Multiple sclerosis

Abstract

Almost 200 years since it was first described, multiple sclerosis (MS) remains one of the most intriguing human diseases, with a complexity of clinical, pathological, and etiological features that have so far defied simple explanation. Although there are tempting hypotheses in abundance, it is still unclear which observations are phenomena and which are epiphenomena, what is cause and what is effect. The nature of the disease is a cruel one, striking people in their youth and most promising years, with a slow inexorable course over decades in many, and leading to gradual incapacitation. By its nature, it affects not only the patients themselves, but their families and friends in profound ways. Until modern imaging methods were introduced, the very diagnosis, based on clinical symptoms which were known to mimic many other diseases, was often in doubt.