Course and Prognosis of Disseminated Sclerosis in Relation to Age of Onset

Müller, Ragnar

doi:10.1001/archneurpsyc.1951.02320110026002

Cited by 47 publications

(10 citation statements)

References 4 publications

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“…This may have resulted from failure to distinguish lesions due to retrobul bar neuritis from the consequences of condi tions such as cataract and glaucoma which are common in the elderly population. Mo tor signs and symptoms, especially spastic paraparesis have been relatively more prom inent in previous surveys [7,8,[10][11][12][13][14][15][16], In contrast, in our population these findings characterised not so much the late onset group, but those patients who were older on prevalence day. This may also reflect diffi culties in distinguishing the effects of MS from other pathologies in older patients [8].…”

Section: Discussioncontrasting

confidence: 55%

“…Many authors have reported that the course of MS in the elderly is associated with higher mortality, [7,11,[19][20][21], worse dis ability and prognosis [9,11,13,[19][20][21][22][23][24][25][26]. In this study, older patients were more dis abled, but with the exception of late onset cases, the actual rate of deterioration seems to have been slower in patients who were older on prevalence day.…”

Section: Discussionmentioning

confidence: 51%

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Features of Multiple Sclerosis in Older Patients in South Wales

White¹,

Swingler

Compston

1990

Gerontology

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Multiple sclerosis (MS) may occur outside the commonly accepted age range. Data relating to features of MS in a population in South Wales have been analysed to find features which characterise older patients. The older patients are more severely disabled due to the accumulation of visual defects and motor signs and symptoms. The course of the disease is marked by single localised attacks with long remissions. Those with onset over 50 years deteriorate more rapidly, but in those who were over 50 at the time of interview, this did not occur. It is suggested that there is no essential difference in MS in older patients, but there may be features which reflect normal ageing and diseases commoner in old age.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 51%

Features of Multiple Sclerosis in Older Patients in South Wales

White¹,

Swingler

Compston

1990

Gerontology

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“…The randomised -study was limited to the 35 to 50 year age group because it is known that this higher age of onset is much more likely to produce a rapid, progressive, unremitting course (Muller, 1951).…”

Section: Discussionmentioning

confidence: 99%

Prolonged azathioprine treatment of non-remitting multiple sclerosis

Rosen

1979

Journal of Neurology, Neurosurgery & Psychiatry

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SUMMARY Two groups of 85 and 42 ambulatory patients with moderately advanced nonremitting multiple sclerosis were treated for six to 14 and three to six years with daily azathioprine. Less than 10% of these patients became confined to a wheelchair. This far exceeds any possible result in a group of non-remitting multiple sclerosis patients not so treated.There has been convincing evidence for at least a partial role of immune mechanisms in the production of multiple sclerosis for many years. These data still seem relevant despite the great proliferation of other data relating to the pathogenesis of this disease (Jersild et al., 1972; Lancet leaders, 1974 Lancet leaders, , 1976Miyamoto et al., 1976). In the mid 1960s the exact nature of the immunological mechanisms of multiple sclerosis were unclear. However, it seemed reasonable to attempt chronic immunosuppressive therapy with agents more potent and reliable than corticosteroids and ACTH, analogous to the data from experimental allergic encephalomyelitis (Hoyer et al., 1962;Paterson and Drobish, 1969;Vogel and Calabresi, 1969). Therefore, patient selection criteria and a chronic treatment protocol using purine analogues were established in 1964 and continued to the present. This report mainly concerns the effect of this treatment on patients with non-remitting multiple sclerosis treated for a minimum of six years. The study was under way for several years before the efficacy of this treatment was realised. When All patients with probable or definite multiple sclerosis by the criteria of Schumacher et al. (1965) and defective colour vision (Rosen, 1965) were considered for the study. In the first series, 48 of the patients were women, 37 were men. Thirtythree were between 25 and 35 years of age, and 52 were in the 35 to 45 year age group at the onset of treatment with azathioprine. All the patients had had the disease, by history, for at least four years. At the time of their inclusion in the study they had all shown objective evidence of worsening of their disease in the previous year. Patients with a static course for over one year before consideration for the study were excluded; so were those patients with a remission within three years of the study.The average patient in this pilot study of 85

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“…The clinical features of MS with onset at 60 years of age or later, as outlined by Hooge and Redekop [4], are similar to those already observed in patients manifesting their first symptoms after 45-50 years of age. Compared with patients with early onset disease, those with late onset 335 present a higher frequency of motor function disturbances with predominant involvement of the spinal cord [2,4,16,23,24]. The clinical course tends to be slowly progres sive from the beginning or after a brief period of relapse and remission [2,4,12,15,16,[23][24][25][26], In the latter case, the intervals between relapses are shorter than in younger patients and the course rapidly becomes progressive [ 15,23,25].…”

Section: Discussionmentioning

confidence: 99%

Multiple Sclerosis with Very Late Onset: Report of Six Cases and Review of the Literature

Azzimondi

Stracciari²,

Rinaldi³

et al. 1994

Eur Neurol

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Multiple sclerosis (MS) usually starts in young adulthood. However, the disease may appear late or very late in life. We report 6 cases with onset after the age of 59 years and review the literature. As in early onset disease, the diagnosis is mainly clinical. Laboratory findings and paraclinical evidence may support the diagnosis if clinical data are not sufficient. In elderly patients clinical history and laboratory data should be thoroughly appraised to exclude conditions more common in old age such as vascular diseases.

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Course and Prognosis of Disseminated Sclerosis in Relation to Age of Onset

Cited by 47 publications

References 4 publications

Features of Multiple Sclerosis in Older Patients in South Wales

Features of Multiple Sclerosis in Older Patients in South Wales

Prolonged azathioprine treatment of non-remitting multiple sclerosis

Multiple Sclerosis with Very Late Onset: Report of Six Cases and Review of the Literature

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