Multiple sclerosis (MS) is a lifelong autoimmune disease that can affect vision, muscle function, sensation, and cognitive abilities. However, most patients have symptoms only for short periods. Dr. Louis J. Rosner and coauthor Shelley Ross provided a detailed description of what to expect in their book Multiple Sclerosis. The course of the disease varies from very mild to serious. The statistics are on the side of the patient, according to Rosner and Ross. Here's how they explained the prognoses for patients with MS:
1. At least 20 percent will have a benign course, with a small number of mild attacks followed by complete recovery.
2. Another 20 to 30 percent will have a relapsing-remitting course, with attacks that are troublesome but never produce permanent disability.
3. The largest group, approximately 40 percent, will have a relapsing-remitting course that becomes progressive after some years. Of these, about half will have only mild permanent disability.
4. The most serious course of the disease is the primary progressive type. This occurs in only 10 to 20 percent of patients, mostly those who are diagnosed at older ages.
MS is almost never a cause of death, and the life expectancy of MS patients is close to that of the general population. Weakness in the legs increases the chance that older MS patients will need mobility aids, including walking canes, but 75 percent will never need a wheelchair.
Factors that increase the probability for a good prognosis, according to Rosner and Ross, are:
1. Onset before age 40
2. One symptoms at onset
3. One symptom during the first year
4. Optic neuritis or sensory signs as the only initial symptom
5. Sudden appearance of symptoms
6. Initial remission within one month
7. Little or no residual effect after each exacerbation
8. No loss of coordination at diagnosis
9. Current ability to walk with minimal loss of balance
Dr. Jozef A. Opara and collaborators reported that various questionnaires can be used to measure how well treatment is improving quality of life for the patient.