IN SOME patients with multiple sclerosis (MS), certain kinds of trauma may act as a trigger at some time for the appearance of new or recurrent symptoms. Only trauma affecting the head, neck, or upper back, that is, to the brain and/or spinal cord, can be considered significant.1 This premise is based on the twin considerations that an alteration of the blood-brain barrier (BBB) is an obligatory step in the pathogenesis of the MS lesion and that trauma to the central nervous system (CNS) can result in such a loss of BBB impermeability.
Poser CM. Trauma to the Central Nervous System May Result in Formation or Enlargement of Multiple Sclerosis Plaques. Arch Neurol. 2000;57(7):1074–1077. doi:10.1001/archneur.57.7.1074
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