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Donald H. Gilden, MD

JAMA. 2001;286:3127-3129.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Multiple sclerosis (MS) is the most common demyelinating disease of humans. In the United States alone, the prevalence is 250 000 to 350 000 cases.¹ Based on data accumulated in 1994, the annual cost was estimated at more than $34 000 per person, translating into a conservative estimate of a national annual cost of $6.8 billion and a total lifetime cost per case of $2.2 million.² Most MS patients are young. Disease usually begins between ages 15 and 45 years and has a relapsing-remitting course, although a substantial proportion of patients develop chronic progressive disease.

The pathologic hallmark of MS is the plaque, an area of white matter demyelination often accompanied by inflammation. The inflammatory infiltrates are composed of T lymphocytes, some B cells and plasma cells, and activated macrophages or microglial cells.³ Although it is generally believed that inflammation is an obligatory and possibly primary feature of demyelination . . . [Full Text of this Article]

Author Affiliation: Departments of Neurology and Microbiology, University of Colorado Health Sciences Center, Denver.

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