Multiple sclerosis: relapses and timing of remissions.
BACKGROUND
Relapse is a relatively sudden worsening of neurological status in multiple sclerosis patients. The aim of this paper is to describe the frequency and timing of the subsequent clinical remission, and factors linked to a possible lack of recovery.


METHODS
Two hundred and twenty-three relapses in 62 multiple sclerosis patients were examined retrospectively. Kurtzke's Expanded Disability Status Scale (EDSS) scores were calculated every 3 months from 1 year before to 1 year after. Remission was defined as improvement vs. the EDSS as scored during the relapse. Recovery was defined as return to the EDSS as scored before the relapse.


RESULTS
The frequency of improvement was 78% at 3 months, 86% at 6, and lower in males (65 vs. 81%). The frequency of recovery was 55% at 3 months, 71% at 6. Kaplan-Meier curves showed stabilization after 6 months, with improvement in 90% of patients, 100% without further relapses. Relapses without recovery were only 30%; 15% excluding short-term relapses.


CONCLUSIONS
Incomplete remissions do not appear to be linked to the evolution of the relapse, but to further relapses in the following months; in other words, to the short-term relapse rate.
Iuliano
Gerardo
G
Azienda Ospedaliera, Ospedali Riuniti di Salerno, U.O. Neurologia, Centro Provinciale Sclerosi Multipla, Salerno, Italia. geriul@tin.it
Napoletano
Rosa
R
Esposito
Antonio
A
D000293:Adolescent; D000328:Adult; D002648:Child; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology* / Q000503:physiopathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000453:epidemiology* / Q000209:etiology; D012008:Recurrence; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors