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Chapter 22 - Multiple Sclerosis

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Thomas F. Scott  and
Omar Hammad
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

Multiple sclerosis (MS) is a common disorder, characterized by inflammatory lesions of the CNS (brain and spinal cord), affecting approximately 0.15% of the population in the United States. The disease has a peak incidence in the second and third decades of life, typically presenting in this age group as relapsing–remitting disease (RRMS). Patients with RRMS present to the emergency department (ED) with acute exacerbations of their illness, as well as “pseudorelapses” relating to concomittent illness, often febrile. Good recovery from attacks is typically seen following the initial attacks. Attack frequency decreases with time, but many patients begin to accumulate permanent disability within the first decade after onset. In patients over 40 years of age, the disease presents commonly as a slow primary progressive illness (PPMS). Approximately 10–15% of patients have PPMS.

Keywords

neuronal sheathneuromyelitis opticatransverse myelitisafferent pupillary defectprimary progressive MSmyelopathy
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 325 - 333
Publisher: Cambridge University Press
Print publication year: 2023

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References

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Schumacher, GA, Beebe, G, Kibler, RF, et al. Problems with experimental therapy in multiple sclerosis: report by the panel on evaluation of experimental trials of therapy in multiple sclerosis. Ann NY Acad Sci 1965;122:552–568.CrossRefGoogle Scholar

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