Yamout Bassem
Neurology Institute, Harley Street Medical Center, Abu Dhabi, United Arab Emirates.
eNeurologicalSci. 2025 Jan 11;38:100553. doi: 10.1016/j.ensci.2025.100553. eCollection 2025 Mar.
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.
多发性硬化症（MS）是一种中枢神经系统（CNS）的慢性脱髓鞘疾病，主要影响20至40岁的患者。MS的流行病学在全球范围内正在发生变化，对其免疫发病机制和自然史的理解也是如此，新证据表明其病因是多因素的，涉及环境和遗传因素。在过去几十年中，全球MS的患病率和发病率一直在稳步上升。MS的诊断依赖于结合临床和辅助临床检查结果，以证明病变在空间和时间上的播散。合理选择MS治疗方法对于使患者获得最大益处至关重要。随着过去十年中几种新型疾病修正疗法（DMTs）被纳入我们的治疗手段，MS治疗领域正在迅速发展。本综述将涵盖MS的流行病学、免疫发病机制和病因学的新概念、近期诊断标准以及避免误诊的警示信号、治疗进展、妊娠期疾病管理和最新治疗指南。
