MyWiki:VideoWiki/Multiple sclerosis

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Definition

Multiple sclerosis (MS) is a demyelinating disease, where the insulating covers, of nerve cells in the brain and spinal cord, are damaged. File:Stereoscopic-three-dimensional-visualization-applied-to-multimodal-brain-images-clinical-Video3.ogv

Symptoms

This damage disrupts the ability of parts of the nervous system to communicate, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems.

Localized symptoms

Specific symptoms can include double vision, blindness in one eye, muscle weakness, trouble with sensation, or trouble with coordination.

Types of MS

New symptoms for MS can occur in different forms, as isolated attacks (called relapsing forms), or building up over time (called progressive forms). The disease usually begins between the ages of 20 and 50, and is twice as common in women as in men.

Remission

Between attacks, symptoms may disappear completely; however, permanent neurological problems often remain, especially as the disease advances.

Cause

While the cause is not clear, the underlying mechanism is thought to be either destruction by the immune system, or failure of the myelin-producing cells. File:Global-and-3D-Spatial-Assessment-of-Neuroinflammation-in-Rodent-Models-of-Multiple-Sclerosis-pone.0076330.s002.ogv

Genetics and environment

What initiates the process is uncertain, but it may include genetics, and environmental triggers, such as a viral infection.

Diagnosis

MS is usually diagnosed based on the presenting signs and symptoms, and the results of supporting medical tests. The most commonly used diagnostic tools are neuroimaging, analysis of cerebrospinal fluid, and evoked potentials. Magnetic resonance imaging of the brain and spine, may show areas of demyelination, as lesions or plaques.

Treatment

There is no known cure for multiple sclerosis. Treatments attempt to improve function after an attack, and prevent new attacks, although medications used to treat MS, while modestly effective, have side effects and may be poorly tolerated.

Physical therapy

Physical therapy can help with people's ability to function. Many people pursue alternative treatments, despite a lack of evidence of benefit.

Outcome

The long-term outcome is difficult to predict, but people with MS live, on average, 5 to 10 years less than those unaffected. Good outcomes are more often seen in women, those who develop the disease early in life, those with a relapsing course, and those who initially experienced few attacks.

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Epidemiology

Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system.

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Global burden

In 2015, about 2.3 million people were affected globally, with rates varying widely in different regions, and among different populations. That year about 18,900 people died from MS, up from 12,000 in 1990.

File:Multiple sclerosis world map-DALYs per million persons-WHO2012.svg

History

MS was first described in 1868 by Jean-Martin Charcot. The name multiple sclerosis refers to the numerous scars (better known as plaques, or lesions) that develop on the white matter of the brain, and spinal cord. 100px|left