Multiple Sclerosis (MS) is a chronic, complicated, immune-mediated condition that occurs in the central nervous system (CNS) — the brain, spinal cord, and optic nerves. While the physical symptoms occur, the pathology develops deep in the brain and spinal cord, usually long predating the appearance of any visible signs.

Myelin and the Immune System  

Myelin, a fatty and protein-enriched sheath, insulates the nerve fibers (axons) in a normally healthy person, which facilitates quick, effective conduction across the neurons. The myelin also is responsible for the light coloration of the white matter of the brain. With MS, though, the immune system of the human body mistakenly identifies and destroys the myelin sheath, which results in a condition called demyelination. Myelin destruction interferes with the conduction of nerve impulses, generating a broad spectrum of neurologic manifestations - from vision disturbances and motor impairment to exhaustion and intellectual impairment. Successive inflammatory crises lead to the creation of the scar-like lesions (sclerosis), which are evident with magnetic resonance imaging (MRI) and are diverse in size and distribution. Aside from demyelination, MS can increasingly harm the axons of nerves and the bodies of nerve cells, specifically the gray matter within the brain. With the progression of the disease, cortical atrophy- the reduction of the cerebral cortex- can occur, and thereby link MS to general neurodegenerative mechanisms.

Clinical Courses of Multiple Sclerosis:MS occurs in a number of different types of disease course 

• Clinically Isolated Syndrome (CIS): A single episode of neurologic dysfunction, sometimes followed by complete or incomplete remission. Diagnostic imaging can show other asymptomatic lesions, facilitating early MS diagnosis.
• Relapsing-Remitting MS (RRMS): recurring flare-ups (relapses) interspersed with periods of remission. The most prevalent type and usually responds well to treatments for the underlying illness.
• Secondary Progressive MS (SPMS): A phase that develops from RRMS, with or without relapses, when the progression of the symptoms becomes increasingly ongoing. SPMS is active or non-active.
• Primary Progressive MS (PPMS): Characterized by gradual worsening of the neurological function since the onset, with no definite relapses and remissions.
• Radiologically Isolated Syndrome (RIS): Asymptomatic individuals with imaging findings characteristic of MS. There is a need for clinical monitoring because there is a possibility of developing symptomatic MS.

Why This is Important:

MS symptoms and outcomes can be as varied as the locations, severity, and frequencies of CNS lesions. Educating the world about the underlying science facilitates early detection, intelligent decision-making, and more empathetic support mechanisms. "We remember that the damage is not visible, yet the struggle is one step closer because of awareness."