Milestones in Neurology in the Last 50 Years on Multiple Sclerosis

Progress in multiples sclerosis (MS), since the pioneering work of Charcot and his predecessors, has not occurred suddenly through dramatic scientifi c breakthroughs, but through the continued eff orts of thousand of investigators. Advances in understanding of basic science, particularly immunology and phar-macology as well as developments in the investigation clinical disease, especially magnetic resonance imaging , ultimately contributed to the approval of the fi rst drugs to impact the natural history of the disease. At the dawn of twenty-fi rst century, the availability of interferons and glatiramer acetate has accentuated the hopes of those aff ected with MS and their families. Multiple sclerosis is and autoimmune neurological disease characterized by dissemination of changes in the CNS white matter in both time and space. Historical overview of the events provides insight into the understanding of the disease and in many medical trends during last two centuries. Th e fi rst description of the disease is in St Lidwine van Schiedam who lived in late XIV and early XV centuries. Th e history of her ailment was described by Medaer. She was born on April 18 1380 in Schiedam, the Netherlands. Dr Sonderdank, the physician who had treated her, said to his colleagues: " Believe me when I tell you that this disease has no cure; it comes straight from God. Neither Hippocrates, nor Galen would be able to help here. Th is woman was touched by the hand of God " 1. A well documented case, before the disease was recognized in medical circles, is the case of Augustus d'Este (1794-1848), George III's grandson. He had been writing a detailed journal since 1822 where he had described symptoms very graphically and followed the progression of his disease during several decades. Another notable personality who is believed to have had multiple sclerosis was the poet Heinrich Heine (1797-1856). Charles Prosper Olliveier d'Auders was the fi rst to give an account of MS in a monograph published in Paris in 1824 in the work entitled " Maladies de la moelle epiniére " , where he described a twenty-year-old with relapsing-remitting neurological symptoms. Robert Carswell was the fi rst to describe pathologic changes of MS in an atlas published in 1838. In France Jean Cruveilhier had described four cases in a text entitled " Diseases of the spinal cord ". Charcot gives Cruveilhei-ru the primacy as the fi rst MS illustrator. Carswell's pictures …