Review of multiple sclerosis: Epidemiology, etiology, pathophysiology, and treatment

Abstract

Multiple sclerosis (MS) is a chronic autoimmune disease with demyelination, inflammation, neuronal loss, and gliosis (scarring). Our object to review MS pathophysiology causes and treatment. A Narrative Review article was conducted by searching on Google scholar, PubMed, Research Gate about relevant keywords we exclude any unique cases and case reports. The destruction of myelinated axons in the central nervous system reserves this brunt. This destruction is generated by immunogenic T cells that produce cytokines, copying a proinflammatory T helper cells1-mediated response. Autoreactive cluster of differentiation 4 + cells, particularly the T helper cells1 subtype, are activated outside the system after viral infections. T-helper cells (cluster of differentiation 4+) are the leading initiators of MS myelin destruction. The treatment plan for individuals with MS includes managing acute episodes, using disease-modifying agents to decrease MS biological function of MS, and providing symptom relief. Management of spasticity requires physiotherapy, prescription of initial drugs such as baclofen or gabapentin, secondary drug options such as tizanidine or dantrolene, and third-line treatment such as benzodiazepines. To treat urinary incontinence some options include anticholinergic medications such as oxybutynin hydrochloride, tricyclic antidepressants (such as amitriptyline), and intermittent self-catheterization. When it comes to bowel problems, one can try to implement stool softeners and consume a high roughage diet. The review takes about MS causes Pathophysiology and examines current treatment strategies, emphasizing the advancements in disease-modifying therapies and symptomatic treatments. This comprehensive analysis enhances the understanding of MS and underscores the ongoing need for research to develop more effective treatments.

Figure 1.

Distribution of MS prevalence. MS = multiple sclerosis.

Figure 2.

Autoimmune theory of the pathogenesis of MS.^[9] MS = multiple sclerosis.

Figure 3.

Clinical course of multiple sclerosis (MS).^[16] (A) Relapsing/remitting MS (RRMS), (B) secondary progressive MS (SPMS), (C) primary progressive MS (PPMS), (D) progressive/relapsing MS (PRMS).

Figure 4.

Multiple sclerosis treatment selection.^[36] It is possible to conduct studies of various interferon (IFN-) preparations, particularly moving from an Avonex-style once-weekly dose schedule to one that involves more frequent dosing (e.g., Rebif, Betaseron/Extavia). Additionally, natalizumab usage is an option for people who have the JC virus. The MRI, or magnetic resonance imaging. MRI = magnetic resonance imaging.