NeurologyPending review
Multiple sclerosis
An autoimmune, T-cell-mediated attack on CNS myelin that produces neurological deficits disseminated in time and space, because demyelinating plaques occur at different sites of the central nervous system on different occasions, each slowing or blocking conduction along the affected pathway.
In a nutshell
MS is autoimmune demyelination of CNS white matter; the deficit produced depends on which tract the plaque sits in, and the diagnosis rests on demonstrating lesions disseminated in time and space, most directly on MRI.
Classic presentation
A young woman with painful unilateral visual loss (optic neuritis) or an episode of limb weakness or sensory disturbance that partially recovers over weeks, with a past episode affecting a different site.
Key points
- Symptoms map directly onto the tract affected by the plaque: optic nerve gives optic neuritis, spinal cord gives weakness, sensory loss or bladder dysfunction, brainstem gives diplopia or internuclear ophthalmoplegia, cerebellum gives ataxia.
Educational content pending clinical review. Not medical advice.