Multiple sclerosis classification: Difference between revisions
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Multiple sclerosis may be classified into four groups according to [[clinical]] course of the [[disease]] including: Relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing.<ref name=":0" /> | Multiple sclerosis may be classified into four groups according to [[clinical]] course of the [[disease]] including: Relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing.<ref name=":0" /> | ||
==Classification== | ==Classification== | ||
In 1996, [[National Multiple Sclerosis Society|US National Multiple Sclerosis Society]] (NMSS) defined multiple sclerosis subtypes according to clinical manifestations.<ref name=":0" /> The fact that the [[clinical]] course of the [[disease]] is a dynamic process makes it possible that the subtypes switch to each other over time.<ref name="pmid24871874" /> | |||
Multiple sclerosis may be classified according to its [[clinical]] course into four groups:<ref name=":0">Lublin FD; Reingold SC. ''Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis.'' Neurology 1996 Apr;46(4):907-11. PMID 8780061</ref> | Multiple sclerosis may be classified according to its [[clinical]] course into four groups:<ref name=":0">Lublin FD; Reingold SC. ''Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis.'' Neurology 1996 Apr;46(4):907-11. PMID 8780061</ref> | ||
==== '''Relapsing remitting:''' ==== | ==== '''Relapsing remitting:''' ==== | ||
RRMS is defined by acute attacks of [[neurological]] [[dysfunction]] followed by full or partial [[recovery]]. Patient clinical [[symptoms]] are stable between the attacks.<ref name=":0" /> | * Relapsing relapsing multiple sclerosis (RRMS) is defined by acute attacks of [[neurological]] [[dysfunction]] followed by full or partial [[recovery]]. Patient clinical [[symptoms]] are stable between the attacks.<ref name=":0" /> | ||
==== '''Secondary progressive:''' ==== | ==== '''Secondary progressive:''' ==== | ||
Patient with long term RRMS can switch to SPMS, when the [[neurological]] [[symptoms]] progressively worsen between the attacks.<ref name=":0" /> | * Patient with long term RRMS can switch to secondary relapsing multiple sclerosis (SPMS), when the [[neurological]] [[symptoms]] progressively worsen between the attacks.<ref name=":0" /> | ||
==== '''Primary progressive:''' ==== | ==== '''Primary progressive:''' ==== | ||
* Primary progressive multiple sclerosis (PPMS) is defined by continuously worsening of [[neurological]] [[dysfunction]] with no distinct attacks and [[remission]]<nowiki/>s.<ref name=":0" /> | |||
==== '''Progressive relapsing:''' ==== | ==== '''Progressive relapsing:''' ==== | ||
PRMS is defined by progression of [[disease]] from the beginning with acute attack episodes.<ref name=":0 | * Progressive relapsing multiple sclerosis (PRMS) is defined by progression of [[disease]] from the beginning with acute attack episodes.<ref name=":0" /> | ||
In recent studies a new subtype | === Other new multiple sclerosis subclasses === | ||
* In recent studies a new subtype of multiple sclerosis was defined as "clinically isolated syndrome '''('''CIS''')'''." It is when the [[clinical]] presentation of a [[disease]] is suggestive of [[myelin sheath]] [[inflammation]] but cannot fulfill the [[diagnostic criteria]] of [[MS]].<ref name="pmid24871874">{{cite journal |vauthors=Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, Wolinsky JS, Balcer LJ, Banwell B, Barkhof F, Bebo B, Calabresi PA, Clanet M, Comi G, Fox RJ, Freedman MS, Goodman AD, Inglese M, Kappos L, Kieseier BC, Lincoln JA, Lubetzki C, Miller AE, Montalban X, O'Connor PW, Petkau J, Pozzilli C, Rudick RA, Sormani MP, Stüve O, Waubant E, Polman CH |title=Defining the clinical course of multiple sclerosis: the 2013 revisions |journal=Neurology |volume=83 |issue=3 |pages=278–86 |year=2014 |pmid=24871874 |pmc=4117366 |doi=10.1212/WNL.0000000000000560 |url=}}</ref><ref name="pmid25887774">{{cite journal |vauthors=Katz Sand I |title=Classification, diagnosis, and differential diagnosis of multiple sclerosis |journal=Curr. Opin. Neurol. |volume=28 |issue=3 |pages=193–205 |year=2015 |pmid=25887774 |doi=10.1097/WCO.0000000000000206 |url=}}</ref> | |||
Another termination | * Another associated termination regarding [[MS]] classification is "radiologic<nowiki/>ally isolated syndrome (RIS)." It defines as [[radiological]] findings of [[myelin sheath]] [[inflammation]] without any [[Sign (medical)|sign]] or [[Symptoms|symptom]]<nowiki/>s in patient. RIS can be an indicator of early stage<nowiki/>s of [[Multiple sclerosis|MS]] disease, but it's not a subgroup of [[Multiple sclerosis|MS]] because [[radiological]] finding of [[Inflammation|inflammatory]] [[demyelination]] without any [[Sign (medical)|sign]] or [[symptoms]] of the [[disease]] is nonspecific.<ref name="pmid24871874" /> | ||
==References== | ==References== | ||
Revision as of 19:15, 1 March 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Multiple sclerosis may be classified into four groups according to clinical course of the disease including: Relapsing-remitting, secondary-progressive, primary-progressive, and progressive-relapsing.[1]
Classification
In 1996, US National Multiple Sclerosis Society (NMSS) defined multiple sclerosis subtypes according to clinical manifestations.[1] The fact that the clinical course of the disease is a dynamic process makes it possible that the subtypes switch to each other over time.[2]
Multiple sclerosis may be classified according to its clinical course into four groups:[1]
Relapsing remitting:
- Relapsing relapsing multiple sclerosis (RRMS) is defined by acute attacks of neurological dysfunction followed by full or partial recovery. Patient clinical symptoms are stable between the attacks.[1]
Secondary progressive:
- Patient with long term RRMS can switch to secondary relapsing multiple sclerosis (SPMS), when the neurological symptoms progressively worsen between the attacks.[1]
Primary progressive:
- Primary progressive multiple sclerosis (PPMS) is defined by continuously worsening of neurological dysfunction with no distinct attacks and remissions.[1]
Progressive relapsing:
- Progressive relapsing multiple sclerosis (PRMS) is defined by progression of disease from the beginning with acute attack episodes.[1]
Other new multiple sclerosis subclasses
- In recent studies a new subtype of multiple sclerosis was defined as "clinically isolated syndrome (CIS)." It is when the clinical presentation of a disease is suggestive of myelin sheath inflammation but cannot fulfill the diagnostic criteria of MS.[2][3]
- Another associated termination regarding MS classification is "radiologically isolated syndrome (RIS)." It defines as radiological findings of myelin sheath inflammation without any sign or symptoms in patient. RIS can be an indicator of early stages of MS disease, but it's not a subgroup of MS because radiological finding of inflammatory demyelination without any sign or symptoms of the disease is nonspecific.[2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Lublin FD; Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 1996 Apr;46(4):907-11. PMID 8780061
- ↑ 2.0 2.1 2.2 Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, Wolinsky JS, Balcer LJ, Banwell B, Barkhof F, Bebo B, Calabresi PA, Clanet M, Comi G, Fox RJ, Freedman MS, Goodman AD, Inglese M, Kappos L, Kieseier BC, Lincoln JA, Lubetzki C, Miller AE, Montalban X, O'Connor PW, Petkau J, Pozzilli C, Rudick RA, Sormani MP, Stüve O, Waubant E, Polman CH (2014). "Defining the clinical course of multiple sclerosis: the 2013 revisions". Neurology. 83 (3): 278–86. doi:10.1212/WNL.0000000000000560. PMC 4117366. PMID 24871874.
- ↑ Katz Sand I (2015). "Classification, diagnosis, and differential diagnosis of multiple sclerosis". Curr. Opin. Neurol. 28 (3): 193–205. doi:10.1097/WCO.0000000000000206. PMID 25887774.