Magnetic resonance images fulfilled the Barkhof-Tintoré criteria for multiple sclerosis in 10 of 11 patients, with conspicuously few subcortical lesions relative to extensive periventricular lesions and lesions extending from the inferior midline aspect of the corpus callosum. Prediction of the non-progressive stage was possible with moderate hazard ratios and low sensitivity.
Early features that predicted a non-progressive course were complete remission of the onset attack, low or moderate initial relapse frequency and-when the patients with possible multiple sclerosis were included-dominating afferent symptoms. The clinical disease activity had abated in these 13 patients, with the caveat that transition to secondary progression continued to occur after four decades, albeit with decreasing risk.
Benign MS is relatively-low activity disease following onset. This is reported to occur in about 25% MSers with up to 25-30years of follow up. This current study looks to see how Benign is Begin MS and shows that it does occur but with unfortunately low frequency. These people generally had good recovery from their attacks a focal (affecting one area of the CNS) disease onset.
Predictors of median time to onset of secondary progression was being female (18 years verses 15 years in males), having a low number of relapses in first five years (less than 3 = 9 years, more than 4 = 4 years), good recovery from last relapse (complete recovery = 13 years, incomplete recovery 4 years), symptoms affecting behavioural effects verses movement effects ( Behaviour = 12 years verses 4 years for motor control problems.
Following onset the majority of people with MS will eventually develop progressive disease. After 40 years the probability of a non-progressive relapsing-remitting course was 22% after 45 years 18% and 50 years 14%.