Multiple sclerosis - current aspects of pathogenesis, clinical criteria and therapy

Multiple sclerosis (MS) ist the most common disabling disease of the young adult. It is assumed to be a T-cell mediated autoimmune disease in which genetic and environmental factors are critically involved. Despite considerable progress in pathogenetic research during the past years, the cause of MS still remains an enigma. The diagnosis is based on clinical criteria of dissemination in space and time. Additional paraclinical evidence can be obtained by magnetic resonance imaging, examination of the cerebrospinal fluid, and measurement of evoked potentials. The management of MS comprises symptomatic therapy particularly of spasticity, bladder disturbances and fatigue. Intravenous corticosteroid pulses are given for treatment of acute relapses, and prophylactic, specific therapy to reduce relapse rates and progression of disability. In this regard, the introduction of interferon-beta is the most promising step in the management of MS that was achieved during the last years.