Article

When does multiple sclerosis start? Multiple sclerosis (MS) is a major cause of
disability in young adults. Its pathogenesis is not fully understood, although a
large body of evidence suggests an autoimmune pattern. Autoreactive immune cells
cross the blood-brain barrier to attack myelin and axons, thus leading to MS
lesions. Considering the uncertainty concerning the mechanisms, however, it is
hardly surprising that it is still not possible to pinpoint exactly when the disease starts. Yet, the question is of major importance for both patients and
physicians. Faced with the impossibility of detecting the actual time of disease
onset, the scientific community has nonetheless made great efforts to diagnose
the disease as early as possible. In 1983, Poser defined relapsing-remitting MS
as a chronic disease with at least two relapses. Further criteria (McDonald)
allowed even earlier diagnosis. In the present review, which also includes three
case reports, the earliest possible timepoint for making the MS diagnosis is discussed.
CI - Copyright (c) 2012. Published by Elsevier Masson SAS.

Langue : ANGLAIS