Multiple Sclerosis

Abstract

Multiple sclerosis is the most common disabling neurologic disease affecting young adults and adolescents in the United States. The first objective of this article is to familiarize nonspecialists with the cardinal features of multiple sclerosis and our current understanding of its etiology, epidemiology, and natural history. The second objective is to explain the approach to diagnosis. The third is to clarify current evidence-based treatment strategies and their roles in disease modification. The overall goal is to facilitate the timely evaluation and confirmation of diagnosis and enhance effective management through collaboration among primary physicians, neurologists, and other care providers who are confronted with these formidably challenging patients.

The experiences of individuals with Multiple Sclerosis in the Western Cape, South Africa

“…Although the precise causes of MS are still unknown, many studies have been conducted in order to investigate probable causes (Courtney et al 2009;Cross, Cross & Piccio 2012;Maghzi et al 2011;Rumrill 2009;Young 2011). Genetic, environmental and immunologic factors have been linked to the development of MS (Courtney et al 2009;Cross et al 2012;Rumrill 2009).…”

“…Genetic, environmental and immunologic factors have been linked to the development of MS (Courtney et al 2009;Cross et al 2012;Rumrill 2009). The presence of DR21501B1, the human lymphocyte antigen allele, is linked to a higher susceptibility chance of triggering MS (Courtney et al 2009;Cross et al 2012;Maghzi et al 2011;Rumrill 2009;Young 2011).…”

“…Genetic, environmental and immunologic factors have been linked to the development of MS (Courtney et al 2009;Cross et al 2012;Rumrill 2009). The presence of DR21501B1, the human lymphocyte antigen allele, is linked to a higher susceptibility chance of triggering MS (Courtney et al 2009;Cross et al 2012;Maghzi et al 2011;Rumrill 2009;Young 2011). There is also a theory that environmental triggers, such as low levels of Vitamin D (as seen in the northern hemisphere), can activate the development of MS in genetically-predisposed individuals (Courtney et al 2009;Maghzi et al 2011;Rumrill 2009).…”

“…There are four subtypes of multiple sclerosis, namely relapsing/remitting, secondary, primary progressive and progressive relapsing (Courtney et al 2009). Relapsing/ remitting MS (RRMS) is usually the first form of diagnosis in 80% of individuals with MS (Reipert 2004).…”

The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis

“…The prevalence of MS rises in higher latitudes, ranging from 20/100,000 to nearly 90/100,000 in the northern hemisphere countries, possibility related to sun exposure, genetics of specific populations in these areas and others yet unknown environmental factors 8,9 . The prevalence of MS in the city of Sao Paulo and Belo Horizonte, two major Brazilian cities, are estimated around 15/100,000 10 and 18/100,000 inhabitants 11 and, although they might not reflect the real national data, they are the most accurate information on the theme to date.…”