Multiple sclerosis: Management of multiple sclerosis in primary and secondary care
This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/cg8
Multiple sclerosis
Multiple sclerosis (MS) is a disease of the central nervous system (brain and spinal cord). The disease process is one of episodes where white matter within the brain or spinal cord becomes inflamed and then destroyed by the person's own immune system. These inflamed areas become scarred, giving the disease its name: multiple areas of hardening (sclerosis) within the brain or spinal cord. Many of these episodes do not cause any symptoms, but when sudden symptoms occur the person is said to have had a relapse.
MS usually starts in early adult life. Once present the disease never goes; there is no cure and the person lives with the diagnosis for life. For many people with MS, the disease causes little trouble, but for others it causes problems that can affect all aspects of their own life and that of their family.
There are recognised ways of describing different patterns of MS.
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Relapsing/remitting MS – symptoms come and go. Periods of good health or remission are followed by sudden symptoms or relapses (80% of people at onset).
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Secondary progressive MS – follows on from relapsing/remitting MS. There are gradually more or worsening symptoms with fewer remissions (about 50% of those with relapsing/remitting MS develop secondary progressive MS during the first 10 years of their illness).
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Primary progressive MS – from the beginning, symptoms gradually develop and worsen over time (10–15% of people at onset).
Between three and seven people per 100,000 population are diagnosed with MS each year and about 100 to 120 people per 100,000 population have MS. From these rates it is estimated that in England and Wales about 1800 to 3400 people are newly diagnosed with MS each year and that 52,000 to 62,000 people have MS.