title: Clinical course in multiple sclerosis patients presenting with a history of progressive disease.
abstract: OBJECTIVE
  Determine the likelihood of worsening clinical status in the near-term course of progressive MS and evaluate the predictive validity of our diagnostic impression of progressive forms of MS.
  
  
  METHODS
  Retrospective review of charts from 175 patients seen between 2000 and 2007 who were diagnosed with either primary or secondary progressive multiple sclerosis. Data extracted included demographic factors, neurological examination findings to determine EDSS, timed 25 foot walk (T25FW) when available, duration of symptoms, clinical course as documented on initial visit, and history of disease-modifying agent (DMA) use. Significant change in EDSS was defined as a change of one point or more from initial to final clinical evaluation. Significant change in T25FW was defined as a ±20% difference from baseline.
  
  
  RESULTS
  Of the 175 charts reviewed, 35 patients met criteria and had sufficient documentation to allow for EDSS abstraction. Twenty-four patients (68.6%) showed no significant change in EDSS from baseline while eleven patients (31.4%) worsened and none improved. For those patients that had T25FW data available, 6 out of 20 (30%) patients worsened while 11 (55%) showed no change. Three patients (15%) improved.
  
  
  CONCLUSIONS
  In this observational study at a tertiary care MS center, patients classified as progressive MS did not progress as often, or as rapidly, as previous studies have suggested. Greater than two-thirds of patients in this cohort, did not increase 1 step on the EDSS.
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA. Electronic address: kpandey@barnabashealth.org.
authors: K S
authors: KS
authors: Pandey
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: S C
authors: SC
authors: Krieger
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: C
authors: C
authors: Farrell
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: C
authors: C
authors: Hannigan
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: T
authors: T
authors: DeAngelis
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: A E
authors: AE
authors: Miller
authors: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Friedman Brain Institute, Mount Sinai School of Medicine, 5 East 98th Street, Box 1138, New York, NY 10029, USA.
authors: F D
authors: FD
authors: Lublin
keywords: Clinical course; EDSS; Observational study; Primary progressive multiple sclerosis; Secondary progressive multiple sclerosis; T25FW