Complications
Multiple sclerosis is not a fatal disease. Some data suggest that it shortens the average life span by only about 6 or 7 years. Still, in about half of MS cases, patients die of complications of the disease, and the disease has significant negative emotional and physical consequences. Suicide rates among patients with MS are higher than average.
The severity of the disease varies widely from patient to patient and is unpredictable. About 20% of patients remain asymptomatic or become only mildly symptomatic after an initial clinical event. Another 20% experience a rapidly progressive condition. Most patients, however, will experience some degree of progression.
Women tend to have a better outlook than men. Factors the determine a higher risk for a severe condition include:
- Age over 40 years at the time of onset of symptoms
- Initial symptoms that affect motor control, mental functioning, or urinary control, or initial symptoms affect multiple regions
- Attacks in the first years that are frequent or interval between the first two attacks is short
- Incomplete remissions
- Rapid progression to disability
- MS that is progressive from the beginning or becomes progressive shortly after the onset
Doctors and researchers often use a scale called the Kurtzke Disability Status Scale to assess and predict future disability. The system uses a score of 1 to 10 to rate the degree of walking disability. Experts have used the scale to attempt to predict average times for progression from one stage to the next depending on whether patients have relapsing-remitting or chronic progressive MS.
Multiple Sclerosis Disability Score and Disease Progression |
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Score |
Disability Description |
Relapsing-Remitting MS: Average time until onset of symptoms* |
Chronic Progressive MS: Average time until onset of symptoms* |
|
1 |
No disability and minimal neurologic symptoms. |
11.4 years from Score 1 to Score 4 |
0 years from Score 1 to Score 4 |
|
2 |
Minimal disability in one or two functional areas. Slight weakness or stiffness, mild walking impairment or visual disturbances |
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3 |
Moderate disability in one functional area, such as vision or the urinary tract, and possibly more than one minimal disability in several others. Either a part of one of the limbs or a whole side can be partially paralyzed. May stagger at times. |
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4 |
Disability is relatively severe but there is full ability to walk without aid. Patients are self-sufficient and can be active 12 hours a day and carry on normal activities. Can walk without aid or rest for 300 to 500 meters. |
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5 |
Disability is severe enough to impair or even preclude a full day's activities. Able to walk unaided and without rest for 100 to 200 meters. |
23.1 years from Score 1 to Score 6 |
7.1 years from Score 1 to Score 6 |
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6 |
Can walk unaided for about 100 meters only with assistance or devices, such as two canes, crutches, or braces. |
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7 |
Mostly restricted to wheelchair, although can manage the wheelchair and leave it unassisted. Can walk with aids no further than about five meters. |
33.1 years from Score 1 to Score 7 |
13.4 years form Score 1 to Score 7 |
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8 |
Mostly restricted to wheelchair or even bed, but still has effective use of arms remains and able to perform many self-care functions. |
(Data not available) |
(Data not available) |
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9 |
Bedridden. Patient can communicate or eat. |
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10 |
Fatality occurs from complications. |
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* Data taken from Relapses and Progression of Disability in Multiple Sclerosis, The New England Journal of Medicine, November 16, 2000, Vol. 343, No. 20 |
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