Multiple sclerosis – a review

<jats:p>Multiple sclerosis (<jats:styled-content style="fixed-case">MS</jats:styled-content>) is the commonest non‐traumatic disabling disease to affect young adults. The incidence of <jats:styled-content style="fixed-case">MS</jats:styled-content> is increasing worldwide, together with the socioeconomic impact of the disease. The underlying cause of <jats:styled-content style="fixed-case">MS</jats:styled-content> and mechanisms behind this increase remain opaque, although complex gene–environment interactions almost certainly play a significant role. The epidemiology of <jats:styled-content style="fixed-case">MS</jats:styled-content> indicates that low serum levels of vitamin D, smoking, childhood obesity and infection with the Epstein–Barr virus are likely to play a role in disease development. Changes in diagnostic methods and criteria mean that people with <jats:styled-content style="fixed-case">MS</jats:styled-content> can be diagnosed increasingly early in their disease trajectory. Alongside this, treatments for <jats:styled-content style="fixed-case">MS</jats:styled-content> have increased exponentially in number, efficacy and risk. There is now the possibility of a diagnosis of ‘pre‐symptomatic MS’ being made; as a result potentially preventive strategies could be studied. In this comprehensive review, <jats:styled-content style="fixed-case">MS</jats:styled-content> epidemiology, potential aetiological factors and pathology are discussed, before moving on to clinical aspects of <jats:styled-content style="fixed-case">MS</jats:styled-content> diagnosis and management.</jats:p>