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Multiple Sclerosis Prognostic Elements

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


Cortical deficits such as aphasia, apraxia, alexia, or neglect

Deficit developing within minutes

Diplopia (double vision)

Early dementia


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


Visual loss


References top of page


  1. Brownlee WJ et al: Diagnosis of multiple sclerosis: progress and challenges. Lancet.389(10076):1336-46, 2017.
  2. 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.
  3. 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.
  4. 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.
  5. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med. 2018 Jan 11;378(2):169-180. doi: 10.1056/NEJMra1401483.
  6. 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.
  7. Ruet A, Deloire M, Charré-Morin J, et al. Cognitive impairment differs between primary progressive and relapsing-remitting MS. Neurology 2013; 80:1501.
  8. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol 2018; 17:162.


Multiple Sclerosis Prognostic Elements