MULTIPLE-SCLEROSIS

Multiple sclerosis is a chronic disease that begins in late adolescenc e or adulthood. It is highly variable in its expression and severity. It is believed to be autoimmune in nature. The cause is unknown both g enetic and environmental factors have been implicated in the pathogene sis. MS generally presents with the acute or subacute onset of neurolo gic abnormalities that may wax and wane over many years. Diagnosis is generally made by means of observation of the clinical course in conju nction with a neurologic examination and laboratory tests. These tests may include magnetic resonance imaging of the head and spine, lumbar puncture, and evoked potentials. Treatment is based on general support ive care, the use of corticosteroids for relapses, and symptomatic man agement of ongoing problems. The frequency of relapses can be reduced with interferon-beta (Betaseron). Copolymer 1 and interferon-beta la a re being evaluated by the U.S. Food and Drug Administration for approv al for use for reduction in the frequency of relapses in relapsing-rem itting MS. Treatment of chronic progression is often attempted with im munosuppressive agents such as corticosteroids, azathioprine, and cycl ophosphamide. Use of other agents is being investigated.