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Natural history of multiple sclerosis. A unifying concept (2006)
| Venue: | Brain |
| Citations: | 64 - 4 self |
BibTeX
@ARTICLE{Confavreux06naturalhistory,
author = {Christian Confavreux and Ra Vukusic},
title = {Natural history of multiple sclerosis. A unifying concept},
journal = {Brain},
year = {2006},
pages = {561--563}
}
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Abstract
Multiple sclerosis can follow very different patterns of evolution and variable rates of disability accumulation. This raises the issue whether it represents one or several distinct diseases. We assessed demographic and clinical characteristics in 1844 patients with multiple sclerosis that we categorized according to the classi-fication of Lublin and Reingold (1996) into 1066 (58%) relapsing–remitting, 496 (27%) secondary progressive, 109 (6%) progressive relapsing and 173 (9%) primary progressive cases of multiple sclerosis. Relapsing–remitting and secondary progressive cases shared similar age at disease onset (median = 28.7 versus 29.5 years; P = 0.21), initial symptoms of the relapsing–remitting phase, degree of recovery from the first neurological episode, and time from the first to the second episode. By contrast, disease duration was twice as long in secondary progressive than in relapsing–remitting cases (mean6 SD = 17.66 9.6 versus 8.76 8.6 years; P < 0.001). Progressive relapsing and primary progressive cases were essentially similar in their clinical char-acteristics. In patients experiencing a progressive course, median age at onset of progressive phase was similar in secondary progressive cases and in cases who were progressive from onset (39.1 versus 40.1 years; P = 0.47). The proportion of cases with superimposed relapses during progression was 40 % in both categories. Finally, the 1562 patients with an exacerbating–remitting initial course and the 282 patients with a progressive initial course of the disease were essentially similar with respect to the time course of disability accumulation from
Keyphrases
multiple sclerosis unifying concept natural history secondary progressive disability accumulation primary progressive case secondary progressive case progressive relapsing disease duration progressive initial course superimposed relapse time course mean6 sd variable rate median age disease onset second episode initial course several distinct disease progressive phase initial symptom different pattern similar age first neurological episode clinical characteristic progressive course clinical char-acteristics remitting phase
