Factors That Can Determine The Severity of Multiple Sclerosis
- Sunday, July 19, 2009, 13:22
- Multiple Sclerosis
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- Dick:
- What do we know, Doctor, about the factors that can determine the severity of MS? I look at factors like the age at onset, gender, early symptoms, MRI status, and other factors that perhaps you would choose to mention.
- Dr. Phillips:
- We always wish for that magic crystal ball that would allow us to predict the future. That’s one of the scariest parts of this illness, I think. Unfortunately, we don’t have a crystal ball for this illness. Yet, as we come to know more and more about this illness, there are certain generalities that can be commented on with regard to ultimate outcomes of the disease. For instance, people who have more severely abnormal brain MRI’s at the onset of the disease have a tendency – perhaps not surprisingly – to do worse quicker in the disease. On the other hand, people who have less abnormal MRI’s tend to maybe do somewhat better and take longer to have additional problems.
People who have more sensory symptoms as opposed to motor or coordination symptoms tend to do better in the long run, but this is of course not an absolute statement or prediction. There is some good evidence that the time interval between the first and the second clinical attack may be predictive. That is, the longer it is from your first attack to the second attack suggests that you might have an ultimately milder course.
Age of onset is worth mentioning mainly because it can be confusing. Usually, people think that people who have early onset disease – in their twenties or thirties – tend to do better than people who have later onset disease. But it’s very important for those people listening who are in their forties and fifties who have maybe just been recently diagnosed and are concerned that being diagnosed at a later age means a bad thing. You know, very often that’s just the time they’re being diagnosed. And in fact, a careful history will reveal that they have had evidence of MS that may go back 10, 20, 30, years. Thus, the age of onset is something that’s a little bit harder to define.
- Dick:
- That would be confusing if the disease were present in some mild or undetectable form and really didn’t identify itself clearly for a couple of decades.
- Dr. Phillips:
- Right, and that’s actually not all that uncommon a scenario.
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