Multiple Sclerosis That Is Progressive From the Time of Onset

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Abstract
IN 1996, an international survey was conducted to standardize multiple sclerosis (MS) disease course definitions. Consensus emerged1 for the following terminology. Relapsing-remitting MS describes patients who experience an initial exacerbation followed by complete or incomplete recovery. Although approximately 85% of patients with MS have this disease course within 10 years of the initial attack, 50% develop a gradual progression of disability that may or may not be accompanied by exacerbations; this is called secondary progressive MS.2-4 Ten percent to 15% of patients experience a gradual progression of disability from the time of disease onset that is not accompanied by exacerbations5; this is called primary progressive MS (PPMS). Finally a new term, progressive relapsing MS (PRMS), was created to describe patients who experience MS that is progressive from the time of onset and is later accompanied by 1 or more relapses.