Benign MS in the MS picture

Multiple Sclerosis or MS is a demyelating disease of the Central Nervous System. Since no two individuals share the same brain chemistry, the disease progresses differently in each person; this lead to the description of several patterns of progression and subtypes. The subtypes and patterns of MS are important for the prognosis of the diseases and for therapeutic decisions. According to the US National Multiple Sclerosis Society, there are four subtypes of Multiple Sclerosis:
1. relapsing remitting,
2. secondary progressive,
3. primary progressive, and
4. progressive relapsing.

Controversy, diagnosis, treatment

Benign Multiple Sclerosis is a type of relapsing remitting MS and it’s characterized by a small number of relapses, which produce only sensory problems and go away without leaving too much disability or damage.
Initially, all Multiple Sclerosis patients are diagnosed with relapsing remitting MS, but the progression of the disease usually leads to secondary progressive after a couple of years, then it worsens to primary progressive leading to progressive relapsing.  However, 10% to 20% of MS sufferers are diagnosed with benign multiple sclerosis, which is the slowest possible progression of the disease that produces only minimal damage to the sufferer, making it possible for him or her to lead an almost normal life. 
The duration of benign MS can be several years to several decades, depending on the individual, it’s lifestyle and genetic makeup. However, according to the estimates, at least half of the persons diagnosed with benign MS will eventually have MS progression.

The diagnosis of benign MS is also quite controversial in the medical community. Researchers proposed for a person to be diagnosed with benign MS if he or she has had multiple sclerosis for at least ten years, and their EDDS (Expanded Disability Status Scale) score is 2.0 or less.

When it comes to the treatment of benign MS, controversy is present. This happens because the diagnosis of benign multiple sclerosis is controversial, and hence the therapeutic approach is most times in the limits of “treat all” or “treat less”. Due to this controversy, there are healthcare specialists who prefer to treat the patient with relapsing remitting benign MS as a patient with relapsing remitting MS, while there are some who approach the disease more easily, treating mainly the symptoms, without suffocating the patient with an array of therapies and medications.

Because of each doctor’s own approach to benign MS, studies on it were not able to be conducted, and hence the long term effect of an treat-all or treat-less approach is yet unknown. However, according to estimates, until now no major differences in the progression of the disease were found due to the treatment. The differences in the progression of the disease being closely related to the person’s own lifestyle, genetic makeup and attitude towards the disease (it is known that depression is an accompanying part of MS, but it seems that patients who overcome this, slow down the progress of the disease – mainly because long term depression modifies the brain’s chemistry, which is already being modified by MS).