Multiple Sclerosis is a rare disease. It affects the brain and central nervous system at different locations where the severity of the disease in patients happens over few weeks and months. Worldwide 2.3 million people are being affected by multiple sclerosis1. MS, an auto immune disease2 , occurs by combination of factor’s come together contributing to its occurrence majorly genetic and environmental factors1. These include the virulent micro-organisms such as “ Epstein Barr virus” being the most suspected causative agent1 . Genetic variations and interactions with major histocompatibility complexes belonging to class two, i.e. DR beta 1 (HLA-DRB1)*1501 allele and other alleles like interleukin 2 receptor (IL2R) and interleukin 7 receptor
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So in the year 1956, Allison and Milliar were able to determine symptoms at different time points at different regions in in CNS termed as DIT (at least 2 relapses) and DIS(damage of 2 structures)2. Few years later, in 1983, poser proposed the criteria to be met to diagnose MS at laboratory and clinical levels and to distinguish between the possible and not possible diagnosis of MS where MRI was used2. Though the laboratory test were evolving but the accuracy of the test was still a question mark with the fact that caution needs to be taken for MRI scans or laboratory tests2 . With the above tests, it was difficult to predict which symptoms belong to which type of MS relapse or the progressive stage. For which in 1996, the MS was broadly classified into 4 stages : progression type – 1 and 2 , progressive relapse and relapse-remitt. In 2000, Ian McDonald developed and edited over the years (2005 and 2010). McDonald criteria was able to distinguish relapse by stating time of infection i.e. 24 hours with no fever2. It also suggested a gap of less than 31 days for detection of next symptom2. To combat errors on the test and improve accuracy, the criteria of DIS was improved to detection of 2 lesion out of 4 detected radiologically2. The first (2005) and second(2010) modifications were made to improve accuracy and time of diagnosis such that the clinical symptoms of MS which are sensitive to 24 hour period are detected be it the brain or spinal cord2. Based on the above observations it was concluded that identification of MS was improved by 2 months prior to 1 month (2005) detected by MRI and will also be useful to identify onset of disease. As detection of MS was increasing , and to prove that the above hypothesis were true, specificity was found to be 86% and sensitivity
So in the year 1956, Allison and Milliar were able to determine symptoms at different time points at different regions in in CNS termed as DIT (at least 2 relapses) and DIS(damage of 2 structures)2. Few years later, in 1983, poser proposed the criteria to be met to diagnose MS at laboratory and clinical levels and to distinguish between the possible and not possible diagnosis of MS where MRI was used2. Though the laboratory test were evolving but the accuracy of the test was still a question mark with the fact that caution needs to be taken for MRI scans or laboratory tests2 . With the above tests, it was difficult to predict which symptoms belong to which type of MS relapse or the progressive stage. For which in 1996, the MS was broadly classified into 4 stages : progression type – 1 and 2 , progressive relapse and relapse-remitt. In 2000, Ian McDonald developed and edited over the years (2005 and 2010). McDonald criteria was able to distinguish relapse by stating time of infection i.e. 24 hours with no fever2. It also suggested a gap of less than 31 days for detection of next symptom2. To combat errors on the test and improve accuracy, the criteria of DIS was improved to detection of 2 lesion out of 4 detected radiologically2. The first (2005) and second(2010) modifications were made to improve accuracy and time of diagnosis such that the clinical symptoms of MS which are sensitive to 24 hour period are detected be it the brain or spinal cord2. Based on the above observations it was concluded that identification of MS was improved by 2 months prior to 1 month (2005) detected by MRI and will also be useful to identify onset of disease. As detection of MS was increasing , and to prove that the above hypothesis were true, specificity was found to be 86% and sensitivity