Background multiple sclerosis ms is a chronic and autoimmune disease of the central nervous system cns mainly characterized by inflammatory demyelination which manifests as relapses and diffuse damage and brain volume loss both accounting for neurodegeneration and therefore physical disability. Multiple sclerosis ms is the commonest non traumatic disabling disease to affect young adults the incidence of ms is increasing worldwide together with the socioeconomic impact of the disease the underlying cause of ms and mechanisms behind this increase remain opaque although complex gene env multiple sclerosis a review eur j neurol 2019 jan26127 40 doi 101111 ene13819 . Multiple sclerosis is a journey from being at risk through the asymptomatic prodromal and symptomatic phases of the disease ms is typically suspected when a person presents with a clinically isolated syndrome cis this can be mono or poly symptomatic depending on the location of the eloquent lesion s. In this comprehensive review ms epidemiology potential aetiological factors and pathology are discussed before moving on to clinical aspects of ms diagnosis and management introduction multiple sclerosis ms is the commonest non trau matic disabling disease to affect young adults 1 there is increasing incidence and prevalence of ms in both developed and developing countries 2 the . Multiple sclerosis a comprehensive review introduction multiple sclerosis ms is a chronic debilitating neurodegenerative disease the basic disease process of multiple sclerosis is characterized by inflammation and then destruction of the myelin sheaths and axons in the central nervous system eg the brain brain stem spinal cord and optic nerve patients typically experience phases
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