Age at onset, initial symptomatology and the course of multiple sclerosis

Analysis of the initial symptomatology, age at onset and course as factors influencing the prognosis of multiple sclerosis (MS) revealed that the rate of deterioration in a sample of 1,571 patients - registered during a neurological examination in a standardized way - was slower for patients with optic neuritis as the initial sign, for patients with an age at onset of under 39 years and for patients with a remissive course of disease. The progression index, obtained by dividing the present disability by the duration of the disease was used as a measure for the rate of progression. The course of the disease was responsible for 13% and age at onset for 1.6% of the total variation in the progression index. Endogenous or exogenous factors may modify the appearance and dynamics of MS which might be a syndrome rather than a disease entity.