Benign multiple sclerosis: a need for a consensus.
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.
Glad
S B
SB
Department of Neurology, Haukeland University Hospital, The Norwegian Multiple Sclerosis Competence Centre, Bergen, Norway. solveig.bergliot.glad@helse-bergen.no
Aarseth
J H
JH
Nyland
H
H
Riise
T
T
Myhr
K-M
KM
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