THE NATURAL-HISTORY OF MULTIPLE-SCLEROSIS

The natural history of multiple sclerosis is highly variable. There is substantial heterogeneity in the clinical manifestations but at this point it is reasonable to consider all idiopathic inflammatory demyelinating diseases of the central nervous system as representing a spectrum of the same disease. The short- and long-term course of multiple sclerosis may be determined by different biologic variables. Short-term benefit in clinical trials should not be assumed to indicate long-term reduction in the risk of permanent disability.