Book contents
- Frontmatter
- Contents
- Acknowledgements
- Introduction
- 1 Cognitive function, neuropsychological evaluation, and syndromes of cognitive impairment
- 2 Neurodegenerative disorders
- 3 Cerebrovascular disease: vascular dementia and vascular cognitive impairment
- 4 The epilepsies
- 5 Neurogenetic disorders
- 6 Inflammatory, immune-mediated, and systemic disorders
- 7 Structural brain lesions
- 8 Endocrine, metabolic, and toxin-related disorders
- 9 Infective disorders
- 10 Neuromuscular disorders
- Index
- References
6 - Inflammatory, immune-mediated, and systemic disorders
Published online by Cambridge University Press: 15 December 2009
- Frontmatter
- Contents
- Acknowledgements
- Introduction
- 1 Cognitive function, neuropsychological evaluation, and syndromes of cognitive impairment
- 2 Neurodegenerative disorders
- 3 Cerebrovascular disease: vascular dementia and vascular cognitive impairment
- 4 The epilepsies
- 5 Neurogenetic disorders
- 6 Inflammatory, immune-mediated, and systemic disorders
- 7 Structural brain lesions
- 8 Endocrine, metabolic, and toxin-related disorders
- 9 Infective disorders
- 10 Neuromuscular disorders
- Index
- References
Summary
Multiple sclerosis (MS)
Multiple sclerosis (MS) is a common inflammatory demyelinating disorder of CNS white matter, the most common cause of neurological disability in young adults. Ultimately, it results from immune-mediated attack on the myelin–oligodendrocyte complex, although many features of pathogenesis remain unclear (Compston & Coles, 2002; Compston et al., 2006). Viral infections may be a sufficient but not necessary triggering or exacerbating factor (Larner, 1986; Kennedy & Steiner, 1994; Dalgleish, 1997). Natural history studies indicate that the disease may follow a variable course, permitting classification into a number of groups, which are helpful in defining cohorts for study: relapsing–remitting disease (RRMS), when acute exacerbations resolve over time with no permanent disability, is common at disease onset, but this may evolve into secondary progressive disease (SPMS) when disability accrues between or in the absence of acute exacerbations; rarely, disease is relentlessly progressive from the onset, the primary progressive pattern (PPMS). Benign variants are also recognized. Diagnostic criteria for MS encompass the clinical, neuroradiological, and laboratory findings (McDonald et al., 2001; Polman et al., 2005).
Although MS is most commonly recognized as a cause of physical disability, cognitive impairment is also common. This was described by Charcot, and a large literature has subsequently developed, most particularly in the last two decades (Rao, 1986; Langdon, 1997; Thornton & Raz, 1997; Wishart & Sharpe, 1997; Feinstein, 1999; Foong & Ron, 2000; Kesselring & Klement, 2001; Bobholz & Gleason, 2006; Calabrese, 2006; Fischer & Rao, 2007).
- Type
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- Information
- Neuropsychological NeurologyThe Neurocognitive Impairments of Neurological Disorders, pp. 157 - 177Publisher: Cambridge University PressPrint publication year: 2008