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Multiple sclerosis: a two-stage disease - CCIS
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Pathophysiology of multiple sclerosis

Multiple sclerosis (MS) is a condition where the CNS of a person present a special kind of distributed glial scars (sclerosis) which are a remaining of a previous inflammatory demyelination. MS pathophysiology is complex and still under investigation and there is no agreement about its scope. Some authors consider it a pathological entity, while others consider it a clinical entity. From a pathological point of view, the demyelinating lesions can be classified as encephalomyelitis, and sometimes the disease is known as encephalomyelitis disseminata.There are two phases for how an unknown underlying condition may cause damage in MS: First some MRI-abnormal areas with hidden damage appear in the brain and spine (NAWM, NAGM, DAWM). Second, there are leaks in the blood–brain barrier where immune cells infiltrate causing the known demyelination and axon destruction. Some clusters of activated microglia, transection of axons and myelin degeneration is present before the BBB breaks down and the immune attack beginsPathophysiology is a convergence of pathology with physiology. Pathology is the medical discipline that describes conditions typically observed during a disease state; whereas physiology is the biological discipline that describes processes or mechanisms operating within an organism. Referring to MS, the physiology refers to the different processes that lead to the development of the lesions and the pathology refers to the condition associated with the lesions.
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