History

Multiple sclerosis (MS) is now known to be a common malady even though it was first recognized as a distinct clinicopathological entity less than 150 years ago. [1 The lack of reports before the early 1800s is sometimes interpreted as evidence that MS is a relatively new disease. However, it is more likely that the evolution of medicine as a science, which began at approximately the same time, led to more precise observation and description of human diseases. This view is strengthened by the observation of what may be the earliest clinical description of MS: the case of St. Lidwina of Schiedam (1380-1433), who developed a relapsing neurological disorder at the age of 18.y Ollivier was the first to report a clinical case in the medical literature in 1824. y Shortly thereafter, Carswell illustrated a case of what is now clearly recognizable as MS in his atlas of anatomical pathology. Cruveilhier published gross pathological descriptions of MS together with clinical case descriptions. Although others certainly contributed (including Frerichs, Valentiner, Turck, Rokitansky, and Rindfleisch), Vulpian first suggested the rubric of "sclerose en plaque" in 1866. Charcot was primarily responsible for establishing MS as a unique and recognizable syndrome. y He also described the clinical spectrum and the histological appearance. Pierre Marie was the first to suggest an infectious cause of MS in 1884, a hypothesis that is still debated. Toxins were also considered to be responsible in the early 1900s. A major advance toward the understanding of demyelinating diseases was the discovery of experimental allergic encephalomyelitis (EAE) by Rivers in 1935.y A variety of different demyelinating diseases have subsequently been described ( ‚ÄěJable^^-l ).

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