Medscape: What are the primary indicators to look for in a patient who is entering into a more progressive form of MS?

Dr. Freedman: Generally speaking, the disease is almost always progressing, but one of our primary concerns is to identify those patients before they experience rapid progression.

The primary indicators to look for include changes in physical exams, cognitive abilities, magnetic resonance images, and electrophysiology. Progression is usually indicated by relapses with a slower recovery time, a shorter time period between relapses, a reduction in the effectiveness of steroids in reducing the inflammation and leading to near complete recovery, loss of endurance, and greater difficulty doing the same tasks. A physical exam might show that there has been some accumulation of a deficit, and, if the Expanded Disability Status Scale (EDSS) is used, it will move in the absence of attacks. These indicators strongly suggest that the patient is entering into a progressive phase....Click to read entire article...Medscape"Multiple sclerosis (MS) is a chronic and often progressive inflammatory disorder of the central nervous system (CNS), and characterizing patient response to various treatments for this disease and monitoring its progression are key to patient management. Medical Editor Penelope Gray-Allan, on behalf of Medscape, discussed patient management and treatment approaches -- presented at the recent meeting of the American Academy of Neurology (AAN) -- with Mark S. Freedman, MD, Professor of Medicine (Neurology), at the University of Ottawa, in Ottawa, Ontario, Canada."