What's prognosis of multiple sclerosis?
It is difficult to predict how multiple sclerosis will progress in any one person. Most people with multiple sclerosis will be able to continue to walk and function at their work for many years after their diagnosis. The factors associated with the mildest course of multiple sclerosis are being female, having the relapsing-remitting form, having the first symptoms at a younger age, having longer periods of remission between relapses, and initial symptoms of decreased sensation or
vision rather than of weakness or incoordination.
Less than 5% of people with multiple sclerosis have a severe progressive form, leading to death from complications within five years. At the other extreme, 10-20% have a benign form, with a very slow or no progression of their symptoms. The most recent studies show that about seven out of 10 people with multiple sclerosis are still alive 25 years after their diagnosis, compared to about nine out of 10 people of similar age without disease. On average, multiple sclerosis shortens the lives of affected women by about six years, and men by 11 years. Suicide is a significant cause of death in multiple sclerosis, especially in younger patients. The degree of disability a person experiences five years after onset is, on average, about three-quarters of the expected disability at 10–15 years. A benign course for the first five years usually indicates the disease will not cause marked disability.
Because of improved treatment for complications such as lung and bladder infections, the life expectancy of those diagnosed with multiple sclerosis is only slightly reduced. The earlier in life disease onset occurs, the slower disability progresses. This is due to more frequent chronic progressive courses with faster accumulation of disability when onset occurs at a higher age. Disability after 5 years correlates well with disability after 15 years: 2/3 of multiple sclerosis patients with low disability after 5 years will not markedly deteriorate during the next ten years. Further multiple sclerosis cases in the family do not influence disease progression. 1 of 3 patients will still be able to work after 15-20 years. Visual loss as the initial symptom is a marker for a rather good prognosis; gait disturbance, weakness or numbness for a rather poor prognosis. Rapid regression of initial symptoms, age at onset below 35, only a single symptom at onset, rapid development of initial symptoms and short duration of the last relapse indicate a good prognosis. When the initial disease course is relapsing remitting, the statistical duration until a wheelchair is needed, is 20 years. This means that many multiple sclerosis patients will never need a wheelchair. If the disease course is primary progressive then a wheelchair at an average will be needed after 6 to 7 years. It has to be noted that most of this longterm data was acquired before the advent of modern immunomodulatory drugs about 10 years ago, which have been shown to delay disease progression over a period of several years.
Currently there are no clinically established laboratory investigations available to predict prognosis or therapeutic response, although promising approaches have been undertaken that need further confirmation, such as determination of the two antibodies anti-MOG and anti-MBP or of TRAIL (TNF-Related Apoptosis Inducing Ligand).
More information on multiple sclerosis
What is multiple sclerosis? - Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by the hardening of patches of tissue in the brain and spinal cord.
What causes multiple sclerosis? - Multiple sclerosis is caused by an unknown agent that gradually destroys the myelin covering, or sheath, of nerve fibers, resulting in a temporary interruption.
Is multiple sclerosis inherited? - Multiple sclerosis is a typical complex trait and susceptibility is genetically determined. People with MS inherit certain regions on individual chromosomes more often than people without MS.
What's the typical course of multiple sclerosis? - Multiple sclerosis is recognized as occurring with seven different patterns. Multiple sclerosis starts with an acute flare-up of symptoms within hours to days.
Who is at the risk of multiple sclerosis? - Multiple sclerosis affects women almost twice as frequently as men. Climate, diet, geomagnetism, toxins, sunlight, genetic factors, and infectious diseases are risk factors for multiple sclerosis.
What types of multiple sclerosis are there? - Multiple sclerosis have different patterns including relapsing/remitting multiple sclerosis, secondary progressive multiple sclerosis, progressive relapsing multiple sclerosis.
What're the signs and symptoms of multiple sclerosis? - The first symptoms of multiple sclerosis are often visual changes. Later symptoms may include fatigue, muscle spasticity and stiffness, tremors, paralysis, pain.
How is multiple sclerosis diagnosed? - A definite diagnosis of multiple sclerosis requires evidence for dissemination of lesions within the central nervous system both in space and in time.
What's the treatment for multiple sclerosis? - The treatment of multiple sclerosis aims at decreasing the rate and severity of relapse, reducing the number of lesions, delaying the progression of the disease.
What's prognosis of multiple sclerosis? - Most people with multiple sclerosis will be able to continue to walk and function at their work for many years after their diagnosis.
Dietary therapy for multiple sclerosis - The main role of diet in multiple sclerosis is to enable people to manage common problems which include fatigue, incontinence and constipation.
Nutritional supplements for multiple sclerosis - Nutritional therapy is used for alleviating the symptoms of multiple sclerosis or altering the natural course of the disease.
Does multiple sclerosis affect pregnancy? - Multiple sclerosis has no adverse effects on the course of pregnancy, labor, or delivery. Pregnancy doesn't affect the long term course of the disease.
Can vitamin D reduce multiple sclerosis risk? - Vitamin D supplements may positively influence the immune systems of patients with multiple sclerosis. Vitamin D has a beneficial influence on ongoing multiple sclerosis.