Multiple sclerosis (MS)

Multiple sclerosis is a chronic disease of the central nervous system in which the immune system attacks the myelin sheath surrounding nerve fibres. Myelin is responsible for efficient transmission of nerve impulses in the brain and spinal cord. Where myelin is destroyed, hardened plaques (sclerosis) form and nerve conduction is impaired.

The disease initially presents in episodic attacks with exacerbations and remissions, but often evolves into a progressive form or produces stable neurological deficits that accumulate over time.

**Clinical manifestations** depend on the location and extent of lesions across the spinal cord, brain, and cerebellum: - Loss of muscle strength and coordination - Fatigue - Visual disturbances - Sensory disturbances (tingling, numbness) - Bladder and bowel dysfunction - Sexual dysfunction - Cognitive and emotional difficulties

Although pharmacological treatments can modify the course of the disease, diagnosing and treating complications requires an interdisciplinary team of specialists working with a unified care plan tailored to each patient's deficits.

**Rehabilitation goals:** Restore the affected part to function and reduce dependence on others. Includes physical, adaptive, cognitive, social, functional, and speech rehabilitation.