While much has been learned about Multiple Sclerosis over the years, it is still a very mysterious condition. It is not known what causes MS, there are no foolproof testing methods and there is no cure. To make matters even more complex, every patient with MS deals with different symptoms to varying degrees. Progression of the condition is also varied from on patient to the next. As you might guess, all of this can make providing a prognosis for Multiple Sclerosis sufferers very difficult.
Multiple Sclerosis Unpredictability
Predicting the short and long term outcomes of Multiple Sclerosis is like trying to predict the daily and lifetime happenings of a child. While you can assume certain things, based on the child’s temperament, their home environment and their personal strengths and weaknesses, no one can really say for certain if a child will have a good day or bad day and most definitely, you cannot really predict who a child will be or what they will do when they grow up. You might have an idea, but so many changes can occur from point A to point B that there is no level of certainty.
This analogy is much like the condition of Multiple Sclerosis. While you can use symptoms, severity of symptoms and the level of progression to date, there is no way to predict the sudden changes that can occur with MS. Remissions happen. Medications stop working. The condition changes for no apparent reason and without warning. Despite all of this, there is some statistical information that you can use to help determine what you MS prognosis might look like.
Understanding MS Statistics
Much of the information about MS is based on statistics, including prognosis for MS sufferers. What you need to understand is that statistics are statistics, meaning that there is no certainty in statistical information. You can use statistics to bet on a game but it does not necessarily mean you will win. The same is true for MS prognosis. While you can compare your variables to statistical MS information, you still do not have a definitive diagnosis. You do, however, have a probability of what your prognosis might be. Understanding the difference is important to being realistic about your condition and your future with MS.
Malignant vs. Benign Multiple Sclerosis
There are actually several different classifications for Multiple Sclerosis, but they all fall towards one side of the coin – malignant or benign. Benign MS is a slow progressing form of the disease. Initially, 20% of sufferers are diagnosed with this type of MS, but in the end, only about 5% end up having a benign form of the disease. Benign MS sufferers tend to have less severe symptoms and the condition is less aggressive than malignant cases.
Malignant MS cases are aggressive and progress very quickly. Severe malignant cases can result in death, sometimes within weeks or months of the onset of the condition. Thankfully, these cases are rather rare. All malignant cases progress faster than benign cases.
Relapsing Remitting Multiple Sclerosis is the most common type of MS. It is considered the most common type of MS, and in most cases, it is considered more along the lines of benign. Sufferers with this type of MS often experience one to several attacks at a time. This is then followed by a complete or partial remission until another attack occurs. Remission can be a misleading term because symptoms from previous attacks are usually permanent and residual, even during remission periods.
Secondary Progressive Multiple Sclerosis starts in the Relapsing Remitting Multiple Sclerosis, but somewhere along the way, remission periods stop. Breaks between attacks do occur but there is no recovery from symptoms. This type of MS is still considered more benign, however.
Primary Progressive Multiple Sclerosis leans more towards the malignant side of MS that is characterized by no remission periods and gradual declines. In Primary Progressive MS, there may be periods in which the condition plateaus, or levels out, providing a small amount of relief from symptoms but decline is constant.
Progressive Relapsing Multiple Sclerosis also leans toward the malignant side. It is much rarer than most other forms of MS and it is classified by a progressive decline that does not have any relief from symptoms. There are no plateaus with Progressive Relapsing MS.
Determining Your Prognosis
Again, it is important to realize that prognosis can change at any given time. The condition can shift from benign to malignant without warning. You may think that you have a malignant form of MS and then, without any rhyme or reason, you go into remission.
Factors that indicate a potentially benign case of MS include:
- Onset of MS before age 25
- Lesions showing on MRI are limited
- Low amount of neurological systems affected 5 years after onset of condition
- First noted symptoms are optic neuritis or sensory in nature
- Neurological deficit score is low after 5 years of onset
- High amount of recovery during remission from last relapse
- Female
- Symptom onset from one region
- No Myelin Basic Protein in cerebrospinal fluid during remission periods
Factors that indicate a potentially malignant case of MS include:
- Higher number of neurological areas affected at onset of MS
- Symptoms at onset were coordination or motor related
- Disease is progressive at onset
- Several lesions showing on MRI at onset
- Onset after 40
- Male
- Brainstem involved during onset
- First two relapses were less than a year apart
- Spinal tap showed oligoclonal banding in early phase of condition
In most cases, MS sufferers will find that their prognosis lies somewhere in between malignant and benign and changes are likely to occur along the way. No matter what your prognosis, however, remember that all anyone has is today. There is no promise of tomorrow. Live today and let tomorrow deal with itself. Don’t spend your time worrying about your future with MS. Instead, focus on the beauty and fulfillment that you can experience today.