Multiple Sclerosis,
Background:
There is growing consensus that neurologists
should consider disease-modifying therapies early in multiple sclerosis
(MS). However, there is a subgroup with a natural benign course, in which
treatment could be postponed. We sought to determine the frequency of benign
MS and early clinical factors that may predict a benign course.
Methods:
We performed a systematic review
of the existing literature on benign MS, which was defined as minimal or
no disability equivalent to a score on the Expanded Disability Status Scale
(EDSS) 3.0 at least 10 years after disease onset.
Results:
Only a small number of studies of
adequate quality was available. In total there were nine published studies
representing 2204 patients. The estimated frequency of benign MS was 26.7%.
Onset with optic neuritis, onset before the age of 40 years, absence of
pyramidal signs at presentation, duration of first remission more than
1 year, and only one exacerbation in the first 5 years after onset of MS,
were associated with a benign course.
Conclusions:
From the existing literature a set
of unrelated clinical characteristics emerged that was associated with
a benign course of MS. However, there is a need for prospective studies
to define more precisely clinical and paraclinical predictors of benign
MS.
© 2001 ingenta
October 2001, vol. 7, no. 5,
pp. 345-347(3)
Ramsaransing G. [1] *; Maurits N.
[1]; Zwanikken C. [1]; De Keyser J. [1]
[1] Department of Neurology, Academisch
Ziekenhuis Groningen, Groningen, The Netherlands [*] Correspondence: G
Ramsaransing, Department of Neurology, Academisch Ziekenhuis Groningen,
P.O. Box 30.001, 9700 RB Groningen, The Netherlands
Abstract: