Multiple sclerosis

This article needs more reliable medical references for verification or relies too heavily on primary sources, specifically: references that do not meet Wikipedia's guidelines for medical content, or are excessively dated, are contained in this article. Please review the contents of the article and add the appropriate references if you can. Unsourced or poorly sourced material may be challenged and removed. Find sources: "Multiple sclerosis" – news · newspapers · books · scholar · JSTOR (July 2022)

Multiple sclerosis
Other names	Multiple cerebral sclerosis, multiple cerebro-spinal sclerosis, disseminated sclerosis, encephalomyelitis disseminata
CD68-stained tissue shows several macrophages in the area of a demyelinated lesion caused by MS.
Specialty	Neurology
Symptoms	Variable, including almost any neurological symptom or sign, with autonomic, visual, motor, and sensory problems being the most common.[1]
Usual onset	Age 20–50[2]
Duration	Long term[3]
Causes	Unknown[4]
Diagnostic method	Based on symptoms and medical tests[5]
Treatment	Disease-modifying therapies[6] Physiotherapy[7] Occupational therapy[7]
Frequency	0.032% (world)

Multiple sclerosis (MS) is an autoimmune disease in which the insulating covers of nerve cells in the brain and spinal cord are damaged.^[3] This damage disrupts the ability of parts of the nervous system to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems.^[1][8][9] Specific symptoms can include double vision, vision loss, eye pain, muscle weakness, and loss of sensation or coordination.^[3][10][11] MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms).^[12][13] In the relapsing forms of MS, between attacks, symptoms may disappear completely, although some permanent neurological problems often remain, especially as the disease advances.^[13] In the progressive forms of MS, bodily function slowly deteriorates and disability worsens once symptoms manifest and will steadily continue to do so if the disease is left untreated.^[14]

While the cause is unclear, the underlying mechanism is thought to be either destruction by the immune system or failure of the myelin-producing cells.^[4] Proposed causes for this include immune dysregulation, genetics, and environmental factors, such as viral infections.^{[15][16][8][17]} MS is usually diagnosed based on the presenting signs and symptoms and the results of supporting medical tests.^[5]

No cure for multiple sclerosis is known.^[18] Current treatments are aimed at mitigating inflammation and resulting symptoms from acute flares and prevention of further attacks with disease-modifying medications.^[8][19] Physical therapy^[7] and occupational therapy,^[20] along with patient-centered symptom management, can help with people's ability to function. The long-term outcome is difficult to predict; better 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.^[21]

Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system.^[22] Nearly one million people in the United States had MS in 2022,^[23] and in 2020, about 2.8 million people were affected globally, with rates varying widely in different regions and among different populations.^[24] The disease usually begins between the ages of 20 and 50 and is twice as common in women as in men.^[2] MS was first described in 1868 by French neurologist Jean-Martin Charcot.^[25]

The name "multiple sclerosis" is short for multiple cerebro-spinal sclerosis, which refers to the numerous glial scars (or sclerae – essentially plaques or lesions) that develop on the white matter of the brain and spinal cord.^[25]