Two presentations reviewed a number of features in MS, which were shown to be of prognostic significance.
Professor George Ebers, Oxford, UK, described a cohort study from Canada. This study was conducted over 25 years, and involved following the natural history of the disease, something that is becoming increasingly difficult since almost all people with MS now receive some kind of therapy.
Results suggested that early relapse rate (even within the first year of disease), first inter-attack-interval, time to early disability, and most importantly the onset of the progressive course, have significant influences on long-term outcome. Professor Ebers hypothesised that suppression of relapses should lead to long-term improvement, but added that this was by no means proven.
Dr Sandra Vukusic, described a similar study for a cohort of MS patients in Lyon, which spanned 43 years, and came to similar conclusions. However, a further study on the natural history of MS in Iceland revealed a far different pattern of MS, with approximately 50 per cent of all cases being benign.
Dr JG Benededikz suggested that the high number of neurologists in Iceland
meant that all prospective MS patients were assessed within days of seeking
advice, and might be a contributing factor to the high incidence of "mild"
disease in that country.