Multiple Sclerosis Prognostic Elements
Quick Summary
Multiple sclerosis (MS) is the most prevalent chronic inflammatory disease of the central nervous system. This incurable disease affects more than 2 million people worldwide with about 75% of cases occurring in women.
MS is a demyelinating disease characterized by multifocal and temporally scattered central nervous system (CNS) damage which leads to the axonal damage. Exogenous, environmental, and genetic factors contribute to the development of MS and the correlations of these factors are still being widely studied. Depending on the severity of signs and symptoms, MS can be described as benign or malignant.
Symptomatic Progression
MS progression is highly variable from one person to the next and its not correlated to risk factors. No treatment currently available completely halts its progression. Many patients have symptoms that persist with periods of remission that vary greatly in duration. After ten to twenty years, many MS patients develop progressive symptoms and impairments.
Common Initial Symptoms
- Fatigue
- Numbness
- Blurry vision
- Weakness
Progressive Symptoms
- Loss of bladder control.
- Impaired ambulation.
- Slowed mental abilities
Using this program
Select any of the following features
that are present in the patient to determine their
prognostic value in predicting a diagnosis of multiple sclerosis.
Acute
transverse myelopathy
Balance or
gait problems
Bladder problems
e.g. frequency and/or urgency of urination
Convulsions
Cortical deficits such as aphasia, apraxia, alexia, or neglect
Deficit developing within minutes
Diplopia (double vision)
Early dementia
Fatigue
Heat sensitivity (Uhthoff phenomenon)
Internuclear ophthalmoplegia
Lhermitte sign (electric shock-like sensations upon flexion of the neck)
Limb ataxia - incoordination of limb movement
Motor (acute
/ subacute)- muscle weakness, impaired balance, and spasticity
Onset between ages 15 and 50 years
Onset before age 10 or after age 50 years
Optic neuritis
Pain is
present
Relapses and remissions
Rigidity or sustained dystonia
Sensory in face e.g.stabbing pain
Vertigo
Visual loss
References
- Brownlee WJ et al: Diagnosis of multiple sclerosis: progress and
challenges. Lancet.389(10076):1336-46, 2017.
- Drulovic J, Basic-Kes V, Grgic S, et al. The Prevalence of Pain in
Adults with Multiple Sclerosis: A Multicenter Cross-Sectional Survey.
Pain Med 2015; 16:1597.
- Kahraman T, Ozdogar AT, Ertekin O, Ozakbaş S. Frequency, type,
distribution of pain and related factors in persons with multiple
sclerosis. Mult Scler Relat Disord 2019; 28:221.
- Kamińska J, Koper OM, Piechal K, Kemona H. Multiple sclerosis - etiology and diagnostic potential. Postepy Hig Med Dosw (Online). 2017 Jun;71(0) 551-563. doi:10.5604/01.3001.0010.3836. PMID: 28665284.
- Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med. 2018 Jan 11;378(2):169-180. doi: 10.1056/NEJMra1401483.
https://pubmed.ncbi.nlm.nih.gov/29320652/
- Richards RG, Sampson FC, Beard SM, Tappenden P. A review of the
natural history and epidemiology of multiple sclerosis: implications for
resource allocation and health economic models. Health Technol Assess.
2002;6(10):1-73. doi: 10.3310/hta6100. PMID: 12022938.
- Ruet A, Deloire M, Charré-Morin J, et al. Cognitive impairment
differs between primary progressive and relapsing-remitting MS.
Neurology 2013; 80:1501.
- Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple
sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018;
17:162.
