Multiple sclerosis is a chronic inflammatory autoimmune disorder of the central nervous system which constitutes the most common cause of neurological disability in young adults.

Typically a disease of young adults, the diagnosis depends on the detection at least two demyelinating lesions in the brain or spinal cord separated in time and space. The course of the disease is characterised by relapses and remissions with some residual disability. Progressive disability may occur from the outset, but more commonly occurs after several years of relapsing and remitting disease.

• approximately 85% of patients with multiple sclerosis present with the relapsing-remitting form, comprising episodic relapses and remissions that may be partial or complete
  • 15% of patients with relapsing-remitting multiple sclerosis have a mild course with minimal disability after 15 years, called benign multiple sclerosis (1)
• approximately 15% of patients present without relapses but show a slowly progressive pattern called primary progressive multiple sclerosis (a few of these may later relapse, called progressive-relapsing multiple sclerosi)
• classification of multiple sclerosis is important as all the disease modifying drugs have shown benefit only in the relapsing-remitting type and no benefit in the primary progressive form (1)

Treatment aims to:

• reduce the severity and frequency of relapses
• limit persistent disability
• relieve symptoms
• promote tissue repair

Reference:

1. Murray TJ. Diagnosis and treatment of multiple sclerosis. BMJ 2006; 332: 525-7.