Since science cannot pinpoint the cause of MS with any accuracy, no one knows the cause. It is likely to be multiple factors. So I believe there is no answer to your question.
They think it is mostly genetic. May be with an environmental trigger. I look at it this way. It is like a cucumber turning into pickle once it is done its always a pickle.
I think it is a lot of things that have to happen at the same time to activate the disease. I think I have had it for 10-15 years before I was diagnosed. It also happens that I did get mono at this time. Whether that has a small part in me getting MS who knows. Some people will say so. We willl just have to wait and see :)
I care for the people who don't yet have it, as the answer(s) will mean the eventual ability to avoid getting it. For myself? I couldn't give a toss. I have it. At present, I can't unhave it.
If only they could answer that million dollar question! Unfortunately it appears to be a mixture of many different factors.
In my cas my MS began with a severe case of ADEM. The MS dx occured about 20 years later.
My best guess would be a combo of a genetic predisposition; environmental factors eg: low vitamin D that made me more vulnerable to it; and a history of infectious mono that set the wonky autoimmune response in motion. But I am not a scientist. This is just speculation.
We believe that many illnesses are caused by not only our environmental conditions and the food intake, but the combination of sodas, smoking, alcohol, etc. and sexual activities. But more important STRESS is the leading cause of most illnesses. I have seen people who have anger management issue worsen with their illnesses because of their yelling and fighting they do on a daily basis with everyone. Sorry to say, but check the Emotional Code book...you will learn much.
If I knew the answer I woould be rich, but I don't so I ain't :-) No one knows what causes it. I tend to discount the genetic causation, as I am the only one on both sides of my family going back 3 generations to get lucky.
My doc runs a full fledged research facility, in addtion to his clinical practice. He tells me that the Holy Grail of MS is the cause. Once it is dicovered the cure is the easy part!
I am the only one in my family and lived in the deep south growing up, so lots of vitamin D and sunshine. I went many years before getting a diagnosis. I had high epstein-barr levels but have never had Mono.
Go figure. I have it, its my BFF, not of my choice, but onward we go, one step at a time. I leave the research to the professionals as I doubt I can figure out the cause (sharing the nobel prize with my MS friends on here when I do) LOL, but doubt it will happen in my lifetime and it won't undo what we already have.
Sorry we can't give you the answer you so want.
I got disseminated histoplasmosis from bats at work. Bats carry the fungus. At the age of 52, after I developed disseminated histoplasmosis (gives a positive ANA titer, b/c the immune system is actually attacking the fungus) I (and my coworkers) developed symptoms of...MS, ALS, lupus, fibromyalgia, sarcoidosis, possible trigeminal neuralgia, migraines, a possible lightning type temporal lobe epileptic seizure, plantar fasciitis, tinnitus, weird rashes....
My coworkers and I all had similar symtpoms. I almost died when they gave me Prednisone
And many of those would have to be ruled out, one by one. Am so sorry this happened to you! Is this considered a workers comp. claim by any chance? Would certainly help with the finances of finding a diagnosis, regardless of which one!