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

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Abstract
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 1571 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 yr 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.