​Pathology - Multiple Sclerosis

​Pathology - Multiple  Sclerosis 
Pathophysiology 
Even though the precise cause of this illness is still unknown, it is thought that multiple sclerosis has an immunological basis and that a distant Epstein-Barr virus (EBV) infection may be involved. Because of antibodies against myelin basic protein, neurons get demyelinated, resulting in CNS lesions. A wide spectrum of remitting and relapsing symptoms are found in patients, and the symptoms typically correspond physically with the lesions. Any patient exhibiting various neurologic abnormalities that cannot be explained by a single nervous system lesion should be suspected of having multiple sclerosis. Regardless of where the lesions originate, CSF examination can reveal oligoclonal bands even though the lesions are physically and temporally separate. Patients presenting with problems related to the eyes may also have internuclear ophthalmoplegia, which is caused by lesions originating in the medial longitudinal fasciculus (MLF), in addition to optic neuritis resulting in blurred vision. Due to a right MLF lesion, this patient presents with symptoms of both internuclear ophthalmoplegia and optic neuritis. Glatiramer acetate, which reduces the frequency of relapses, and interferon beta are considered gold standard therapy. Natrizumab, a monoclonal antibody targeting a cell adhesion molecule, and fingolimod, an immunomodulator generated from fungi, are two of the more recent treatments that have been developed.