Clinical course, symptoms and prognosis of multiple sclerosis

Relapsing remitting disease is the major clinical manifestation of multiple sclerosis (MS) which may after several years progress to a secondary progressive course. A small group of patients will present with a primary progressive course without distinct clinical bouts. Pare forms of MS include fulminant disease which can lead to a fatal outcome in a few months time. The clinical presentation of MS patients is characterized by a combination of neurological deficits representing the dissemination of disease activity in time and space. Well known ore mater and sensory disturbances, however, the implication of cognitive and sexual dysfunction on the quality of life has been recognized more recently. Reliable parameters to predict individual disease course are currently not available. Some factors point to a more rapid progression such as multisystem onset and rapid clinical deterioration at the beginning. On the contrary, even patients with initially benign disease may develop serious disability over time.