A progressive inflammatory demyelinization of the white matter of the brain and spinal cord. Presents with multiple and varied neurological symptoms. Usual course is intermittent, progressive, and relapsing. There seems to be a strong genetic component in susceptibility to the disease. Etiology is unknown; theories include autoimmune and/or viral causation.

Structural clinical symptoms include:

-joint pain,

-incoordination and loss of position and vibration sense,

-hand paralysis and clumsiness,

-monoparesis, hemiparesis,

-paresthesias and hyperactive deep tendon reflexes.

Other findings include emotional lability, fatigue, hyperesthesia, ocular paralysis, trigeminal neuralgia, and urinary and genital problems.

There is no specific therapy. Drugs are prescribed as needed to ameliorate symptoms and often include moderate to high dose corticosteroids. Remissions occur spontaneously and make treatment evaluation difficult. The expected course of the disease is highly variable and unpredictable. About 70% of patients lead active, productive lives with prolonged remissions; average duration exceeds 25 years. 30% relapse in one year, 20% in 5-9 years, 10% In 10-30 years.

CLINICAL

Physiotherapy is recommended to MAINTAIN RANGE OF MOTION AND STRENGTH AND TO AVOID CONTRACTURES. It is important to avoid a hopeless outlook. Nevertheless, it is also important to avoid making false claims of cure. Bodywork should be aimed at maintaining and enhancing activity level; it needs to include the whole body to monitor potential contractures – in the small joints as well as the large. If high dose corticosteroids are prescribed, there may be problems with tissue tone; a light touch is recommended until tone is restored.Multiple Sclerosis