Benign Multiple Sclerosis: A Retrospective Survey and Evaluation of Descriptive Clinical Criteria

A reasonable amount of multiple sclerosis (MS) patients exhibit a benign course. The patients who can lead an independent life with a low EDSS score less than 3,5 after ten years or longer disease duration are regarded to have a benign course. However the concept itself has attracted a great deal of debate on the description as well as existence of this category. In this study we analyzed the demographic and clinical features of benign MS patients from 2 MS centers in Western Turkey. Sixty one patients among 173 (35%) with 10 years or longer disease duration had EDSS scores less than 3,5. The presenting symptoms were motor in 42%, sensory in 30%, optic neuritis in 27%, brainstem finding 23% and cerebellar in 17%. In statistical analysis gender, duration of the disease, interattack interval, and attack rate were independent of the disease course. Age at onset of the disease and hence age at present, were the only meaningful variables. In this selected group of patients, we compared the patients with higher (2,5-3,0) and lower (≤2,0) EDSS scores. Again none of the variables above were statistically meaningful except age at onset of the disease and age at present. Younger age predicted better prognosis. In conclusion benign MS is still a retrospective definition. Clinical factors by themselves don't yield an early and accurate prediction of prognosis. The new cut-off level 2,0 needs to be studied in larger groups.