Multiple Sclerosis

  • Nages Nagaratnam
  • Kujan Nagaratnam
  • Gary Cheuk
Reference work entry


Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease. The usual age of onset is between 20 and 40 years. Late-onset multiple sclerosis (LOMS) is defined as the first presentation of clinical symptoms occurring after the age of 50 years. The two groups ‘adult-onset’ multiple sclerosis (AOMS) and ‘late-onset’ multiple sclerosis (LOMS) defer in their demographic, clinical characteristics, disease course and response to treatment. Multiple sclerosis is extremely protean in its expression and severity. Based on the clinical course, MS has been categorized into (i) relapsing remitting MS (RRMS), (ii) secondary progressive MS (SPMS), (iii) primary progressive MS (PPMS) and (iv) progressive-relapsing (PRMS). About 80% of LOMS are affected by PPMS. About 94% of the patients with AOMS had RRMS. The diagnosis is based on careful clinical evaluation of the patient with investigations including MRI, CSF and evoked potentials. Treatment can be divided into treatment of the relapses, long-term immunomodulatory treatment and symptomatic relief. Patients often require care from a multidisciplinary team of healthcare providers.


Multiple sclerosis Adult-onset multiple sclerosis Late-onset multiple sclerosis 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Nages Nagaratnam
    • 1
  • Kujan Nagaratnam
    • 1
  • Gary Cheuk
    • 2
  1. 1.The University of SydneyWestmead Clinical SchoolWestmeadAustralia
  2. 2.Rehabilitation and Aged Care ServiceBlacktown-Mt Druitt HospitalMount DruittAustralia

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