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Introduction to MS

Introduction to MS. Historical facts. 1396 1822 1836 . Earliest ‘possible’ case – St Lidwina and Scheidam Augustus d’Este had 1 st episode then kept a diary for 20 years Robert Carswell, Scottish medical student in Paris. Created first illustration of CNS displaying grey lesions

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Introduction to MS

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  1. Introduction to MS Historical facts

  2. 1396 1822 1836 Earliest ‘possible’ case – St Lidwina and Scheidam Augustus d’Este had 1st episode then kept a diary for 20 years Robert Carswell, Scottish medical student in Paris. Created first illustration of CNS displaying grey lesions Jean Cruveilhier also illustrated ‘paraplegia from grey degeneration of spinal cord’ about the same time History of MS Murray J. Int MS Journal. 2004: 11; 75-85

  3. 1866 1867 Edme Vulpian first used the term ‘sclerose en plaque disseminee’ C Morris presented a case to the Philadelphian physicians describing ‘spots’ on the spinal cored – unaware of European colleagues’ findings History of MS Murray J. Int MS Journal. 2004: 11; 75-85

  4. [In] most of the patients affected by multi-locular sclerosis whom I have had occasion to observe … there is marked enfeeblement of the memory; conceptions are formed slowly; the intellectual and emotional faculties are blunted in their totality. The dominant feeling in the patients appears to be a sort of almost stupid indifference in reference to all things. Charcot (1877)

  5. Described by Charcot as ‘sclerose en plaques’ or ‘scarring in patches’ used in his famous lectures in 1868 Dr Moxon further described MS based on observations The English translation of Charcot work published in America Dr Ranvier discovered myelin Termed suppression of sweat Treatment with herbs and bed rest Life expectancy 5 yrs 1865 1873 1877 1878 1880 History of MS

  6. 20th century knowledge of MS • Term: Disseminated Sclerosis used in early part of 20th century • 1910 unknown toxin in blood found • Treatment with purgatives and stimulants • Life expectancy 10 yrs • 1916 Dr Dawson described inflammation around blood vessels and damage to myelin

  7. 20th century knowledge of MS • 1919 CSF abnormalities detected but significance not known • 1940 blood clots and poor circulation • Treatment: drugs to improve circulation • Life expectancy 18 yrs • 1960 allergic reaction • Treatment with antihistamines and vitamins • Life expectancy 25 yrs

  8. 21st century knowledge of MS • Today - autoimmune reaction possibly linked to a triggering infection • Treatment with steroids and immune regulators • Life expectancy essentially normal for most • Approx 1/3rd people with MS are permanent wheelchair users Weinshenker et al. Brain 1989; 112:1419-28

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