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Understanding Benign MS

Multiple Sclerosis Primer

Multiple sclerosis (MS) a chronic condition in which the immune system attacks a fatty substance called myelin that surrounds nerve fibers within the central nervous system (CNS). The immune attack results in inflammation, which damages nerve cells.

Over time, scar tissue (lesions) forms. Lesions interfere with the ability of the CNS to communicate with other parts of the body. The location of the lesions determines the symptoms. MS varies a great deal from one person to another, and can be quite unpredictable.

Read on to learn more about benign MS, as well as other forms of the condition.

Diagnosing Benign MS

The term “benign MS” can be confusing. Even if initial symptoms are mild, a person can’t be identified as having benign MS at the time of their diagnosis. There is no way to predict if—or how—MS will progress in the years to come.

According to Johns Hopkins Medicine, about five to 10 percent of MS patients have a benign course. Unfortunately, it takes as long as 15 years after the initial diagnosis to know if a course is benign.

Neurologists use the Expanded Disability Status Scale (EDSS) to assess physical impairment. According to the scale, MS is considered benign if there is no evidence of worsening function or disease activity.

Progression of Symptoms in Benign MS

When it comes to symptoms and disease progression, all forms of MS are unpredictable. Symptoms of MS include visual disturbances, numbness, and problems with coordination and balance. Some people start out with mild symptoms that take decades to progress. Others experience rapid progression from the beginning. Most people fall somewhere in between.

Mild symptoms early on don’t necessarily mean MS is benign. Symptoms can worsen over time. People who have benign MS have the mildest form of the disease. They may experience symptoms, but their disabilities won’t accumulate, and an MRI won’t show increased disease activity.

Once Benign, Always Benign?

People with benign MS can go decades without serious symptoms, but many develop more severe symptoms over time. Increased disease activity can be identified on an MRI.

Using cognitive tests and brain scans, a 2009 study of 63 people diagnosed with benign MS showed that 30 percent worsened over a period of five years. The study also indicated that symptoms in men with benign MS were almost three times more likely to worsen than they were in women.

Basically, even benign MS is subject to change.

Treatment for Benign MS

There is no cure for any form of MS. Treatment involves symptom management and disease-modifying medications.

According to the National Institute of Neurological Disorders and Stroke (NINDS), long-term follow-up of benign MS patients who did not take MS drugs showed that some eventually became disabled.

Newly diagnosed MS patients and those who are diagnosed with benign MS should discuss the pros and cons of disease-modifying drugs with their neurologists.

Relapsing Forms of MS

Like benign MS, RRMS can change its course. When RRMS transitions into progressive MS, it’s called secondary progressive MS (SPMS). There are no clear attacks or periods of remission in SPMS.

People with primary progressive MS (PPMS) experience steady worsening of symptoms from the onset. There are no clear attacks, and disability accumulates over time.

Progressive Forms of MS

Like benign MS, RRMS can change its course. When RRMS transitions into progressive MS, it’s called secondary progressive MS (SPMS). There are no clear attacks or periods of remission in SPMS.

People with primary progressive MS (PPMS) experience steady worsening of symptoms from the onset. There are no clear attacks, and disability accumulates over time.

Key Points to Ponder

Although the diagnosis and prognosis for benign MS are unclear, there are a few things to keep in mind:

  • Mild symptoms at the time of diagnosis don’t necessarily indicate a benign course of the disease.
  • Benign MS cannot be identified at the time of initial diagnosis. That can take as long as 15 years.
  • Benign MS doesn’t mean that MS cannot or will not eventually progress.
  • The course of MS is unpredictable.
  • If you’re diagnosed with any form of MS, you should weigh the pros and cons of disease-modifying medications with your doctor.

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