Pathogenesis

Epidemilogical data suggests both a generic

susceptibility and some enviromental influence,
affecting during childhood and resurfacing after years
of latency
Viral infections have been studied as a possible trigger factor,
but data has been inconclusive
Same applies to data obtained from bacterial infections

Pathogenesis
Combination of an intial event early in life with a
secondary fact later in life has been linked to
reactivation of the disease and its exacerbation
Secondary mechanism can be an autoimmune disease ranging
from affecting structural integrity of myelin to axonal
destruction

Parallels have been drawn between this pattern and

that found in Acute Disseminated Encephalomyelitis
Supported by the presence of antibodies specific to myelin
proteins
Ex. MBP found in both the serum and CSF of MS patients, as an
indication of active demyelination

Clinical manifestations
Early symptoms and signs
Weakness and numbness , in one or both limbs, present in
50% of the patients
Tingling in the extremities, in addition to tight band sensation
around the trunk or limbs
Associated with involvement of the posterior column of the spinal cord

Clinical manifestations
Early symptoms and sings
Symptoms are present in one leg, but signs are present in
both lower extremities

Several syndromes are also associated with MS and are

part of the initial manifestation
Optical Neuritis ( Retrobulbar Neuritis/Papilitis)
25% of all adults patients and higher in children
First manifestation is an episode of Optic Neuritis, over several days
Partial or total loss of vision, with a scotoma involving the macular area
and blindspot