Brain, Vol. 112, No. 6, 1419-1428, 1989
© 1989 Guarantors of Brain
research-article |
THE NATURAL HISTORY OF MULTIPLE SCLEROSIS: A GEOGRAPHICALLY BASED STUDY
2 PREDICTIVE VALUE OF THE EARLY CLINICAL COURSE
Department of Clinical Neurological Sciences, University of Western Ontario London, Ontario, Canada
Correspondence to:
Correspondence to. Dr G C Ebers, Department of Clinical Neurological Sciences, University Hospital, 339 Windermere Road, London, Ontario N6A 5AS, Canada
Controversy exists regarding the predictive value of the early clinical courser of multiple sclerosis (MS). Three parameters often considered are the attack rate, the first interattack interval and the rate at which disability develops in teh early years of the disease. We have recorded the time to reach successive levels of disability defined by the Kurtzke Disability Status Scale (DSS) in 1,099 MS patients followed at University Hospital, London, Canada between 1972 and 1984. Our population is particularly suitable because of its size, the high degree of ascertainment of cases in the community, and the regular follow-up provided. Life table analysis was used to compare survival in patients stratified according to the above three parameters using DSS 6 as end point. Significant differences were evident in the survival distributions. Despite the extensive interindividual variation in the rate at which disability developed, the early course of MS may be useful in determining the relative risk of rapid progression.
Received June 23, 1988. Revised January 4, 1989. Accepted February 10, 1989.
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