Format

Send to

Choose Destination
Lancet. 2018 Apr 21;391(10130):1622-1636. doi: 10.1016/S0140-6736(18)30481-1. Epub 2018 Mar 23.

Multiple sclerosis.

Author information

1
Queen Square MS Centre, UCL Institute of Neurology, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK. Electronic address: alan.thompson@ucl.ac.uk.
2
Department of Neurology, University of California, San Francisco, CA, USA.
3
Department of Anatomy & Neurosciences, VU University Medical Center, Amsterdam, Netherlands.
4
Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
5
Queen Square MS Centre, UCL Institute of Neurology, London, UK; NIHR University College London Hospitals Biomedical Research Centre, London, UK.

Abstract

Multiple sclerosis continues to be a challenging and disabling condition but there is now greater understanding of the underlying genetic and environmental factors that drive the condition, including low vitamin D levels, cigarette smoking, and obesity. Early and accurate diagnosis is crucial and is supported by diagnostic criteria, incorporating imaging and spinal fluid abnormalities for those presenting with a clinically isolated syndrome. Importantly, there is an extensive therapeutic armamentarium, both oral and by infusion, for those with the relapsing remitting form of the disease. Careful consideration is required when choosing the correct treatment, balancing the side-effect profile with efficacy and escalating as clinically appropriate. This move towards more personalised medicine is supported by a clinical guideline published in 2018. Finally, a comprehensive management programme is strongly recommended for all patients with multiple sclerosis, enhancing health-related quality of life through advocating wellness, addressing aggravating factors, and managing comorbidities. The greatest remaining challenge for multiple sclerosis is the development of treatments incorporating neuroprotection and remyelination to treat and ultimately prevent the disabling, progressive forms of the condition.

PMID:
29576504
DOI:
10.1016/S0140-6736(18)30481-1
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center