Multiple sclerosis: early prognostic guidelines.
To determine tentative early prognostic indicators in multiple sclerosis (MS), literature dealing with MS prognosis and rehabilitation, the records of University of Washington MS Clinic patients, and the opinions of directors of MS Clinics throughout the United States were reviewed. From a review of more than 200 books and articles, as well as MS clinic records, 13 indicators were identified. Characteristics reported as indicating a relatively good prognosis were: 35 years of age or less at onset, current ambulatory ability, monosymptomatic onset, sudden appearance of symptoms, initial remission within 1 month, most recent but less than 2 months, little or no residual deficit after each exacerbation, absence of extensor plantar reflexes and cerebellar signs at initial examination, optic neuritis or other sensory symptom as the sole presenting symptom, absence of initial motor symptoms and pyramidal and cerebellar signs minimal 5 years after onset. The 30 MS clinic directors responding to the survey felt that useful indicators, in order of their usefulness, were: current ambulatory ability, minimal pyramidal and cerebellar signs 5 years after onset, good remission of initial symptoms, prompt resolution of initial symptoms, age 35 or less at onset, only 1 symptom occurring during the 1st year, sudden appearance of initial symptoms, brief duration of the most recent exacerbation, and absence of cerebellar signs at initial examination. In addition to identifying tentative early prognostic indicators, this paper also outlines a simple method of quantifying the level of disability and outlines typical disease courses and rehabilitation service needs in MS.
D000328:Adult; D000367:Age Factors; D004185:Disability Evaluation; D006801:Humans; D008124:Locomotion; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000534:rehabilitation; D011379:Prognosis