Abstract

Multiple sclerosis is the most common chronic neurologic condition affecting young adults in the United States, with a prevalence of approximately 1 in 1000. Previously thought to be an inflammatory, demyelinating disease primarily affecting central nervous system (CNS) white matter, more recent imaging studies have shown that significant damage to cortical gray matter also occurs. Multiple sclerosis affects twice as many women as men, and the prevalence rises as geographical distance from the equator increases. Visual disturbances (diplopia, blurred vision), weakness, gait disturbance, vertigo, fatigue, urinary retention and incontinence, and difficulties with speech and swallowing are all common clinical signs and symptoms of MS. Neuropsychiatric symptoms are also common and may be the first sign of MS. Because many of the typical signs and symptoms are nonspecific and pseudoneurologic, patients are frequently mistaken for having a primarily mental illness, and a diagnosis may be delayed [1]