Multiple Sclerosis (MS)
Multiple Sclerosis (MS)
Student’s Name
Institutional Affiliation
Instructor’s Name
Description of Pathology
Multiple sclerosis (MS) is a chronic inflammatory disease affecting primarily the central
nervous system. It leads to clinical symptoms like visual loss or mobility impairment, which may
not always correspond with MRI changes. Often lifelong and rarely severely disabling if
which the body's defense system attacks the myelin sheath—a protective covering surrounding
nerve cells in the brain and spinal cord (McGinley et al., 2021). This destructive process causes
these cells to lose function. The relapsing-remitting and primary progressive forms of MS
manifest in cycles of symptoms appearing and improving. Symptoms of multiple sclerosis often
occur together and include double vision, tremors, difficulty walking due to imbalance,
numbness in certain areas of the body, exhaustion, and coordination problems. Long-term
vitamin D insufficiency has been linked to an increased risk of sclerosis and symptom onset,
related to insufficient levels of vitamin D and sun exposure (Baskaran et al., 2023). The rising
number of disease symptoms highlights the need for screening to prevent catastrophic outcomes.
multiple sclerosis worldwide. Chronic illness disproportionately affects people of European and
Nordic European descent, which explains the high incidence in European and North American
countries (Baskaran et al., 2023). According to Walton et al. (2020), the prevalence of MS in
North America was 288 cases per 100,000 people, with about 913,925 diagnosed. Situational
data, such as detailed breakdowns by demographics, is not readily available in places like New
Jersey. The state, however, has the highest illness rate in the country, at 377.4 cases per 100,000
The central nervous system (CNS) is the major body system affected by multiple
sclerosis. The CNS is composed of the brain, spinal cord, and optic nerves responsible for
processing sensory information, coordinating movement, and regulating various body functions.
In the CNS, neurons and glial cells form a part of normal anatomy. Neurons which carry the
electric impulses in the body are the most important cells of the body. The cells of the glia or
neuroglia perform an essential function in protecting and insulating the neurons. According to
Calahorra et al. (2022), myelin is a fatty substance produced by oligodendrocytes in the CNS that
creates an insulating sheath that covers the axons of neurons, allowing for rapid nerve impulse
conduction.
In a normal, healthy central nervous system, the myelin sheath enables fast and efficient
conduction of electrical signals between neurons to establish smooth communication with other
parts of our body. The brain is made up of several parts with different functions. The cerebrum
for example is involved in reasoning and memory while the cerebellum is in body movements
and balance. The spinal cord acts as a pathway for signals travelling to and from the brain,
including reflex actions and voluntary movement. The other important feature of the CNS is the
blood-brain barrier (BBB). According to the research done by Schreiner et al. (2022), the blood-
brain barrier is a selective barrier that separates the blood that circulates in one’s body from the
cerebral spinal fluid while only allowing certain substances into the brain. For restoration of the
The normal physiology of the central nervous system (CNS) is essential for maintaining
proper functioning and health of the body. The CNS contains the brain, spinal cord and optic
nerves and controls our ability to think, process information through various phenomena like
4
memory & cognitive skills, generate emotions as well as coordinate movement by transmission
of both electrical signals (nervous activity) plus chemical neurotransmission. The CNS consists
of a network of nerve cells or neurons that send electrical signals to one another along axons, the
thin projections emerging from each cell body that are covered in slightly fatty wrapping called
myelin. Oligodendrocytes are myelin-producing cells in the central nervous system (CNS),
which increases nerve impulse conduction velocity facilitating rapid communication between
different parts of the nervous system (Calahorra et al., 2022). This communication is important
for muscle coordination, sensory perception, cognitive functions and other body homeostasis etc.
Intact myelin sheath and functional synapses (at which neurons communicate with each
other) are indispensable for the normal physiology of CNS. In a healthy CNS, nerve impulses
hop along the myelinated axons from one node of Ranvier (gaps in the myelin sheath) to another,
this action is known as saltatory conduction (Calahorra et al., 2022). This speed of signal
propagation in a manner well suited to conducting signals over long distances, such as within the
nervous system or from one side of the body to the other is necessary for voluntary muscle
control, particularly fine skills requiring high temporal precision and support low error rates.
Moreover, synapses also allow the release of neurotransmitters by one neuron which are relayed
to another thereby providing a basis for higher-order function processing supporting cognitive
and motor behaviors. Another crucial normal physiological component of the CNS is the blood-
brain barrier (BBB), which shields the brain from toxic substances allowing only essential
nutrients to pass through. The BBB is necessary to keep the synaptic environment stable which
Mechanism of Pathophysiology
5
The pathophysiology of multiple sclerosis involves the central nervous system and is
results in white matter lesions or plaques within the central nervous system from inflammation
caused by immune cells attacking myelin and damaging axons. This causes nerves to transmit
signals more slowly (since the Myelin helps increase electric velocity) thus impairing normal
nerve signaling; a condition called Demyelination. Multiple sclerosis leads to injury and loss of
neurons, which result from chronic inflammation and demyelination (Tobore, 2020). An
individual with a normal, healthy immune system usually produces proteins (immunoglobulins,
Ig or antibodies) and cells that help protect the body from invaders but are kept from
overreacting against itself. But in MS, this balance goes awry when genetic susceptibility
combines with environmental factors (like a viral infection or vitamin D deficiency) to set off an
autoimmune response. According to Van Langelaar et al. (2020), it is a type of response that
occurs when T cells —a set of white blood cells that too, aim to keep a person healthy by
recognizing and destroying potentially harmful invaders— become active. In MS, these T cells
wrongfully perceive the myelin sheath — a fatty insulation layer surrounding nerve fibers in the
After activation, these autoreactive T cells are attracted to travel through the blood-brain
barrier (BBB) — a key feature designed to keep harmful components from getting into the CNS.
The breakage of the BBB in MS results in an influx of anti-myelin T cells through (i) producing
pro-inflammatory cytokines that recruit other immune effector populations including B cells and
macrophages to inflammatory sites within CNS. B cells manufacture antibodies that target
myelin, prompting an even stronger immune assault. Macrophages, the cells that normally engulf
and destroy pathogens then begin to assault and degrade the myelin sheath (Van Langelaar et al.,
6
2020). This loss of myelin, also referred to as demyelination, impedes the ability of neurons to
effectively carry electrical signals leading directly to the different forms of neurological
disability observed that exemplify MS: muscle weakness; visual disruptions and coordination
problems.
With time, the continuous inflammation and demyelination with attempted repair
contribute to plaque or scar formation in the CNS, mainly seen within the white matter of the
brain/spine. These patches are where the myelin has been stripped away and replaced with scar
tissue, which makes it even more difficult for nerves to send signals. Moreover, the continuing
immune-mediated assault can damage axons beneath neurons or possibly as well, resulting in
permanent neuronal loss and driving gradual disability of MS patients (Haki et al., 2024). These
features of demyelination, axonal injury and sclerotic plaque are the pathological hallmarks of
MS obviating major disruption to normal CNS anatomy and physiology leading ultimately to
illness.
Prevention
consistent with environmental factors contributing to multiple sclerosis's onset. Given the fact
that the majority of individuals do not know about its early signs or can otherwise misinterpret
initial symptoms to those related to other diseases, this patient education program may
tentatively serve as a feasible approach to controlling prevalence across the national level (Haki
et al., 2024). Unfortunately, multiple sclerosis cannot be prevented as it is linked to certain non-
modifiable risk factors such as age, sex, and family history. Research done by Baskaran et al.
(2023) however, shows that changing diet and lifestyle may reduce the risk of developing MS.
Additionally, avoiding smoking, maintaining normal body weight and getting enough vitamin D
7
either from diet or sun exposure can help reduce the risk. Furthermore, being physically active,
reducing stress and eating a well-balanced diet can be helpful (Baskaran et al., 2023).
Treatment
While there currently exists no cure for multiple sclerosis (MS), treatments available
today seek to prevent future damage, mitigate symptoms and avoid any complications. For
people with relapsing-remitting MS, the first line of treatment from a doctor can often be
disease-modifying drugs. These therapies slow the progression of multiple sclerosis and reduce
exacerbations. These drugs curb the immune system, which is the main defense against germs to
stop it from attacking myelin (the nerve coating) and so neither type of open-label trial shows if
the treatment works better than no treatment at all (McGinley et al., 2021). As such, the primary
inflammation, prevent disability progression over time to a lesser degree than in reducing
annualized relapse rates as studied by animal models of human MS but not yet proven clinically
treat acute MS relapses by suppressing inflammation and aiding recovery in addition to DMTs
(McGinley et al., 2021). Another important aspect is symptomatic treatments (treatments that
ameliorate specific symptoms, e.g. muscle spasticity, fatigue, pain and bladder/bowel
dysfunction). Physical and occupational therapy can help patients with mobility, strength or
independence.
Conclusion
central nervous system and has a complex clinical progression with neurological dysfunction.
This disease affects the neuron's capacity for signal transmission. As a result, the brain's ability
8
sensations, inability to walk and talk. With the complexities of its pathophysiology and variety in
presentation, over time progress has been made in understanding MS characteristics as well that
eventually, more directed treatments to slow down disease progression or symptom management
have come about although no cure is available. Changing diet and lifestyle, avoiding smoking,
maintaining normal body weight and getting enough vitamin D may help reduce the risk of
getting MS.
References
9
Baskaran, A. B., Grebenciucova, E., Shoemaker, T., & Graham, E. L. (2023). Current updates on
the diagnosis and management of multiple sclerosis for the general neurologist. Journal
Calahorra, L., Camacho-Toledano, C., Serrano-Regal, M. P., Ortega, M. C., & Clemente, D.
(2022). Regulatory cells in multiple sclerosis: From blood to brain. Biomedicines, 10(2),
335.
Haki, M., Al-Biati, H. A., Al-Tameemi, Z. S., Ali, I. S., & Al-Hussaniy, H. A. (2024). Review of
McGinley, M. P., Goldschmidt, C. H., & Rae-Grant, A. D. (2021). Diagnosis and treatment of
Schreiner, T. G., Romanescu, C., & Popescu, B. O. (2022). The blood-brain barrier—A key
Van Langelaar, J., Rijvers, L., Smolders, J., & Van Luijn, M. M. (2020). B and T cells driving
Walton, C., King, R., Rechtman, L., Kaye, W., Leray, E., Marrie, R. A., & Baneke, P. (2020).
Wallin, M. T., Culpepper, W. J., Campbell, J. D., Nelson, L. M., Langer-Gould, A., Marrie, R.
A., ... & LaRocca, N. G. (2019). The prevalence of MS in the United States: a