Neurology
Multiple Sclerosis
다발성경화증
CNS demyelinating immune-mediated disease (dissemination in time and space)
- How common
- Commonly encountered in neurology
- Typical age
- Variable age
What is it?
Core pathophysiology of Multiple Sclerosis.
Commonly affected: Affected neural region (peripheral nerve, brain, spinal cord, or muscle)
How it develops
- Trigger/predispositionTriggering or predisposing factors for Multiple Sclerosis
- Neural injurySpecific nerve/muscle injury occurs
- ManifestationCharacteristic neurologic features appear
- CourseRecovery or progression depends on treatment
Symptoms
- Characteristic neurologic symptomClassic Multiple Sclerosis feature
- Motor/sensory changeWeakness, sensory loss, paresthesia
- Functional impairmentDifficulty with ADLs
How it is examined
- Neurologic examStrength, sensation, reflex, cranial nerve, cerebellar
- Specific testsAppropriate workup for Multiple Sclerosis (NCS/EMG/MRI/serology)
Imaging
Plain X-ray generally not used for diagnosis.
- N/A
Brain/spine MRI or NCS/EMG as appropriate.
- Region-specific neurologic findings
Non-surgical care
- PharmacotherapyDiagnosis-specific neurologic medication
- Rehab/PTFunctional recovery and maintenance
- Trigger managementModify identified triggers
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Refractory or structural abnormality
Procedures that may be discussed
- Nerve decompression or targeted procedure
- Immunotherapy/plasmapheresis (if autoimmune)
Outlook
Variable based on timing of diagnosis/treatment; most improve with active care.