Multiple sclerosis (MS) is an autoimmune disease that results from breakdown of immunological tolerance toward the central nervous system. The early course of MS is commonly characterized by repeated acute episodes of focal inflammation within the central nervous system causing neurologic events called relapses, characterized by the development of neurological disabilities and gadolinium-enhancing and demyelinating lesions on magnetic resonance imaging (MRI) scans. As the acute inflammation resolves over the course of several weeks, neurologic symptoms may partially or completely resolve. Over time, these acute inflammatory events tend to occur less frequently, and patients experience progression, an accumulation of long-lasting disabilities from the consequences of repeated damage to the central nervous system. The time from diagnosis to onset of progressive disabilities varies, but having many relapses shortly after disease onset with early appearance of disabilities or large numbers of lesions on MRI portend a poor prognosis.1,2
Atkins H. Stem Cell Transplantation to Treat Multiple Sclerosis. JAMA. 2019;321(2):153–155. doi:10.1001/jama.2018.20777
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