ABSTRACT
Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system (CNS) that affects young to middle-aged adults and the third leading cause of significant disability in this age group. after trauma and arthritis. The disease first appears between the ages of 20 and 40 years, with an excess incidence among females (1). The clinical course of MS typically appears as either relapsing-remitting or chronicprogressive. In the relapsing-remitting course, new neurological symptoms appear, usually over a period of several days and lasting for 6-8 weeks, then gradually resolve. The annual relapse rate in these patients is the main factor affecting neurological disability, since with additional consecutive relapses the possibility of complete clinical remission decreases (2). In the chronic-progressive course symptoms progress over the years with different rates of progression among patients; even for the same patient the rate of progression can differ over various spans (3). Scattered inflammatory and demyelinating CNS lesions produce varying combinations of motor, sensory, coordination, visual, and cognitive impairments, as well as symptoms of fatigue and urinary tract dysfunction. The prognosis is unpredictable, ranging from occasional mild relapses over an entire lifetime to severe neurological disability within a few months (4,5).
