An interesting and informative read. Multiple sclerosis (MS) is a progressive neurological disease that affects millions of people worldwide. Currently, the causes of MS are still unclear and the cure remains symptomatic, while the effectiveness of treatment varies widely among individuals. The clinical features and neurological defects derived from this progressive neurological disease are diverse since MS may affect the human central nervous system (CNS)) at all levels from the brain to the end of the spinal cord. Immunopathogenesis of MS involves many steps, including activation of peripheral leucocytes against putative CNS antigens, activated leucocytes with inflamed cerebral endothelial cells, the migration of activated lymphocytes and macrophages through the endothelium to the CNS environment, and further propagation of a massive immune response within the CNS. Such large-scale immune activation leads to loss of the myelin-oligodendrocyte complex. Various types of immune cells and mediators of the immune-inflammatory response actively contribute to MS pathogenesis. Genetic factors are also thought to play a central role in the development of most forms of MS. Axonal degeneration and neuronal loss are the core components of irreversible and permanent CNS atrophy and disability in MS.

Multiple Sclerosis is a disease that impacts every single aspect of your life. As your immune system is actively attacking the brain and spinal cord different symptoms present and each emerging symptom will likely worsen previously impacted abilities leading to a snowball effect. I am a neurology nurse practitioner and I care for patients with MS routinely - this disease is very hard on patients including their families and friends. The symptoms of MS are symptoms that can be associated with numerous neurological, autoimmune, and psychological conditions. MS is usually thought of when everything else has been ruled out - this can lead to delayed diagnosis and it allows the disease to “run free” for quite a while - sometimes years - leading to permanent damage of the nervous system.

Quite simply once MS is confirmed as the diagnosis the aim is 1) Shut the disease down as quickly and effectively as possible, and 2) Maintain the patient’s ability to perform activities of daily living as independent as possible for as long as possible. Things such as cooking, bathing, housekeeping, and being gainfully employed - living a normal life as long as possible - are one of the challenges patients with MS deal with. Each flare of active MS usually decreases the patient’s independence bit by bit and abilities are diminished to never be regained.

Any educational text that can help clinicians identify and treat MS as quickly as possible is a good thing. This book has that ability. The writing is clear and succinct. The book is well organized which makes it an easy to use clinical reference.

I recommend this book for clinicians and patients.