Benign MS May Not Stay Benign
Nearly Half of 'Benign Multiple Sclerosis' Cases Worsen Decades Later, Study Shows
Feb. 12, 2007 -- Nearly half of cases called benign multiple sclerosis may
unpredictably worsen decades after diagnosis, a Canadian study shows.
The findings suggest that doctors should be cautious about using the term
"benign multiple sclerosis" or "benign MS."
"We need to be careful what we tell people, and not give them false hope
that their symptoms may never get worse," says Ana-Luiza Sayao, MD, in a
Sayao works in Vancouver at the University of British Columbia.
She and her colleagues studied 169 patients with "benign MS," which
the researchers defined as having a low level of disability 10 years after
Multiple sclerosis is a disease of the brain and spinal cord. Its symptoms
may include vision problems, muscle weakness, and difficulty with walking,
coordination, and balance.
Some patients experience relatively mild MS; other cases are severe.
Changes in ‘Benign’ MS
Sayao and colleagues checked the patients' medical records 20 years after MS
Just more than half the patients -- 52% -- still had "benign MS,"
meaning their disability was still relatively mild 20 years after MS
But disability had worsened in the other patients.
Of all the patients studied, roughly one in five needed a cane to walk 20
years after their MS diagnosis.
Sayao's team found no factors -- such as patients' sex or age at MS onset --
that predicted which cases would worsen.
The study questions the use of the term "benign multiple
"Although there is certainly a unique subgroup of patients with MS who
remain mild in disability over the long term, a lack of consensus in the
criteria that define 'benign' MS continues to exist," the researchers
Journal editorialist Scott Pittock, MD, agrees.
"Whether there is a benign form of multiple sclerosis continues to be a
controversial issue," writes Pittock, who works at the Mayo Clinic in
Pittock says "a 'watchful waiting approach,' with regular clinical and
MRI monitoring" may be preferable for some patients with benign MS before
starting MS drug treatment.
He also sees reason for optimism for such patients.
"The MS prognostic glass is half full for a high proportion of these
most benign cases," Pittock writes.