title: Benign multiple sclerosis: a need for a consensus.
abstract: OBJECTIVE
  To investigate the impact of different definitions on the frequency of benign multiple sclerosis (MS) in patients with a long follow-up, and to study the presence of non-motor symptoms and employment across the definitions.
  
  
  METHODS
  All patients alive (n = 188) with disease onset during 1976-1986 in Hordaland County, Norway, were clinically examined including the Expanded Disability Status Scale (EDSS) in 2003. Non-motor symptoms which included depression, cognitive impairment, fatigue and pain, and employment status were also registered. Three definitions of benign MS were used based on the following EDSS cut-off values: 2.0, 3.0 and 4.0. Two additional definitions were added using an EDSS <or=4.0 and incorporating either full-time or full- and part-time employment status.
  
  
  RESULTS
  The frequency of benign MS increased from 14.5% for EDSS <or=2.0 to 40.8% for EDSS <or=4.0, but was only 12.3% for the definition based on full-time employment. Patients with an EDSS <or=2.0 had markedly less non-motor symptoms and lower unemployment rates than the other groups.
  
  
  CONCLUSIONS
  An EDSS score <or=2.0 with at least 10 years of disease duration seems to be the most appropriate criterion in identifying patients with benign MS.
authors.affiliation: Department of Neurology, Haukeland University Hospital, The Norwegian Multiple Sclerosis Competence Centre, Bergen, Norway. solveig.bergliot.glad@helse-bergen.no
authors.forename: S B
authors.initials: SB
authors.lastname: Glad
authors.forename: J H
authors.initials: JH
authors.lastname: Aarseth
authors.forename: H
authors.initials: H
authors.lastname: Nyland
authors.forename: T
authors.initials: T
authors.lastname: Riise
authors.forename: K-M
authors.initials: KM
authors.lastname: Myhr
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D018450:Disease Progression; D004651:Employment / Q000639:trends; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000453:epidemiology*; D012720:Severity of Illness Index