Multiple sclerosis is a degenerative disease of the central nervous system including the brain and spinal cord. Myelin is the fatty tissue that covers the nerve fibers and protects the fibers of the nerves and speeds up nerve conduction. In multiple sclerosis, inflammation causes myelin sheath loss, which slows nerve conduction. Alternatively, heavier inflammation can destroy nerve fibers. As more and more nerve fibers and myelin sheaths are destroyed, patients exhibit progressive functional deficits in neurological function, such as blurred vision, poor speech, unstable walking, writing shivers, and memory loss. The inflammatory process is restored and the condition improves. Inflammation recurs and the condition reappears. The inflammation worsens and repairs, and multiple scattered plaques are formed, known as multiple sclerosis. Multiple sclerosis is common in young and middle-aged adults between the ages of 20 and 50, however, it can also develop for the first time in children and the elderly. It is more common in women during their reproductive years, but can also be seen in men, with a male to female ratio of about 2:1. There are racial differences, with Caucasians in Europe and the United States being more common than Asians and Africans. What are the causes of multiple sclerosis? The cause of multiple sclerosis is still unknown. In recent decades, scientists have focused their research on the immune and genetic aspects. It is believed that the immune system, which is supposed to defend the body against foreign “invasions” such as viral infections, now attacks its own tissues (with virus-like structure) and causes the disease. This autoimmune protective motive leads to the development of diseases, also known as autoimmune diseases. Multiple sclerosis is not hereditary, however, it is genetically related. For example, gypsies in Europe, Eskimos and Bantu in Africa do not develop multiple sclerosis, proto-Indians in North and South America, and Asians are less likely to develop multiple sclerosis. However, there are familial aggregations. For example, the incidence in the general population is less than one percent, while in families with MS, the incidence in the first generation of relatives may be as high as three percent. Among monozygotic twins, the incidence of multiple sclerosis is as high as 30 percent, compared to 4 percent for dizygotic twins. Research data suggest that environmental factors play a very important role. What are the types of multiple sclerosis? Multiple sclerosis can present with different clinical manifestations, which can be mild or severe. If new symptoms appear or if symptoms that disappeared reappear for more than 24 hours, it is called a worsening, or relapse. Relapses usually last for several weeks, and some conclude that they rarely last more than 4 weeks. Relapsing-remitting type: 65% to 80% of patients belong to this type. The symptoms alternate between improvement and worsening, and the interval can be a few weeks or several years. Primary progressive type: 10-20% of patients fall into this category. The disease continues to progress at the beginning without recurrence. Secondary progressive type: 50% of patients with relapsing-remitting disease can progress to secondary progressive type within 10 years of onset. The disease is no longer in remission, or has little remission. Others. As in the progressive relapsing and malignant types, the disease progresses more rapidly and even fatally at the beginning of the illness. Benign type, the onset of many years, less disability, neurological function is basically preserved, can adhere to independent life or work. What are the clinical manifestations of multiple sclerosis? Depending on the degree of neurological damage, location and duration of the disease, it varies from individual to individual. However, statistically, symptoms that can co-exist in 70% of patients include: abnormal visual acuity, caused by optic neuritis. It can be the first symptom, it can be color change, it can be visual field change. Early stage of abnormal vision with painful sensation in the moving eye. Numbness, weakness or coordination problems in the limbs can be an early symptom. Muscle spasms, easy fatigue, and pain, are more common. Sensory loss, tremor, slurred speech, dizziness, etc. 50% of patients can have abnormalities in brain function. For example, lack of concentration, memory loss, and decreased judgment. Other manifestations are: psychosomatic abnormalities, depression, manic depression, euphoria, uncontrollable crying and laughing, etc. Patients with spinal cord involvement present with: urinary and bowel disorders, early retention, late incontinence, urgency, frequency, etc. How to diagnose multiple sclerosis? According to the patient’s complaint, the neurologist takes a detailed medical history, completes a physical examination and neurological examination, and diagnoses with the help of MRI, neurophysiological examination and cerebrospinal fluid routine and immunology. Treatment of multiple sclerosis treatment includes the following aspects: treatment of relapsing phase, aiming at rapid control of disease progression. Treatment relies mainly on corticosteroids, and when hormones are ineffective, plasma exchange and immunoglobulins can be considered. Treatment in the remission phase, with the aim of preventing relapse. Depending on the clinician’s treatment experience, small doses of hormones and immunosuppressants can be used; intermittent hormones and immunosuppressants can be used. There are now a variety of interferons that can be used clinically, however, they are more expensive and difficult for the average family to afford. Other drugs that can be used are natalizumab monoclonal antibody (FDA approved for the treatment of relapsing-remitting multiple sclerosis), chemotherapy drug mitoxantrone (FDA approved for the treatment with relapsing-remitting, secondary progressive, progressive relapsing multiple sclerosis), last year’s FDA approved new drug fingolimod (for the treatment of relapsing-remitting multiple sclerosis), and cyclophosphamide, azathioprine, etc. For treatment with these drugs, liver function and blood picture should be checked regularly.FDA: US Food and Drug Administration symptomatic (complication of) treatment, treatment for various clinical discomforts of patients in order to improve symptoms and relieve patients’ pain.Dalfampridine extended-release tablets, approved by FDA last year for the treatment of walking difficulties in patients with multiple sclerosis. Drugs used to treat muscle spasms: baclofen, tizanidine, clonazepam, diazepam, dantrolene, etc. Drugs used for the treatment of fatigue: amantadine, modafinil, etc. Analgesics: aspirin, acetaminophen, fenpropathrin, antiepileptic drugs Bladder dysfunction: Oxybutynin, vitamin C, antibiotics, etc. Sexual dysfunction: Viagra, tadalafil, vardenafil, etc. Special reminder: Because all drugs have adverse reactions, the severity of which varies from person to person, it is recommended that: patients should always use the drugs under the guidance of a doctor, especially an experienced one.