Multiple sclerosis natural history, complications and prognosis: Difference between revisions

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==Overview==
==Overview==
Multiple sclerosis usually starts between age of fifteen to forty years, rarely before age fifteen or after age sixty with symptoms such as [[optic neuritis]], [[diplopia]], [[sensory]] or motor loss, [[vertigo]], and [[Balance disorder|balance]] problems. It may be classified into four groups according to [[clinical]] course of the [[disease]] including relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing. [[Complications]] that can develop as a result of multiple sclerosis are: medication complication, [[fatigue]], [[mood]] problems, [[spasticity]], [[bowel]] and [[bladder]] dysfunction, [[cognitive impairment]], heat sensitivity, [[Incoordination]], [[pain]], [[sexual dysfunction]], sleep disorders, [[vertigo]], [[visual loss]]. there are some factors associated with a particularly poor [[prognosis]] among [[patients]] with multiple sclerosis such as relapsing versus progressive disease, early symptoms, demographics, sex, and smoking.
Multiple sclerosis usually start between age of fifteen to forty years, rarely before age fifteen or after age sixty with [[symptoms]] such as [[optic neuritis]], [[diplopia]], [[Sensory loss|sensory]] or [[Muscle weakness|motor loss]], [[vertigo]] and [[Balance disorder|balance]] problems. It may be classified into four groups according to [[clinical]] course of the [[disease]] including relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing. [[Complications]] that can develop as a result of multiple sclerosis are: [[medication]] [[complication]], [[Fatigue]], [[mood]] problems, [[Spasticity]], [[Bowel]] and [[bladder]] dysfunction, [[Cognitive impairment]], Heat sensitivity., [[Incoordination]], [[Pain]], [[Sexual dysfunction]], [[Sleep disorder|Sleep disorders]], [[vertigo]], [[visual loss]]. there are some factors associated with a particularly poor [[prognosis]] among [[patients]] with multiple sclerosis such as: Relapsing versus progressive disease, early symptoms, Demographics, Sex, [[Smoking]].


==Natural History, Complications, and Prognosis==
==Natural History, Complications, and Prognosis==

Revision as of 16:40, 19 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Multiple sclerosis usually start between age of fifteen to forty years, rarely before age fifteen or after age sixty with symptoms such as optic neuritis, diplopia, sensory or motor loss, vertigo and balance problems. It may be classified into four groups according to clinical course of the disease including relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing. Complications that can develop as a result of multiple sclerosis are: medication complication, Fatigue, mood problems, Spasticity, Bowel and bladder dysfunction, Cognitive impairment, Heat sensitivity., Incoordination, Pain, Sexual dysfunction, Sleep disorders, vertigo, visual loss. there are some factors associated with a particularly poor prognosis among patients with multiple sclerosis such as: Relapsing versus progressive disease, early symptoms, Demographics, Sex, Smoking.

Natural History, Complications, and Prognosis

Natural History

Complications

Complications that can develop as a result of mutiple sclerosis include:

  • Fatigue: Fatigue is seen in almost 80% of MS patients. They commonly feel exhausted and out of energy. We can see fatigue exacerbation before acute attacks in MS and for a while after that.[18]
  • Spasticity: Damage to the upper motor neurons and decrease inhibition of lower motor neurons in MS can increase muscle tone and rigidity in 75% of MS patients.[5]
  • Vertigo: Benign positional paroxysmal vertigo is the most common cause of vertigo in an MS patient. In the course of the disease about 30-50% of patients experience this symptom.[14]

Prognosis

There are some factors associated with a particularly poor prognosis among patients with multiple sclerosis. However, we can’t surly say what is the prognosis of MS patients.[30]

  • Relapsing versus progressive disease: Progressive form of MS seems to have a worse prognosis in comparison to relapsing remitting form of MS. Disabilities start sooner in progressive form[31][32][33] but some studies showed that age of onset is more important in MS disability than the form of the disease.[34][35]
  • Sex: Women seems to have younger age of onset and so better prognosis than men.[31]
  • Smoking: Transition of RRMS to SPMS can be accelerated with smoking.[39]
  • Lipid specific immunoglobulin level: Lipid specific immunoglobulin level in CSF can predict long term outcomes of MS disease.[40]

References

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