Relapsing Remitting MS
- More common in caucasian populations, peak onset between 20-40, with a female predominance
- Episodic neurological symptoms disseminated both in time and within the central nervous system
- Spontaneous early remissions, sometimes of many years
- Symptoms are often associated with prominent physical fatigue
Primary Progressive MS
- Becomes more common in older patients (mean age of onset of 40, can present up to 60 or very occasionally older), with no sex predominance
- Typically progressive gait disturbance. Patients will generally complain of fatigable lower limb weakness, stiffness or ‘heaviness’, often associated with early bladder symptoms of urgency, frequency and/or erectile dysfunction in men
MS remains a clinical diagnosis, there is no ‘gold standard’ investigation, though MRI scanning will reveal typical white matter or spinal changes in the vast majority of patients (>95%). Nevertheless a number of other conditions can mimic MS both clinically and radiologically and the diagnosis is one of exclusion, requiring that no better explanation can be found for the patients symptoms and neurological signs (ref 171).
171. McDonald WI, Compston A, Edan G et al. Recommended diagnostic criteria for Multiple Sclerosis: Guidelines from the international panel on the diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50: 121-127.
Last edited: 26/1/2004
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