Natural history of multiple sclerosis

  title={Natural history of multiple sclerosis},
  author={Brian G. Weinshenker},
  journal={Annals of Neurology},
Multiple sclerosis (MS) is the most common idiopathic inflammatory disease of the central nervous system. The distinction between MS and other benign or fulminant inflammatory demyelinating disorders is based on quantitative, rather than qualitative, differences in chronicity and severity. Primary progressive MS may differ from relapsing‐remitting MS in MRI lesion frequency, immunogenetic profile, responsiveness to immunosuppressive treatment, and histology. In 60% of patients, MS begins as a… 

Primary-progressive multiple sclerosis

The natural history of multiple sclerosis with childhood onset

Onset of progressive phase is an age-dependent clinical milestone in multiple sclerosis

Patients with RRMS do not inevitably develop a progressive disease course, and onset of progression is more dependent on age than the presence or duration of a pre-progression symptomatic disease course.

Multiple sclerosis - etiology and diagnostic potential.

Despite huge progress regarding MS as well as the availability of different diagnostics methods this disease is still a diagnostic challenge, due to fact that MS has diverse clinical course and there is a lack of single test, which would be of appropriate diagnostic sensitivity and specificity for quick and accurate diagnosis.

Longterm prognosis of multiple sclerosis in untreated patients and in patients treated with first generation immunmodulators

The long-term prognosis was determined in a 50-year follow-up in the geographically and temporally defined “Gothenburg Incidence Cohort” and whether first generation immunomodulating drugs in the relapsing remitting phase delay the time to secondary progression was investigated.

Evidence for an Early Treatment of Multiple Sclerosis

The demonstration of early irreversible axonal damage is a strong argument in favor of early treatment, an option that is beginning to be favored by many neurologists, and is probably explained by the complex pathogenesis of MS.

Predicting a window of therapeutic opportunity in multiple sclerosis.

  • O. Andersen
  • Biology, Psychology
    Brain : a journal of neurology
  • 2010
A contemporary analysis is that relapses represent multifocal inflammatory lesions, whereas the later, progressive phase is mainly driven by neurodegeneration, and the immunopathology may persist, albeit in an altered form, throughout the progressive phase.

The outcome spectrum of multiple sclerosis: disability, mortality, and a cluster of predictors from onset

An incidence cohort of Gothenburg residents with MS onset in 1950–1964 provided hard outcome data in untreated patients over several decades, and predicted the disease course during five decades indirectly, by predicting time to secondary progression.

Clinical characteristics and long term prognosis in early onset multiple sclerosis

It is confirmed that several specific clinical characteristics can be identified in EOMS patients, such as a mainly relapsing–remitting disease onset and frequent presentation with brainstem– cerebellar dysfunction, but after a long period of follow–up the overall disease course and prognosis do not seem to differ from that in adult onset MS.



The natural history of multiple sclerosis: a geographically based study. 5. The clinical features and natural history of primary progressive multiple sclerosis.

From clinical onset, rate of progression was faster in the PP- multiple sclerosis group than in the secondary progressive (SP)-multiple sclerosis group, and when the rates of progression from onset of the progressive phase to DSS 6, 8 and 10 were compared, SP-multiple sclerosis had a more rapid progressive phase.

Factors associated with a malignant or benign course of multiple sclerosis.

Both host factors (age at first manifestation of symptoms and types of symptoms at onset) and environmental factors (place of residence and exposure to heat and cold) are determinants of disease course and it is suggested that most patients with MS should avoid Exposure to heat.

Major differences in the dynamics of primary and secondary progressive multiple sclerosis

Findings may indicate a difference in the dynamics of disease activity between the two forms of progressive MS, particularly in relation to the inflammatory component of the lesions, and have important implications for the selection of patients and the monitoring of diseaseactivity in therapeutic trials.

The natural history of multiple sclerosis: a geographically based study. 2. Predictive value of the early clinical course.

The time to reach successive levels of disability defined by the Kurtzke Disability Status Scale in 1,099 MS patients followed at University Hospital, London, Canada between 1972 and 1984 is recorded.

The Natural History of Multiple Sclerosis

  • B. WeinshenkerG. Ebers
  • Medicine, Psychology
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques
  • 1987
ABSTRACT: Studies which have attempted to define the outcome of multiple sclerosis (MS) have methodologic difficulties arising from patient referral biases and the length of follow-up required, which

Factors associated with a rapid course of multiple sclerosis.

A cohort of 886 cases of multiple sclerosis who had onset between Jan 1, 1960, and Dec 31, 1969, and who were resident in 1970 in either a low-prevalence area or in a high-preValence area were followed up for changes in disability status throughDec 31, 1979.

The natural history of multiple sclerosis: a geographically based study. 3. Multivariate analysis of predictive factors and models of outcome.

A multivariate hierarchical analysis was used to assess the significance of several demographic and clinical factors in multiple sclerosis patients and generated predictive models which permit the calculation of the median time to DSS 6 for patients with a given set of covariates.

STUDIES ON THE NATURAL HISTORY OF MULTIPLE SCLEROSIS: 7. Correlates of Clinical Change in an Early Bout

Factors of predictive value for the course of an early bout of multiple sclerosis were sought from a nationwide series of over 500 men who, before and during the bout under study, were on active duty

Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up.

In patients with an acute onset, low onset age, high degree of remission at first exacerbation, symptoms from afferent nerve fibres and onset symptoms from only one region (as compared with polyregional symptoms of the central nervous system, were factors significantly associated with a favourable long-term prognosis.