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What is the risk of permanent disability from a multiple sclerosis relapse?

Khemissa Bejaoui1, Loren A Rolak

  • 1Department of Neurology, Marshfield Clinic, Marshfield, WI 54449, USA.

Neurology
|March 17, 2010
PubMed
Abstract

Insights

Severe disability from multiple sclerosis (MS) relapses is rare. Most patients recover, and this risk does not significantly change with interferon treatment, easing fears of sudden irreversible MS progression.

Area of Science:

  • Neurology
  • Immunology

Background:

  • Relapsing-remitting multiple sclerosis (MS) is characterized by unpredictable attacks.
  • The potential for acute relapses to cause severe, sustained disability is a significant concern for patients.

Purpose of the Study:

  • To quantify the incidence of severe, sustained disability (Expanded Disability Status Scale [EDSS] ≥6.0) following acute relapses in patients with MS.
  • To identify potential risk factors, including genetic and clinical markers, associated with such severe outcomes.

Main Methods:

  • Analysis of a comprehensive database of patients with MS from the Marshfield Multiple Sclerosis Center.
  • Review of relapse data, disability progression (EDSS scores), and patient treatment history.

Main Results:

  • Out of 1,078 patients experiencing 2,587 relapses, only 7 developed sustained severe disability (EDSS ≥6.0) post-relapse.
  • No significant differences in HLA-DR or NOS2A genetic loci were found between affected and unaffected patients.
  • No specific clinical factors identified patients at high risk for this outcome.
  • Two patients experiencing disabling attacks were on interferon therapy.

Conclusions:

  • Sudden, irreversible severe disability from MS relapses is a rare event.
  • The fear of such outcomes should not unduly influence treatment decisions.
  • The occurrence of severe disabling relapses is independent of interferon treatment status.

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