Epidemiological investigations into multiple sclerosis in Southern Hesse. V. Course and prognosis.

Course and possible prognostic predictors were studied retrospectively in 363 MS patients collected during an epidemiological study. The proportion of patients showing a primarily progressive course was 18%; 19% of patients of more than 10 years duration showed a benign course, and 8% of those of less than 16 years duration, a malignant course. Although benign cases were twice as frequent in females as in males, the difference between both sexes was not significant. A primarily or secondarily progressive course, a high number of functional systems involved and cerebellar signs occurring in the course indicated a poor prognosis whereas symptoms at onset, age at onset as such, and occupation were without predictive value. No predictors of a favourable course were found. Of the patients of 11-15 years duration, 17% were confined to a wheelchair, 40% were restricted to a walking distance of 500 metres or less, 61% were unable to work and 45% had urinary incontinence. The corresponding figures for those of 21-25 years duration were 40%, 71%, 76% and 50%.