STUDIES ON THE NATURAL HISTORY OF MULTIPLE SCLEROSIS: 7. Correlates of Clinical Change in an Early Bout

Abstract

Factors of predictive value for the course of an early bout of multiple sclerosis were sought from a nationwide series of over 500 men who, before and during the bout under study, were on active duty in the U.S. Army. Most features of the neurologic involvement, as well as spinal fluid and season, were unrelated to change in hospital. Outcome was statistically associated with brain stem signs and age, but in an irregular fashion. Those for whom this was the onset bout (Group B) and those given “specific” treatment changed more for better and worse. The major correlates with improvement were short duration of the bout, sensory signs, and overall severity of neurologic impairment at admission; some inverse relationship was seen with total duration of illness for those with prior bouts (Group A). Bout duration and severity seemed additive in their effects: Of those with short and severe bouts, 95 per cent improved and none worsened; of those with long and mild or moderate bouts, 12 per cent improved and 17 per cent worsened. The relation with bout duration has been found in other series, but not that with severity.