The Neurologist: Clinical & Therapeutics Journal
Open Access

Multiple sclerosis (MS) is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. 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. Specific symptoms can include double vision, blindness in one eye, muscle weakness, and trouble with sensation or coordination. The most common immune-mediated disorder affecting the central nervous system is multiple sclerosis (MS), which was first described in 1868 by French neurologist Jean-Martin Charcot. The term “multiple sclerosis” refers to the numerous glial scars (or sclerae – essentially plaques or lesions) that develop on the white matter of the brain and spinal cord. Better outcomes are more common in women, those who develop the disease early in life, and those who experience

Autonomic, visual, motor, and sensory issues are the most common neurological symptoms of MS. The specific symptoms, which are determined by the locations of the lesions within the nervous system, may include sensitivity loss or changes in sensation, such as tingling, pins and needles, or numbness. pronounced reflexes, muscle spasms, difficulty moving, coordination, and balance issues (ataxia), muscle weakness; difficulties speaking or swallowing, difficulties seeing (nystagmus, optic neuritis, or double vision), fatigue, and acute or persistent pain; and problems with the bladder and bowel (such as neurogenic bladder), among other things. When multiple sclerosis is more advanced, walking can be difficult and there is a greater chance of falling. Thinking problems and emotional problems like depression or mood swings are also common. The primary deficit in cognitive function that people with MS experience is slowed informationprocessing speed, with memory also being affected more frequently and executive function being affected less frequently [1-3]. The expanded disability status scale (EDSS) is the main measure of disability and severity, with other measures such as the multiple sclerosis functional composite being increasingly used in research. EDSS is also correlated with falls in people with MS. While it is a popular measure, EDSS has been criticized for some of its limitations, such as relying too much on walking. The condition begins in 85% of cases as clinically isolated Exacerbations rarely occur more frequently than twice per year. Some relapses, however, are preceded by common triggers and they occur more frequently during spring and summer. Similarly, viral infections such as the common cold, influenza, or gastroenteritis increase their risk. Stress may also trigger an attack. Women with MS who become pregnant experience fewer relapses; However, the risk increases in the first few months after delivery. Overall, pregnancy does not appear to affect long-term disability. Relapse rates have not been found to be affected by a number of events, including vaccination, breast feeding, physical trauma, and Uhthoff’s phenomenon.

One hypothesis is that infection by a widespread microbe contributes to disease development and that the geographic distribution of this organism significantly influences the epidemiology of MS. The hygiene hypothesis and the prevalence hypothesis are two opposing versions of this hypothesis, with the hygiene hypothesis being more favored. The hygiene hypothesis proposes that exposure to certain infectious agents early in life is protective. The prevalence hypothesis states that the disease is more prevalent in areas where the infectious agent is more prevalent, implying that an early, silent, and persistent infection raises the risk of disease. The presence of oligoclonal bands in the brain and cerebrospinal fluid of the majority of people with MS, the association of several viruses with human demyelinating encephalomyelitis, and the occurrence of demyelination in animals caused by some viral infections are all evidence for a virus as the cause. Epstein-Barr virus (EBV) can cause infectious mononucleosis and infects approximately 95% of adults. Although only a small percentage of those infected with EBV later develop MS, there is “compelling epidemiological and mechanistic evidence for a causal role of EBV in multiple sclerosis. A study of individuals who served in the United States military between 1993 and 2013 compared 801 people who developed MS on or after military service to 1,566 matched controls who did not develop MS during this observation period. Infection with EBV was associated with a 32-fold increased risk of MS, according to the study. It found no evidence of an increased risk following infection with other viruses, including the cytomegalovirus, which is transmitted similarly. Despite the fact that EBV alone may not be sufficient to cause MS, the finding strongly suggests that EBV is a factor in its onset [4,5].

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