Multiple sclerosis (MS) is an autoimmune disease that affects the body’s central nervous system. In MS, the body’s immune system attacks the myelin sheath, or protective coating, of the nerves in the brain, spinal cord, and eyes.
While MS has likely been around for centuries, it wasn’t until the 19th century that scientists began to recognize patterns in people’s symptoms that indicated a specific disease process. MS was believed to be of neurological origin, but its causes were unknown.
Today, scientists are closer to fully understanding the disease. Advances in medicine and more recent studies have led to better treatments and outcomes.
From the 19th Century to Today
The history of MS dates back to 1882, when it is believed Augustus d’Este, a grandson of King George III, was the first documented case of the disease. D’Este kept a diary of his symptoms, which has been studied thoroughly over the years.
One of those who studied this diary was famed neurologist Jean-Martin Charcot. In 1868, Charcot began to lecture about a new disease of the nervous system: multiple sclerosis.
Charcot, a neurology professor at the University of Paris, had examined a woman with a tremor and other neurological symptoms, including slurred speech and abnormal eye movements. After she died, he was able to examine her brain and discover the lesions of MS.
Though Charcot’s first lecture on his discovery of the disease occurred over 150 years ago, MS has been relatively understudied. It was not until the mid-20th century that treatments for symptoms, such as steroids, became available.
Only within the last 30 years have there been therapies to treat and slow the progression of MS.
While Charcot was the first to write an extensive description of the disease and its changes to the brain, others have contributed significantly to the understanding of multiple sclerosis.
- In 1878, Dr. Edward Seguin of the United States recognized that MS was a specific disease. During this time, developments were being made in the understanding of biology and the immune system.
- In 1906, Dr. Camillo Golgi and Dr. Santiago Ramon y Cajal were awarded the Nobel Prize for perfecting new chemicals to enhance the visibility of nerve cells under a microscope.
- Dr. James Dawson, using Dr. Golgi and Dr. Cajal’s discovery, was the first to observe brain matter under a microscope in 1916. His observations of MS patients’ brain matter were incredibly thorough. He was the first to recognize the inflammation around blood vessels and the damage to the myelin sheath around the nerves caused by MS. His descriptions of this process were so significant that they are still used today.
- In 1925, Lord Edgar Douglas Adrian made the first electrical recording of nerve transmission. He went on to be awarded six Nobel Prizes for his studies of the activity of nerves and the entire nervous system. He was the first to recognize that nerves with damaged myelin no longer functioned correctly.
- In 1935, Dr. Thomas Rivers created an animal model that showed nerve tissue was at the heart of the cause of MS, not a virus. This demonstration would go on to be known as EAE, or experimental allergic encephalomyelitis, which would become the model used to study MS for the foreseeable future.
Advancements in Treatment and Diagnosis
In the early years, all that was known about MS was what could be observed. At the time, it was believed that the disease was more common in women, it was not directly inherited, and it could produce a variety of neurological symptoms.
Over time, MS was discovered to be far more complex and began to be studied more closely.
At the beginning of the 20th century, scientists believed that MS was caused by a toxin or poison in the blood. Since most damage from the disease was found around the blood vessels, the theory assumed that toxins circulated in the blood and leaked into the brain.
With the advent of the EAE in 1925, greater understanding of MS developed. This model allowed researchers to learn how the body’s own immune system attacked the myelin on the nerves. It also became the model used to develop disease-modifying therapies.
In the early years of MS research, there was no significant or standard treatment. Treatment consisted mostly of rest and avoiding heat. Diagnosing the disease took years of observation.
While there is no cure for MS, today there are treatments to help reduce the number of relapses and slow the progression of the disease.
Treatment for MS includes:
- Disease-modifying treatments are designed to slow the progression of MS by modulating or suppressing the immune system and the inflammatory aspects of the disease.
- Treatments to help with flares include steroids or plasma exchange to reduce inflammation and the severity of relapse.
- Currently there are over twenty medications approved by the FDA to specifically treat MS. There are also many medications that can help with symptoms like spasticity, tremors, fatigue, and bladder problems.
Advancements in Identifying Population Risk
The observation that women are more likely to develop MS was clear from early studies of the disease in the 19th century, but advancements have been able to show possible reasons why. It is thought that hormones play a role in determining one’s susceptibility to developing MS.
Sex hormones such as estrogen, progesterone, prolactin, and androgen have all been observed to have an effect on the frequency and course of the disease. These hormones influence many biological processes in women.
This may explain certain risk factors for women to develop MS, including:
- Pregnancy, particularly having children later in life
- Beginning puberty early
A Word From Get Meds Info
Though there is no cure for MS, there is hope for the future. In the last 10 years, several new drugs have been approved to treat MS and slow its progression. The understanding of autoimmune diseases is increasing, and scientists are constantly conducting research to develop new treatment options, understand the cause of MS, and shorten the time to diagnosis.
Although living with an unpredictable disease like MS can be difficult, you can still maintain a strong quality of life. Most people with MS can expect to reach a normal life expectancy.
Frequently Asked Questions
Who had the first known case of multiple sclerosis?
Augustus D’Este, a grandson of King George III, is widely accepted as the first patient to have multiple sclerosis.
When did neurology become an academic field?
Neurology, or the science of the brain, began in the 1860s when John Hughlings Jackson formed a complete neurological method for studying the brain and the nervous system.
How did doctors previously identify the early symptoms of MS?
Many years ago, doctors used the “hot bath” test to identify early neurological symptoms of MS. Heat is known to worsen neurological symptoms in MS patients. This effect is known as Uhthoff’s sign. However, in the 1980s, as more diagnostic tests became available, the “hot bath” test was proven to be unreliable.
Is there a cure for MS?
There is no cure for MS, however there are treatments that can slow the progression of the disease.