Prognosis

It is very difficult to prognosticate effectively for patients with MS. Some patients have a very benign course and/or respond well to treatment, whereas others become rapidly disabled within several years of diagnosis. One long-term follow-up study of a pivotal interferon beta-1b trial in patients with MS suggested that long-term physical and cognitive outcomes may be largely determined early in the disease course.[200]

Various factors favoring better prognosis have been reported in demographic studies conducted in the pretreatment era, and include female sex, sensory symptoms, or optic neuritis at onset.[201] Poorer prognostic factors include frequent relapses and motor or cerebellar onset.[202][203]

Magnetic resonance imaging (MRI) is a useful tool to assist in prognosis; e.g., to predict MS development, disability, and disability progression.[3] Higher MRI lesion burden at onset may portend a poorer prognosis, particularly for cognitive outcomes.[200][204]

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