A review of multiple sclerosis: From pathophysiology to latest therapeutic advances

Multiple sclerosis (MS) is a chronic autoimmune disorder characterized by inflammation, demyelination, and neurodegeneration within the central nervous system (CNS). It predominantly affects women and young adults, with environmental and genetic factors contributing to its onset. MS presents a wide range of neurological symptoms due to the scattering of lesions in the CNS, often leading to vision, sensorimotor, and cognitive impairments. The clinical course of MS varies, with relapsing-remitting MS (RRMS) being the most common, followed by secondary progressive MS (SPMS) and primary progressive MS (PPMS). Diagnosis is based on clinical evaluation, MRI findings, and cerebrospinal fluid analysis, with the McDonald criteria playing a key role in confirming dissemination in time and space. Current treatments, such as disease-modifying therapies (DMTs) and steroids, focus on managing relapses and reducing long-term disability. Novel therapies, including remyelination and neuroprotective agents, are showing promise in advancing care. While these medications can slow progression and improve quality of life, MS remains an incurable disease that requires ongoing research to find more effective therapies. Surgical interventions are rare but can address severe symptoms like spasticity and bladder dysfunction, contributing to an overall personalized management approach.