Patients present with either sub-acute, episodic neurological symptoms (85%), termed relapsing remitting Multiple Sclerosis (MS), or in a minority with steadily progressive neurological symptoms from onset (15%), termed primary progressive MS. Over time most patients with relapsing remitting MS acquire residual disability from relapses and enter a later ‘secondary’ progressive phase of the disease (ref 170).
In relapsing remitting MS symptoms tend to evolve over days to weeks and resolve over weeks to months. Common presenting symptoms include:
- unilateral visual loss or blurring with prominent loss of colour vision and pain on eye movement (optic neuritis)
- sensory loss, parasthaesia or weakness in one or more limbs (partial transverse myelitis)
- double vision (brain-stem syndromes)
Primary progressive MS generally presents with progressive gait disturbance, with a progressive spastic paraparesis being by far the most common finding. In occasional patients ataxia, sphincter or cognitive symptoms may be more prominent.
170. Compston A, Coles A. Multiple Sclerosis. Lancet 2002; 359: 1221-1231.
Last edited: 21/1/2004
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