Multiple Sclerosis

Genetic factors are recognized as playing a role in MS. This is not to say that they cause MS. Although MS is typically a disease of people of European ancestry, it also occurs in African...

A comment about the relationship of virus infection to autoimmune disease in general is warranted. Infectious mononucleosis occurs only when adolescents or young adults are infected with the EBV. The symptoms of infectious mononucleosis (and...

The typical MS plaque seen in patients who have died early in their illness or who have had brain biopsies is composed of a mixture of lymphocytes with many more macrophages, without antibody. The macro-phages...

For a long time, antibody was considered to be a likely cause of myelin damage in MS, but the theory fell into disrepute. More recently, there appears to be stronger evidence that an antibody to...

Autoimmunity is an immune reaction against “self.” Autoimmune disease implies that tissue damage is a result of an autoimmune (autoallergic) reaction. This may be the result of antibody production or as a result of lymphocytes...

A great deal of evidence has been accumulated over the last several decades that abnormal immune reactions against myelin proteins can be detected in patients with MS. Although antibodies to myelin are common in patients...

Chlamydia pneumoniae and, more recently, Acineto-bacter are other organisms that have been implicated by other research. The chlamydia (C. pneumoniae) that is being studied is not the organism that commonly causes sexually transmitted disease. Although...

Currently, a great deal of interest is in the newly recognized family of viruses known as HSV-6. This virus family is distantly related to HSV-1 (the cold sore virus) but is very closely related to...

My doctor told me that I have antibody to the Epstein-Barr virus. Why do I have this antibody if I have MS? All of us encounter the EBV at some point in our lives. The...

The herpes families of viruses are DNA viruses that once inside our bodies persist for the rest of our lives. Although herpes simplex type I (HSV-1) and type II (HSV-2) can live in neurons and...

The onset of an acute demyelinating disease (postinfectious encephalomyelitis) occurs after a number of different infections such as measles and mumps as well as smallpox vaccination. About one quarter of these cases diagnosed as postinfectious...

There is no simple single answer to the questions “what causes MS?” or “why do some people get MS?” Over the last century and a half, three important inter-related contributing factors have been recognized: environmental...

The loss of bladder function occurs in a proportion of patients. With acute attacks when control of voiding is lost, recovery follows promptly. However, from several older studies of patients with long-term follow-up, it is...

How long will I be able to walk? Will I get paralyzed and end up in a wheelchair? The ability to walk is affected in an increasing proportion of untreated MS patients over time. However,...

Memory can be affected by MS. Confusion can accompany attacks and can be associated with memory difficulty, but this is not defined as true memory impairment. It is associated with generally impaired cognition. Anxiety and/or...

There are probably many reasons why some people worsen more quickly than others. Stress is implicated in many other diseases, and without question, it plays an important role in MS. It is clear that some...

Recently, there has been speculation that disability in MS patients will be predictably present after several years of illness. Some have claimed that there is no difference between various patient groups and that dis-ability eventuates...

Some neurologists, many in academic circles, have a perception that MS is predictably associated with dis-ability. Before the advent of new testing procedures, particularly MRI of the brain and spinal cord, many patients were not...

The absence of attacks with new neurologic symptoms, or recurrence of older problems, does not necessarily mean that a person has progressive MS. Patients can be stable for long periods of time. To recognize progression...

At first, my response was to assume that the person who asked this question was simply asking about the definition of this type of illness. However, he was actually asking about differences in populations and...

Spinal MS was a term used for primary progressive MS but has not generally been used for the last 30 years or so. It was a good descriptor for this illness because the predominant symptoms...

Both secondary progressive and relapsing progressive MS were referred to as chronic progressive in the past. The term chronic progressive is no longer used. Primary progressive patients were also sometimes referred to as chronic progressive....

Patients with relapsing-remitting illness have attacks of one or more symptoms with varying frequency and with variable degrees of recovery but do not progress between attacks. Relapsing-remitting MS patients have attacks without interval progression, which...

To most physicians dealing with MS and many patients, this illness seems to be a family of closely related disorders. To begin with, a doctor’s clinical diagnosis of MS is based on the recognition of...

The McDonald committee outlined the criteria in an article titled Recommended Diagnostic Criteria, which is in the Annals of Neurology. These criteria have been adopted in the United States and internationally.