New Multiple Sclerosis Phenotypic Classification

• DOI: 10.1159/000367614
• Publication Date: 2014-09-26T06:31:08Z
• Authors: Fred D. Lublin
• Keywords: Clinically isolated syndrome; Clinical phenotype

Background: In 1996, the clinical course of multiple sclerosis (MS) was characterized as relapsing-remitting, primary progressive, secondary progressive or relapsing. Since then, an increased understanding MS and its pathology prompted a re-examination these phenotypes. Main recommendations 2013 revisions are provided herein. Summary: Clinically isolated syndrome has been added, relapsing eliminated, from descriptions. All forms should be further subcategorized either active non-active. Active is defined occurrence relapse presence new T2 gadolinium-enhancing lesions over specified period time, preferably at least one year. An additional subcategory for patients with differentiates between those who have shown signs disability progression given time remained stable. The term ‘worsening' recommended to describe whose disease advancing any reason, whereas ‘disease progression' reserved truly progressing (as opposed worsening relapse). ‘benign' used caution can worsen even after many years apparent stability. Key Messages: Newer characterizations phenotypes include consideration activity (based on rate imaging findings) progression. Accurate descriptions useful communication, prognostication, trial design guide everyday decision-making. © 2014 S. Karger AG, Basel