“Why did I get this disease?” and “What are the chances my children will get MS? “ are questions commonly asked of clinicians. Because of ongoing research in the areas of genetics and environmental factors, we are able to provide more information than ever before, but still no definitive answers. What has clearly emerged in the last two decades is that MS risk is determined by a complex interaction between multiple gene variations and various environmental factors (van der mei et al, 2011; Simon et al, 2010; Fontaine & Barcellos, 2008) – with increasing evidence pointing to a role for the Epstein-Barr virus, exposure to ultra-violet light/vitamin D, and cigarette smoking (Wingerchuk, 2011).

As just one example of this interaction, De Jager et al (2008) demonstrated that having the HLA DR15 gene increased a person’s risk of MS from two to nearly three times and having antibodies to the Epstein-Barr virus increased a person’s risk up to two times. However those individuals who had both were nine times more likely to develop MS.

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