During the periods when multiple sclerosis is active or progressive, leukocytes, white blood cells, flood the inflammation site. This process is known as the inflammatory response. During the inflammatory response, three main things happen. First, the myelin gets stripped away from the nerves which interrupts electrical impulses to the muscles. Secondly, the inflammation damages the membrane of the axon which is also part of the nerve transmission process. And lastly, the inflammation kills oligodendrocytes, which are myelin producing cells. Without myelin being replaced on neurons, symptoms will progressively get worse. As the disease continues, axons continue to die, but not necessarily from the inflammation response. This is a period of secondary progression, in which the death of axons is referred to as Wallerian Degeneration.
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During the periods of regression, several things happen. Most importantly, the inflammation dies back down. Then the neurons are able to resume their normal functions and the individuals begin to recover to some degree. While the disease is in remission, the damaged axons still exhibit some functioning by producing more sodium channels to send nerve impulse transmissions. The central nervous system contributes to the process of remission by creating new neuronal pathways around the damaged nerves. The oligodendrocytes start the procedure of remyelination of the damaged sheaths on the axons which also contributes to remission. Repairing the damaged sheaths to full function may take years to achieve or never actually be achieved. Sometimes scar tissue replaces the lost myelin which can block new myelin from forming. If this happens, the nerves nerve full recover.
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