Thursday, 23 February 2012

Education: defining the course of MS

Lublin  and Reingold. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology. 1996 Apr;46(4):907-11.


Recognizing the need for improved definitions, the National MS Society conducted a survey of physicians who specialized in treating MS. There was a consensus of opinion regarding the definitions of four subtypes of MS. The classification system was published in 1996: 
  1. Relapsing-remitting MS (RRMS)
  2. Secondary Progressive MS (SPMS)
  3. Primary Progressive MS (PPMS) 
  4. Progressive relapsing MS (PRMS)





"As a result, these are only four subtypes of MS that are currently recognised. Unfortunately, there was no consensus regarding other definitions including chronic progressive, benign and malignant MS. Because the definition of these latter terms is unclear, their use is generally discouraged in scientific publications. This however does not get away from their use in clinical practice, for example the recent posts on fulminant and malignant MS."


Related posts of interest on this blog: 


26 Aug 2011
Fulminant MS can be accompanied by optic neuritis (ON); however a long interval between ON and the fulminant phase has not been reported. This is a case report of 30-year-old woman with a history of ON that occurred 1 ...
27 Aug 2011
The term fulminant is a carry-over from the pre disease-modifying therapy era. Most cases presenting with Marburg's variant of MS who treated promptly with appropriate therapies, respond to treatment, and can do very well. ...

6 comments:

  1. I don't know Prof G, reading all this stuff about Marbung's variant and malignant MS has put me on a downer. Sure, you can argue that you know a lot more about MS than you did 10 years ago, but it seems there's actually more about the disease that we don't yet know. It's more complex than anyone imagined.

    I have progressive MS and am getting worse at a pretty fast rate. I'm pretty young too. I'm fighting hard but deep down I know that it's a losing battle. The disease will always win out. That goes for everyone with MS. It is depressing.

    ReplyDelete
  2. Re: "I have progressive MS and am getting worse at a pretty fast rate. I'm pretty young too."

    In MS'ers with rapidly progressive MS the presence of gadolinium-enhancing lesions on MRI predicts response to some therapies; in this situation a lot of neurologists would give MS'ers the benefit of the doubt and treat them.

    ReplyDelete
  3. Since I started reading this blog I have actually started to believe that we will 'soon' know the cause and have a cure.

    I already knew about how bad MS can be. I used to think MS is too complex and nobody has any idea of what causes it.

    The depressing thing was to learn how long it takes to do research & trials.

    This post from 1 June 2011 is one of the most hopeful things I have read-
    http://multiple-sclerosis-research.blogspot.com/2011/06/abstract-for-ms-frontiers-meeting.html

    ReplyDelete
  4. "As a result, these are only four subtypes of MS that are currently recognised. Unfortunately, there was no consensus regarding other definitions including chronic progressive, benign and malignant MS. Because the definition of these latter terms is unclear, their use is generally discouraged in scientific publications. This however does not get away from their use in clinical practice, for example the recent posts on fulminant and malignant MS."

    --- I wonder where is the above text cited from. It seems that the author of this webpage has cited the info from the paper by
    'Lublin & Reingold, 1996', however, I have got the copy of the full-text of this paper and couldn't find the quotated text in the paper.

    ReplyDelete
  5. Re: "As a result, these are only four subtypes of MS that are currently recognised. Unfortunately, there was no consensus regarding other definitions including chronic progressive, benign and malignant MS. Because the definition of these latter terms is unclear, their use is generally discouraged in scientific publications. This however does not get away from their use in clinical practice, for example the recent posts on fulminant and malignant MS."

    All text in quotations marks and italics is mine. It is not from the paper.

    ReplyDelete
  6. Re: "As a result, these are only four subtypes of MS that are currently recognised. Unfortunately, there was no consensus regarding other definitions including chronic progressive, benign and malignant MS. Because the definition of these latter terms is unclear, their use is generally discouraged in scientific publications. This however does not get away from their use in clinical practice, for example the recent posts on fulminant and malignant MS."

    All text in quotations marks and italics is mine. It is not from the paper.

    ReplyDelete

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