|
|
The course of Multiple Sclerosis (MS) is initally unpredictable for any particular person. While some are only minimally affected by the disease, others experience very rapid progression to total disability. Eventually all MSers spend time between these extremes, for varying periods of time. In general the younger you are at the official onset of MS, the slower disability progresses. Most of the onset damage is completely repaired and there is little or no initial disability, even when the onset is severely disabling. However, with or without visible (clinical) attacks, the MS disease process continues. After 10 - 15 years or upon reaching approximately age 40, the number of clinical attacks decline; but disability now becomes increasingly visible, lingers longer, and remissions cease. Conversely, the older you are when MS clinically begins, the less likely you are to have a complete initial recovery. At first, attacks are more numerous; but this pace lessens very quickly and disability quickly accumulates, before leveling off. Although every individual experiences a different combination of MS symptoms, there are a number of distinct disease stages and/or types that have historically been identified and recognized, as the naturally occurring course of Multiple Sclerosis. 
|
After one or two attacks with complete recovery and without any disabilty, this form or stage of MS does not worsen with time and there is no permanent disability or disease progression. Benign Multiple Sclerosis tends to follow, non-visible Sensory Symptoms (ie. Dysesthesia, Optic Neuritis, Paresthesias, Paroxysmal) at onset; not Motor Symptoms (ie. Diplopia, InCoordination, Tremor), with a totally complete recovery and no disability. However, some in this category will eventually experience disease progression; their course of disease will change and evolve into the Progressive stages of MS, within 10 - 15 years of its official onset. Benign MS can only be positively identified, after there is minimal disability (EDSS < 3.0), 10 to 15 years following its official onset. Initially, it would have been categorized as R/R MS. In this form or stage of MS there are sporadic attacks (exacerbations, relapses), during which new symptoms appear and/or existing ones become more severe. They can last for varying periods (days or months) and are followed by partial or total recovery and remission. MS may be clinically inactive (SubClinical), for months or years, between any number of intermittent attacks. However, the disease process is ongoing and damage continues, with or without clinical attacks; microscopic lesions and diffuse damage (Axonal loss) silently proceed. This is the most common beginning phase of MS. However, 50% of cases will have progression within 10 - 15 years, and an additional 40% within 25 years of onset; as the disease evolves, into the Secondary/Progressive phase. The clinical signs of progression are:
|
Secondary/Progressive
MS - approx 40%
|
|
|
Pain: Is experienced with MS for about 50 - 60% of MSers, e.g. Facial Pain (Trigeminal Neuralgia), L'hermitte's Sign, Headaches, Spasticity (Muscle Cramps and Spasms). Sexuality & Intimacy: Impotence, Erectile Dysfunction, Diminished Arousal, Decreased Lubrication secretions, and Loss of Sensation. These dysfunctions are directly caused by MS (DeMyelination, Axonal Loss) in the CNS and ANS that mediate sexual feelings and responses.
Spasticity: Increased muscle tone is experienced as Stiff, Tight Muscels (Spasticity), which affects mobility and generally includes Muscle Spasms and/or Clonus. Speech Dysfunctions: Slowing of Speech, Slurring of words, Scanning Speech, changes in the Rhythm of Speech (Dysarthria), and Difficulty in Swallowing (Dysphagia). Visual Disturbances: Blurred Vision (Uhthoff's Syndrome), Double Vision (Diplopia), Optic Neuritis, Afferent Pupillary Defect, involuntary rapid Eye movements (Nystagmus, Oscillopsia), partial Blindness (Scotoma), and very rarely complete Blindness. Weakness: usually affects your legs and overall stamina, which quickly makes walking or any sustained activity, extremely exhausting. While some of these symptoms are immediately obvious, others such as fatigue, altered sensation, pain, memory and concentration problems are often hidden (invisible) symptoms. |
