Multiple Sclerosis

Music and Lyrics by Arie Perry, M.D.

MS is thought to be an autoimmune, demyelinating disease
Forming plaques in the brain and the spine, stripping myelin with ease
Relapsing and remitting most of the time, progressive deficits are clues to the crime
Sites of involvement seem random to me, but they determine signs and symptoms we see, oh MS!

Optic neuritis, spinal pathology, periventricular plaques,
Dawson's fingers fan out radially, surrounding vascular tracks
They're sharply demarcated, I don't know why; looks gray and sunken to the naked eye
Cortex may be involved, this we know now,
Cognitive loss occurs, perhaps this is how, oh MS

Foamy macrophages predominate, in plaques with activity,
Perivascular lymphocyte cuffs, increase the cellularity
Marked myelin loss is seen on Luxol fast blue, PAS positive material too
Axons are spared on neurofilament stains, although affected,
Most axons are retained in MS!…oh MS!

Tumefactive MS is challenging, diagnostically,
A ring enhancing mass often provokes, a tissue biopsy
Mitotic figures shouldn't be misconstrued, don't call it GBM or you might get sued
Foamy macrophages provide the clue, to let you know that tumor's probably not true, oh MS

A chronic debilitating disease, we need new therapies, new therapies