[Overview of the clinical forms of multiple sclerosis in Japan]

The clinical course of MS may follow a variable pattern over time, and a clinical classification has been defined into three categories: relapsing-remitting, secondary progressive, and primary progressive. More recently, from the stand point of therapeutic utility, a new classification system including clinically isolated syndrome, relapsing MS, secondary progressive MS, and primary progressive MS. The optico-spinal MS (OS-MS) is characterized by a female preponderance, a later onset, milder abnormalities on brain MRIs, and is positively associated with DPB1*0501, indicating that the OS-MS is immunogenetically as well as clinically a distinct subtype of MS. Conventional MS is also heterogeneous especially in disease course, HLA associations, and CSF findings. MS is one clinical entity of idiopathic inflammatory demyelinating diseases (IIDD) of the CNS. However, the classifications of the IIDD seem to quite different even between the specialists for MS research. We should try to get a consensus for the classifications of IIDD, and for the clinical entity "MS".