Multiple sclerosis

Multiple sclerosis (MS) is a non-contagious chronic disease of the brain and spinal cord characterized by a variety of neurologic symptoms caused by demyelination of neurons. Multiple sclerosis results from attack by a patient's own immune system on their central nervous system and is thus categorized as an autoimmune disease.

Prognosis

Because of improved treatment for complications such as lung and bladder infections, the life expectancy of those diagnosed with MS is only slightly reduced. The earlier in life disease onset occurs, the slower disability progresses. This is due to more frequent chronic progressive courses with faster accumulation of disability when onset occurs at a higher age. Disability after 5 years correlates well with disability after 15 years: 2/3 of MS patients with low disability after 5 years will not markedly deteriorate during the next ten years. Further MS cases in the family do not influence disease progression. 1 of 3 patients will still be able to work after 15-20 years. Visual loss or sensory symptoms (numbness and/or tingling) as the initial symptoms are markers for a rather good prognosis; gait disturbance or weakness for a rather poor prognosis. Rapid regression of initial symptoms, age at onset below 35, only a single symptom at onset, rapid development of initial symptoms and short duration of the last relapse indicate a good prognosis. When the initial disease course is relapsing remitting, the statistical duration until a wheelchair is needed, is 20 years. This means that many MS patients will never need a wheelchair. If the disease course is primary progressive then a wheelchair at an average will be needed after 6 to 7 years. It has to be noted that most of these longterm data were acquired before the advent of modern immunomodulatory drugs about 10 years ago, which have been shown to delay disease progression over a period of several years.

Related Topics:
Lung - Bladder - Infection - Life expectancy - Disability - Numbness - Tingling - Prognosis - Gait disturbance - Weakness - Wheelchair - Immunomodulatory drug

~ ~ ~ ~ ~ ~ ~ ~ ~ ~

Currently there are no clinically established laboratory investigations available to predict prognosis or therapeutic response, although promising approaches have been undertaken that need further confirmation, such as determination of the two antibodies anti-myelin oligodendrocyte glycoprotein and anti-myelin basic protein or of TRAIL (TNF-Related Apoptosis Inducing Ligand).

Related Topics:
Laboratory investigation - Prognosis - Therapeutic response - Antibodies - Anti-myelin oligodendrocyte glycoprotein - Anti-myelin basic protein - TNF - Apoptosis - Ligand

~ ~ ~ ~ ~ ~ ~ ~ ~ ~