Multiple sclerosis natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
* medication complication: Insufficient blood supply to the bone can cause avascular osteonecrosis. After trauma corticosteroid treatment is the most common cause of AVN. | |||
== Prognosis == | == Prognosis == | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.
Overview
Natural History
The symptoms of multiple sclerosis usually develop in the first/ second/ third decade of life, and start with symptoms such as optic neuritis, diplopia, sensory or motor loss, vertigo and balance problems. In young adult eye and sensory problems are prominent while in older patients we see motor problems more often.[1]
Complications
- medication complication: Insufficient blood supply to the bone can cause avascular osteonecrosis. After trauma corticosteroid treatment is the most common cause of AVN.
Prognosis
there are some factors associated with a particularly poor prognosis among patients with multiple sclerosis but We can’t surly say what is the prognosis of MS patients.[2]
Relapsing versus progressive disease
Progressive form of MS seems to have worse prognosis in comparison to relapsing remitting form of MS. Disabilities start sooner in progressive form[3][4][5] but some studies showed that age of onset is more important in MS disability than the form of the disease.[6][7]
Early symptoms
Some first manifestations of MS disease like bowel and bladder dysfunction, seems to have a worse prognosis.[8]. Another study demonstrated that having so many symptoms at the onset of the disease have a worse prognosis than being monosymptom.[9]
Demographics
Onset of MS in Black Americans is in later age and they are more susceptible of having multifocal signs and symptoms and involvement of optic nerve and spinal cord.[10]
Sex
Women seems to have younger age of onset and so better prognosis than men.[3]
Smoking
Transition of RRMS to SPMS can be accelerated with smoking.[11]
References
- ↑ Weinshenker BG, Bass B, Rice GP, Noseworthy J, Carriere W, Baskerville J, Ebers GC (February 1989). "The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability". Brain. 112 ( Pt 1): 133–46. PMID 2917275.
- ↑ Swanton J, Fernando K, Miller D (2014). "Early prognosis of multiple sclerosis". Handb Clin Neurol. 122: 371–91. doi:10.1016/B978-0-444-52001-2.00015-7. PMID 24507526.
- ↑ 3.0 3.1 Weinshenker BG (1994). "Natural history of multiple sclerosis". Ann. Neurol. 36 Suppl: S6–11. PMID 8017890.
- ↑ Confavreux C, Vukusic S, Moreau T, Adeleine P (November 2000). "Relapses and progression of disability in multiple sclerosis". N. Engl. J. Med. 343 (20): 1430–8. doi:10.1056/NEJM200011163432001. PMID 11078767.
- ↑ Tremlett H, Paty D, Devonshire V (January 2006). "Disability progression in multiple sclerosis is slower than previously reported". Neurology. 66 (2): 172–7. doi:10.1212/01.wnl.0000194259.90286.fe. PMID 16434648.
- ↑ Confavreux C, Vukusic S (March 2006). "Age at disability milestones in multiple sclerosis". Brain. 129 (Pt 3): 595–605. doi:10.1093/brain/awh714. PMID 16415309.
- ↑ Confavreux C, Vukusic S (March 2006). "Natural history of multiple sclerosis: a unifying concept". Brain. 129 (Pt 3): 606–16. doi:10.1093/brain/awl007. PMID 16415308.
- ↑ Langer-Gould A, Popat RA, Huang SM, Cobb K, Fontoura P, Gould MK, Nelson LM (December 2006). "Clinical and demographic predictors of long-term disability in patients with relapsing-remitting multiple sclerosis: a systematic review". Arch. Neurol. 63 (12): 1686–91. doi:10.1001/archneur.63.12.1686. PMID 17172607.
- ↑ Kremenchutzky M, Rice GP, Baskerville J, Wingerchuk DM, Ebers GC (March 2006). "The natural history of multiple sclerosis: a geographically based study 9: observations on the progressive phase of the disease". Brain. 129 (Pt 3): 584–94. doi:10.1093/brain/awh721. PMID 16401620.
- ↑ Cree BA, Khan O, Bourdette D, Goodin DS, Cohen JA, Marrie RA, Glidden D, Weinstock-Guttman B, Reich D, Patterson N, Haines JL, Pericak-Vance M, DeLoa C, Oksenberg JR, Hauser SL (December 2004). "Clinical characteristics of African Americans vs Caucasian Americans with multiple sclerosis". Neurology. 63 (11): 2039–45. PMID 15596747.
- ↑ Roudbari SA, Ansar MM, Yousefzad A (July 2013). "Smoking as a risk factor for development of Secondary Progressive Multiple Sclerosis: A study in IRAN, Guilan". J. Neurol. Sci. 330 (1–2): 52–5. doi:10.1016/j.jns.2013.04.003. PMID 23628463.