tysabri. These medications reduce the number of relapses (attacks) and some reduce disability. Supportive care includes physical and occupational therapy, social support and other comorbidities.