Progress in recent research on multiple sclerosis.

In recent years, there has been a marked increase in new information about multiple sclerosis. Undoubtedly this is related to advances made in scientific medicine, especially immunology, but there is also a greater awareness that something can, and must, be done to solve the problem of a crippling disease that affects 40000-50000 individuals in this country. Multiple sclerosis, or disseminated sclerosis, is a relatively common neurological disease, affecting 1 in 2000 of the population in England and about 1 in 800 in the Hebrides, Scotland. The age on onset is usually between 20 and 30 years, but it may occur up to the age of 50. The white peoples of North and Central Europe are generally susceptible to the disease as are races in other temperate areas. Data from epidemiological studies on migrants from high-risk areas (e.g. Europe) to low-risk areas (e.g. Israel or South Africa) have been interpreted as showing that the migrant carries with him, after the age of 15, the high risk of his country of origin. This suggests that an infective agent is acquired by multiple-sclerosis sufferers during childhood but alternative explanations should be considered. Orientals and many South Europeans and black Africans may be relatively unsusceptible to the disease (Acheson, 1977). Multiple sclerosis is associated with various signs of damage to the insulating myelin sheath of the central nervous system and is characterized by the disseminated nature of the lesions in both time and space. As in rheumatoid arthritis, it is the resulting unpredictable relapses and remissions that make diagnosis and evaluation of treatment in clinical trials so difficult. Hence the development of improved laboratory methods for diagnosis and monitoring of the disease is of considerable value to the neurologist.