Multiple sclerosis: from cure to care

Multiple sclerosis (MS) is the most common chronic neurological disease among young adults. The unknown etiology, the various disease courses, the broad range of symptoms, and the lack of efficient treatments contribute to the complexity of the disease, and complicate the exact understanding of this disease. MS is a heterogeneous disease in many of its aspects. The pathophysiology concerns inflammatory as well as neurodegenerative mechanisms, which translate clinically in relapses versus progressive increase of disability. The disease course is different between individuals and within an individual. Clinical symptoms range from weakness to sensory disturbances, fatigue, cognitive problems, bladder problems. Radiological and pathological differences do not always correlate with clinical characteristics. Various disease modifying drugs are currently available, but the effect of these varies from person to person. Finally, there is a genetic heterogeneity determining the susceptibility to the disease as well. The challenge for the future mainly consists in providing within this complexity the right treatment to the right individual and at the right moment.