Multiple Sclerosis, Understanding The Name And The History

Cases of sclerosis have been described since 1396. Saint Lidwina of Holland may have suffered from this condition. The court doctor that examined Lidwina said: “Believe me, there is no cure for this illness; it comes directly from God. Even Hippocrates and Gallenus would not be of any help here.”

Another attack was described in 1882 in the diary of Sir Augustus D'Este, grandson of King George III of England , as it follows: “At Florence , I began to suffer from a confusion of sight. About the 6th of November, the malady increased to the extent of my seeing all objects double. Each eye had its separate visions. Dr. Kissock supposed bile to be the cause. I was twice blooded from the temple by leeches. Purges were administered. One Vomit and twice I lost blood from the arm. The Malady in my eyes abated, again I saw all object naturally in their single state. I was able to go out and walk.”

The first mention of this disease may be in the thirteen century sagas of Iceland . Carswell in London and Cruveilhier in Paris provided the first illustrations in 1840. Charcot described clinically the disease and the process of demyelination in plaques and Rindfleisch gave a description of the vascular inflammatory CNS lesions in 1860.

Clinical manifestations

The lesions generated by MS in the brain and spinal cords completely disestablish the function of the central nervous system. The symptoms are different in nature and intensity and include tiredness, disturbed functions in the sensory, bladder, motor, bowl, sexual organs, cerebellum, optic nerve and cognitive realms.

The symptoms produce disability in 75% of the cases. The location of plaques follow a certain “plan” including mostly the periventricular white matter so there are a few common signs for all the affected people, as it is the case of ophthalmoplegia, caused by the damage of the medial longitudinal fascicule. The longest period of symptoms' continuous manifestation, varies from two to six weeks then they enter remission sometimes for good. But 40% of the attacks generated long lasting problems.

The course and subtypes of MS

The disease is unpredictable . It may enter remission, then explode into violent attacks. Subtypes are important for a prognosis of the future course of the disease. They are interchangeable and have also an important role in the development of the new treatments.

The four standardized types of the MS are:

• - Relapsing – remitted, which describes the initial course of 85 – 90 % of the MS persons. The characteristics of this form are: violent attacks followed by periods of remission. But the consequences of the attacks are permanent in many cases. When the deficits resolve, specialists call it “benign MS”.
• - Secondary – progressive form is the next phase of relapsing – remitted form. It attacks over 80 % of the people with the first form. The relapsing – remitted form then enters decline, which includes new symptoms, worsening of the cognitive functions and this is not all. It is the most common and damaging form.
• - Primary – progressive represents a form that knows no remissions after the first symptoms. No clear attack is present, just perpetual decline. It mostly affects people at older ages.
• - Progressive – relapsing includes both a perpetual decline and also unexpected severe attacks.