neurologic disorders
Multiple Sclerosis (MS)
Prognosis for Multiple Sclerosis
The course of multiple sclerosis is highly varied and unpredictable. In most patients, especially when MS begins with optic neuritis, remissions can last months to>10 years. Most patients (60 to 80% [ Prognosis references ]) who initially have a clinically isolated syndrome eventually develop MS, with a second lesion becoming evident or MRI detecting a lesion, usually within 5 years after the initial symptoms begin. Treatment with disease-modifying therapies can delay this progression. If patients have a radiologically isolated syndrome without a history of a clinical episode consistent with demyelination, the risk of developing MS is 19 to 90%, depending on the patient's age and the presence of spinal cord or gadolinium-enhancing lesions ( If the initial brain or spinal MRI shows more extensive disease, patients may be at risk of earlier disability, as may patients who have motor, bowel, and/or bladder symptoms when they present or who have incomplete recovery during relapses. Some patients, such as men with onset in middle age and with frequent exacerbations, can become rapidly incapacitated. Cigarette smoking may accelerate disease progression. Life span is shortened only in very severe cases. 1.National Multiple Sclerosis Society: Clinically isolated syndrome (CIS). Accessed 5/1/23. 2.Lebrun-Frénay C, Rollot F, Mondot L, et al: Risk factors and time to clinical symptoms of multiple sclerosis among patients with radiologically isolated syndrome.JAMA Netw Open4 (10):e2128271, 2021. doi: 10.1001/jamanetworkopen.2021.28271 