Prognosis

Most patients with the relapsing and remitting form of MS progress to a stage where relapses become much less frequent, but they continue to accumulate disabling symptoms. This new phase of the disease is termed ‘secondary progressive multiple sclerosis’.

No treatment for MS is curative. The average life expectancy is reduced by 5 to 10 years, with only 40% of patients reaching the age of 70.

The ability to walk is an important aspect of independence and is retained by 90% of MS patients 10 years after diagnosis and 75% at 15 years.

Two-thirds of MS patients die of the complications of their disease, especially pulmonary complications.

Suicide is significantly more common. For those whose disease progresses rapidly over a few years, the suicide risk is seven times greater than the population as a whole.

Generally, sensory and cranial nerve symptoms predict a less unfavourable outcome than those caused by motor nerves or cerebellar dysfunction.

A minority of patients have a very mild form of the disease with little or no disability. Their neurological disability may barely affect their daily activities, and the disease does not shorten their life span.

Acute fulminant MS:

A rare aggressive, rapidly deteriorating form of MS has been described that leads to death or severe residual disability within days.

Learning bite

MS is associated with a 5- to 10-year reduction in life expectancy with death occurring as a result of respiratory and renal complications or suicide in two-thirds of patients.