Wikipedia:VideoWiki/Multiple sclerosis

Multiple sclerosis (MS) is a demyelinating disease, where the insulating covers, of nerve cells in the brain and spinal cord, are damaged.{{cite web|title=NINDS Multiple Sclerosis Information Page|url=http://www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm|website=National Institute of Neurological Disorders and Stroke|access-date=6 March 2016|date=19 November 2015|url-status=dead|archive-url=https://web.archive.org/web/20160213025406/http://www.ninds.nih.gov/disorders/multiple_sclerosis/multiple_sclerosis.htm|archive-date=13 February 2016}}

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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.{{cite journal | vauthors = Compston A, Coles A |author1-link=Alastair Compston | title = Multiple sclerosis | journal = Lancet | volume = 372 | issue = 9648 | pages = 1502–17 | date = October 2008 | pmid = 18970977 | doi = 10.1016/S0140-6736(08)61620-7 }}{{cite journal | vauthors = Compston A, Coles A | title = Multiple sclerosis | journal = Lancet | volume = 359 | issue = 9313 | pages = 1221–31 | date = April 2002 | pmid = 11955556 | doi = 10.1016/S0140-6736(02)08220-X }}{{cite book|title=Bradley's neurology in clinical practice.|year=2012|publisher=Elsevier/Saunders|location=Philadelphia, PA|isbn=1-4377-0434-4|edition=6th|vauthors=Murray ED, Buttner EA, Price BH |veditors=Daroff R, Fenichel G, Jankovic J, Mazziotta J |chapter=Depression and Psychosis in Neurological Practice}}

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

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New symptoms for MS can occur in different forms, as isolated attacks (called relapsing forms), or building up over time (called progressive forms).{{cite journal | vauthors = Lublin FD, Reingold SC | author1-link=Fred D. Lublin | title = Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis | journal = Neurology | volume = 46 | issue = 4 | pages = 907–11 | date = April 1996 | pmid = 8780061 | doi = 10.1212/WNL.46.4.907 }} The disease usually begins between the ages of 20 and 50, and is twice as common in women as in men.{{cite journal | vauthors = Milo R, Kahana E | title = Multiple sclerosis: geoepidemiology, genetics and the environment | journal = Autoimmunity Reviews | volume = 9 | issue = 5 | pages = A387-94 | date = March 2010 | pmid = 19932200 | doi = 10.1016/j.autrev.2009.11.010 }}

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

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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.{{cite journal | vauthors = Nakahara J, Maeda M, Aiso S, Suzuki N | title = Current concepts in multiple sclerosis: autoimmunity versus oligodendrogliopathy | journal = Clinical Reviews in Allergy & Immunology | volume = 42 | issue = 1 | pages = 26–34 | date = February 2012 | pmid = 22189514 | doi = 10.1007/s12016-011-8287-6 }}

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What initiates the process is uncertain, but it may include genetics, and environmental triggers, such as a viral infection.{{cite journal | vauthors = Ascherio A, Munger KL | title = Environmental risk factors for multiple sclerosis. Part I: the role of infection | journal = Annals of Neurology | volume = 61 | issue = 4 | pages = 288–99 | date = April 2007 | pmid = 17444504 | doi = 10.1002/ana.21117 }}

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MS is usually diagnosed based on the presenting signs and symptoms, and the results of supporting medical tests.{{cite journal | vauthors = Tsang BK, Macdonell R | title = Multiple sclerosis- diagnosis, management and prognosis | journal = Australian Family Physician | volume = 40 | issue = 12 | pages = 948–55 | date = December 2011 | pmid = 22146321 }} 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.{{cite journal | vauthors = McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, McFarland HF, Paty DW, Polman CH, Reingold SC, Sandberg-Wollheim M, Sibley W, Thompson A, van den Noort S, Weinshenker BY, Wolinsky JS | author1-link=W. Ian McDonald | author16-link=Jerry Wolinsky | title = Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis | journal = Annals of Neurology | volume = 50 | issue = 1 | pages = 121–7 | date = July 2001 | pmid = 11456302 | doi = 10.1002/ana.1032 }}{{cite journal | vauthors = Polman CH, Reingold SC, Edan G, Filippi M, Hartung HP, Kappos L, Lublin FD, Metz LM, McFarland HF, O'Connor PW, Sandberg-Wollheim M, Thompson AJ, Weinshenker BG, Wolinsky JS | title = Diagnostic criteria for multiple sclerosis: 2005 revisions to the "McDonald Criteria" | journal = Annals of Neurology | volume = 58 | issue = 6 | pages = 840–6 | date = December 2005 | pmid = 16283615 | doi = 10.1002/ana.20703 }}{{cite journal | vauthors = Rashid W, Miller DH | title = Recent advances in neuroimaging of multiple sclerosis | journal = Seminars in Neurology | volume = 28 | issue = 1 | pages = 46–55 | date = February 2008 | pmid = 18256986 | doi = 10.1055/s-2007-1019127 }}

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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.

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Physical therapy can help with people's ability to function. Many people pursue alternative treatments, despite a lack of evidence of benefit.{{cite journal | vauthors = Huntley A | title = A review of the evidence for efficacy of complementary and alternative medicines in MS | journal = International MS Journal | volume = 13 | issue = 1 | pages = 5–12, 4 | date = January 2006 | pmid = 16420779 | doi = }}

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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.{{cite journal | vauthors = Weinshenker BG | title = Natural history of multiple sclerosis | journal = Annals of Neurology | volume = 36 Suppl | issue = Suppl | pages = S6-11 | year = 1994 | pmid = 8017890 | doi = 10.1002/ana.410360704 }}

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Multiple sclerosis is the most common immune-mediated disorder affecting the central nervous system.{{cite journal | vauthors = Berer K, Krishnamoorthy G | title = Microbial view of central nervous system autoimmunity | journal = FEBS Letters | volume = 588 | issue = 22 | pages = 4207–13 | date = November 2014 | pmid = 24746689 | doi = 10.1016/j.febslet.2014.04.007 }}

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In 2015, about 2.3 million people were affected globally, with rates varying widely in different regions, and among different populations.{{cite journal | author = GBD 2015 Disease and Injury Incidence and Prevalence Collaborators | title = Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1545–1602 | date = October 2016 | pmid = 27733282 | pmc = 5055577 | doi = 10.1016/S0140-6736(16)31678-6 }}{{cite book |author=World Health Organization |title=Atlas: Multiple Sclerosis Resources in the World 2008 |publisher=World Health Organization |location=Geneva |year=2008 |pages=15–16 |isbn=92-4-156375-3 |url=http://whqlibdoc.who.int/publications/2008/9789241563758_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20131004215703/http://whqlibdoc.who.int/publications/2008/9789241563758_eng.pdf |archive-date=4 October 2013 }} That year about 18,900 people died from MS, up from 12,000 in 1990.{{cite journal | author = GBD 2015 Mortality and Causes of Death Collaborators | title = Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015 | journal = Lancet | volume = 388 | issue = 10053 | pages = 1459–1544 | date = October 2016 | pmid = 27733281 | pmc = 5388903 | doi = 10.1016/s0140-6736(16)31012-1 }}{{cite journal | vauthors = | title = Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 | journal = Lancet | volume = 385 | issue = 9963 | pages = 117–71 | date = January 2015 | pmid = 25530442 | pmc = 4340604 | doi = 10.1016/S0140-6736(14)61682-2 }}

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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.{{cite journal | vauthors = Clanet M | title = Jean-Martin Charcot. 1825 to 1893 | journal = International MS Journal | volume = 15 | issue = 2 | pages = 59–61 | date = June 2008 | pmid = 18782501 | url = http://www.msforum.net/Site/ViewPDF/ViewPDF.aspx?ArticleID=E80DC748-5048-4BD2-9393-18BCAE0A1514&doctype=Article | format = PDF }}
* {{cite journal |author=Charcot, J. |year=1868 |title=Histologie de la sclerose en plaques |journal=Gazette des hopitaux, Paris |volume=41 |pages=554–5 }}

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