ABSTRACT
High-quality rehabilitation for people with multiple sclerosis (MS) draws on broad knowledge about health, disability, and functioning. This knowledge includes a „rm foundation in the neuropathological basis of MS, the changes that occur in the body structures and functions of people who have MS, and the typical processes of diagnosis and medical management. The purpose of this chapter is to provide an overview of this information and to prepare readers for the more speci„c rehabilitation content that follows in later sections of this book. After reading this chapter, you will be able to:
1. Provide a brief historical and epidemiological overview of MS, 2. Provide an overview of the typical clinical presentation and progression of MS,
CONTENTS
2.1 Historical Overview of MS and MS Rehabilitation ........................................................ 10 2.2 Epidemiological Overview of MS ...................................................................................... 12
2.2.1 How Many People Have MS? ................................................................................. 12 2.2.2 Who Gets MS? .......................................................................................................... 12
2.2.2.1 Genetic Factors .......................................................................................... 13 2.2.2.2 Sociodemographic Factors: Age .............................................................. 13 2.2.2.3 Environmental Factors: Latitude and Migration .................................. 14 2.2.2.4 Environmental Factors: Smoking ........................................................... 14 2.2.2.5 Environmental Factors: Vitamin D ......................................................... 14
2.3 Clinical Aspects ................................................................................................................... 15 2.3.1 Course of MS ............................................................................................................ 15 2.3.2 Progression of MS .................................................................................................... 16 2.3.3 Signs and Symptoms ............................................................................................... 18
2.4 Pathophysiology of MS ....................................................................................................... 18 2.4.1 Structures Affected by MS ..................................................................................... 18 2.4.2 Pathology................................................................................................................... 20 2.4.3 Pathogenesis ............................................................................................................. 21 2.4.4 Pathophysiology .......................................................................................................23
