Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system
characterized by exacerbations of neurological dysfunction due to inflammatory demyelination.
Neurologic symptoms typically present in young adulthood and vary based on the site
of inflammation, although weakness, sensory impairment, brainstem dysfunction, and
vision loss are common. MS occurs more frequently in women and its development is
complex—genetics, hormones, geography, vitamin D, and viral exposure all play roles.
Early MS is characterized by relapsing-remitting course and inflammation of the white
matter, although as patients age, the disease often transitions to a pathologically
distinct secondary progressive phase with gradual disability accrual affecting gait,
coordination, and bladder function. A minority of patients (10%) have disease that
is progressive at onset. In the past decade, there has been a remarkable expansion
in disease-modifying therapy for MS, but treatment of progressive disease remains
a challenge. This article reviews foundational concepts in MS and emerging work that
has reshaped understanding of the disease, providing new insight for therapeutic advance.
Keywords
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Article info
Publication history
Published online: December 21, 2017
Neurology Series Editor, William J. Mullally, MDFootnotes
Funding: None.
Conflicts of Interest: JS has consulted with Teva Neuroscience, Genzyme, Hoffman-Laroche, Biogen Idec, Novartis, and Bayer. JZ has no conflicts of interest to disclose.
Authorship: Both authors had access to the data and a role in writing this manuscript.
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© 2018 Elsevier Inc. All rights reserved.
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- Corrigendum to Multiple Sclerosis Re-Examined: Essential and Emerging Clinical ConceptsThe American Journal of MedicineVol. 131Issue 12
