Multiple sclerosis. Observations and reflections--a personal memoir.

摘要: Abstract The pathogenesis of MS has become better understood as a result recent advances in several areas, particularly epidemiology and neuro-imaging. A number epidemiologically based conclusions need to be revised, most importantly the putative direct relationship between prevalence latitude, concept that epidemics have occurred some parts world. It is now clear genetic factors play much more important role genesis disease than environmental factors, although latter cannot ignored. existence susceptibility, coupled with either protective or enhancing which may environmental, recognized being individuals northern European origin. Much evidence suggests initiated by viral illness (or possibly vaccination) at time before puberty. This first antigenic challenge results development what called “MS trait”, systemic condition never develop into actual observed well unaffected siblings patients. trait almost certainly manifestation an alteration immune system; its effect render blood-brain barrier vulnerable variety agents will increase permeability. In order for involve central nervous system, loss integrity obligatory step, observation been amply confirmed neuroimaging studies. upon appears non-specific, since it from such diverse causes infection, vaccination, mild trauma. Edema inflammation follow, but myelinoclasia not always consequence; thus plaque formation occur initial lesion disappear without leaving trace. mechanism myelinoclasia, played lymphocytes, remain unknown. Although does affect asymptomatic long after formed, even person's entire life.