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Benign multiple sclerosis: a need for a consensus

Authors

  • S. B. Glad,

    1. The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Department of Clinical Medicine, University of Bergen, Bergen, Norway
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  • J. H. Aarseth,

    1. The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
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  • H. Nyland,

    1. The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Department of Clinical Medicine, University of Bergen, Bergen, Norway
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  • T. Riise,

    1. The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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  • K.-M. Myhr

    1. The Norwegian Multiple Sclerosis Competence Centre, Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Department of Clinical Medicine, University of Bergen, Bergen, Norway
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  • Conflicts of interest : K-MM's department has received research grants and compensation for participation in clinical trials from Bayer–Schering, Biogen Idec, Glaxo-SmithKline, Merck Serono and Sanofi-Aventis. The authors have no other potential conflicts.

Solveig B. Glad, Department of Neurology, Haukeland University Hospital, N-5021 Bergen, Norway
Tel.: +47 55 975045
Fax: +47 55 975901
e-mail: solveig.bergliot.glad@helse-bergen.no

Abstract

Glad SB, Aarseth JH, Nyland H, Riise T, Myhr K-M. Benign multiple sclerosis: a need for a consensus. Acta Neurol Scand: 2010: 122 (Suppl. 190): 44–50. © 2010 John Wiley & Sons A/S.

Objectives –  To investigate the impact of different definitions on the frequency of benign multiple sclerosis (MS) in patients with a long follow-up, and to study the presence of non-motor symptoms and employment across the definitions.

Materials and methods –  All patients alive (n = 188) with disease onset during 1976–1986 in Hordaland County, Norway, were clinically examined including the Expanded Disability Status Scale (EDSS) in 2003. Non-motor symptoms which included depression, cognitive impairment, fatigue and pain, and employment status were also registered. Three definitions of benign MS were used based on the following EDSS cut-off values: 2.0, 3.0 and 4.0. Two additional definitions were added using an EDSS ≤4.0 and incorporating either full-time or full- and part-time employment status.

Results –  The frequency of benign MS increased from 14.5% for EDSS ≤2.0 to 40.8% for EDSS ≤4.0, but was only 12.3% for the definition based on full-time employment. Patients with an EDSS ≤2.0 had markedly less non-motor symptoms and lower unemployment rates than the other groups.

Conclusions –  An EDSS score ≤2.0 with at least 10 years of disease duration seems to be the most appropriate criterion in identifying patients with benign MS.

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