Multiple sclerosis — a disease of the central and peripheral nervous system? (literature review)

Multiple sclerosis is considered a chronic autoimmune demyelinating disease of the central nervous system. However, the issue of peripheral nervous system involvement in multiple sclerosis is still relevant. Some studies suggest that demyelination of peripheral nerves is present in multiple sclerosis. In addition, the described data suggest that the process of peripheral nerve demyelination in this disease is more widespread than suspected. It is hypothesized that peripheral neuropathy in such patients results from the same pathogenesis affecting the central nervous system. Some studies have reported that patients had antibodies to peripheral myelin antigens. Changes in the structure of peripheral nerves were confirmed by magnetic resonance imaging and neurography. At the same time, pathologic studies were performed that revealed decreased myelin thickness. Some neurophysiological abnormalities in the examination of peripheral nerves in patients with multiple sclerosis using nerve conduction studies are also described. It is important to diagnose peripheral neuropathy in time, as it can complicate the clinical picture and multiple sclerosis types. However, the data on the frequency and extent of peripheral nervous system damage in multiple sclerosis remain controversial and not fully understood, although current studies demonstrate a possible link between peripheral neuropathy and multiple sclerosis. To better understand this pathogenesis, additional research on peripheral nerve damage in multiple sclerosis is needed, which will deepen knowledge of the pathophysiology of this disease and improve approaches to diagnosis and treatment.