Neurol Sci. 2003 Dec;24 Suppl 5:S268-70
Trojano M, Paolicelli D, Bellacosa A, Cataldo S.
Department of Neurological and Psychiatric Sciences, University of Bari, Piazza Giulio Cesare 11, I-70124, Bari, Italy.
The development of a progressive course is by far the most deleterious event in the case of a multiple sclerosis (MS) patient.
It occurs in about 90% of relapsing remitting patients by 20-25 years from onset.
The clinical transition to secondary progressive MS is phenotypically distinctive and both patients and physicians acknowledge that a fundamental shift in the degree of responsiveness to anti-inflammatory therapies has occurred.
This review discusses the clinical studies that provided important findings relating to our understanding on different mechanisms that may contribute to irreversible disability in MS.