Multiple Sclerosis: Early Diagnosis and Comprehensive Management

MS is an autoimmune disease, with genetic factors and environmental factors having important roles. Characteristically, MS affects the spinal cord, brain and optic nerves in the central nervous system and spares the nerve roots and peripheral nerves in the peripheral nervous system. Usually MS has a relapsing-remitting course with repeated neurological episodes, each followed by partial or complete recovery and a period free of new symptoms. Most patients with relapsing-remitting MS eventually develop secondary progressive MS, with progressive deterioration independent of relapses. - In about 10% of patients, MS follows a primary progressive course, with progressive deterioration from onset without discrete attacks. Interferon beta and glatiramer acetate reduce the attacks of relapsing-remitting MS by one-third but are not beneficial in primary or secondary progressive MS. Major depression occurs at some stage in 50% of patients with MS; a high index of suspicion is needed to ensure early diagnosis and treatment