Is it possible for someone with very benign MS to never have a serious relapse?

Answer 1

One of the conundrums surrounding MS is that it has no symptoms which are unique to it. Every symptom you can experience in MS can be attributed to something else. A diagnosis of MS, therefore, is a diagnosis of exclusion. When you exclude everything else which could be causing that symptom, it can only be MS.

MS also cannot be conclusively diagnosed using any imaging or chemical analysis. These things point to MS, but they are not conclusive.

Part of the diagnosis of MS is the experience of the relapses themselves. In order to be diagnosed with clinical MS, you need to experience two distinct episodes disseminated by space and time. Dissemination of space means two separate physical systems, while dissemination of time usually means about six months.

About the best you can hope for is a single, clinically isolated event, and no further relapses. While it can't officially be diagnosed as clinical MS, it can be treated that way. Studies are attempting to show whether or not early intervention (after the initial event) with disease-modifying medication can prevent full-blown clinical MS.

To answer your question, you need to experience at least one relapse before you can officially be diagnosed with possible or probable MS.

Thank you for your reply, this information is really important to me!! But your answer also raised further questions! (And since I've tried researching this online and elsewhere and got lost in the heap of info, I'll go ahead and ask some more). My mate had a single episode which led him to the hospital and after a spinal tap, MRIs and all those great tests, he was diagnosed with MS. He has ever since been treated with disease-modifying drugs (which he hates as they are injected) and never had another episode since. That is he hasn't had any other episode since the first one in 4 years except for a strange sensation in his spinal chord which he and other MSers describe as "electricity running up your spine" which occurs rarely.

My question is: Is it possible that he may never have another episode? (If such a thing can be predicted!!) And since there is absence of episodes for such a long time is it worth continuing the treatment? I am asking this because all those injections and blood tests and MRIs can take a significant toll on the psychology of someone afraid of needles.

I would be very grateful for another reply as I haven't had the chance to speak with a doctor about this yet.

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Fear not, there is hope!

Specifically, there are a few things that may help to put your mind at ease slightly.

1. While it is not possible to predict whether or not you will have another relapse, what is known from empirical studies is that the longer you go without a relapse, the longer it will likely be before you have another. For example, if it's been five years since your last relapse, all else being equal, it will possibly be another ten years before you have another.

2. For the needle-phobic, there is a new therapy that is just making its way on to the market, and it is oral (i.e. it's a pill). There is expected to be at least one of the pills approved this year. If using needles is interfering with you getting treatment, this may be an option that you and your neurologist can discuss.

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Again I am grateful for the reply!

I know about the pill but my mate's doctor said "you don't change from a treatment that seems to be working fine to the pill just because you don't like the needle".... I guess he's right but we'll see into that again when it gets approved.

The way I understand it though is that nobody can completely exclude a future relapse no matter how long you go with no episodes.

Not that I complain, things are as good as they could be! A big thanx to all who took the time to reply and helped me understand some things better!