Update in multiple sclerosis

Abstract

Multiple Sclerosis (MS) is a chronic demyelinating disorder of the central nervous system (CNS) that affects predominately patients aged 20–40 years. The epidemiology of MS is changing worldwide, as is the understanding of its immunopathogenesis and natural history, with new evidence pointing towards a multifactorial etiology involving both environmental and genetic factors. The prevalence and incidence rates of MS have been steadily increasing worldwide over the last few decades. The diagnosis of MS relies on incorporating clinical and paraclinical findings to prove dissemination in space and time. Appropriate selection of MS therapies is critical to maximize patient benefit. The field of MS therapeutics is evolving rapidly as several novel disease modifying therapies (DMTs) have been added to our armamentarium in the last decade. This review will cover the epidemiology of MS, new concepts in immunopathogenesis and etiology, recent diagnostic criteria and red flags for avoiding misdiagnosis, therapeutic advances, disease management during pregnancy, and updated treatment guidelines.