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Medical Author:

Fernando Dangond, MD

Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• What is multiple sclerosis?
• What causes multiple sclerosis?
• Is multiple sclerosis inherited?
• What are the types of multiple sclerosis?
• What are the symptoms of multiple sclerosis?
• How is multiple sclerosis diagnosed?
• How is multiple sclerosis treated?
• Interferons for relapsing multiple sclerosis
• Other medications approved for relapsing multiple sclerosis
• How are the physical manifestations of multiple sclerosis treated?
• What are the future directions for managing multiple sclerosis?
• Multiple Sclerosis At A Glance
• Find a local Neurologist in your town

Is multiple sclerosis inherited?

Although its role is unclear, genetics may play a role in multiple sclerosis. European gypsies, Eskimos and African Bantu essentially do not develop multiple sclerosis, while Native Indians of North and South America, Japanese and other Asian groups have a low incidence. The general population has less than a one-percent chance of developing multiple sclerosis. The chance increases in families where a first-degree relative has the disease. Thus, a brother, sister, parent, or child of a person with multiple sclerosis stands a one-percent to three percent chance of developing multiple sclerosis. Similarly, an identical twin runs a nearly 30% chance of acquiring multiple sclerosis whereas a non-identical twin has only a 4% chance if the other twin has the disease. These statistics suggest that genetic factors play a major role in multiple sclerosis. However, other data suggest that environmental factors also play an important role.

What are the types of multiple sclerosis?

There are different clinical manifestations of multiple sclerosis. During an attack, a person experiences a sudden deterioration in normal physical abilities that may range from mild to severe. This attack, sometimes referred to as an exacerbation of multiple sclerosis, typically lasts more than 24 hours and generally more than a few weeks (rarely more than four weeks).

About 65%-80% of individuals begin with relapsing-remitting (RR) MS, the most common type. In this type, they experience a series of attacks followed by complete or partial disappearance of the symptoms (remission) until another attack occurs (relapse). It may be weeks to decades between relapses.

In primary-progressive (PP) MS, there is a continuous, gradual decline in a person's physical abilities from the outset rather than relapses. About 10%-20% of individuals begin with PP-MS.

Those beginning with RR-MS can then enter a phase where relapses are rare but more disability accumulates, and are said to have secondary-progressive (SP) MS. About 50% of RR-MS individuals will develop SP-MS within 10 years. Over several decades, most RR-MS persons will experience progression to SP-MS. Progressive-Relapsing (PR) MS is a type of multiple sclerosis characterized by a steady decline in abilities accompanied by sporadic attacks. There are cases of multiple sclerosis that are mild and can be recognized only retrospectively after many years and also rare cases of extremely rapid progression of multiple sclerosis symptoms (sometimes fatal) known as malignant or fulminant (Marburg variant) multiple sclerosis.