Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease of
the central nervous system (CNS) and a common cause of disability in young
adults; it is most likely an autoimmune disease.
Typically, MS initially follows a relapsing-remitting course, but most pati
ents eventually develop secondary progressive MS, where there is progressiv
e deterioration without relapses or remissions; in some patients, MS has a
primary progressive course.
The diagnosis of MS requires evidence of CNS lesions disseminated in time a
nd place, as well as the exclusion of other likely causes of these lesions;
the clinical history, neurological examination and investigations, such as
magnetic resonance imaging of the brain and spinal cord, all have key role
s in the diagnosis.
Education and counselling of the patient and family members are essential f
or good patient management.
Moderate to severe attacks of MS are best treated with intravenous infusion
s of high-dose methylprednisolone.
Interferon beta reduces the frequency of attacks and the progression of dis
ability in relapsing-remitting MS.
Symptomatic therapy is important in the management of spasticity, pain, uri
nary problems and the other symptoms or complications of MS.