Benign Multiple Sclerosis Actually Exists

A small percentage of MS patients have very mild disease

Multiple Sclerosis, Consultation. Credit: BSIP / Contributor / Getty Images

Benign multiple sclerosis sounds like an oxymoron, doesn't it? Well, believe it. Some people with MS live with relapsing-remitting multiple sclerosis in which few relapses occur throughout the course of their disease. These relapses tend to produce sensory symptoms, which go away and leave very little or no residual damage or disability.

How Common Is Benign MS? 

By some estimations, benign MS occurs in 10% to 20% of people with MS, but it is impossible to predict at the time of diagnosis who will follow this course.

There is debate on the topic of exactly how to definitively diagnose benign MS, given that a patient's disease activity may change suddenly throughout the course of their disease. In fact, one study showed that only 15 percent of patients with benign MS actually had a long-term benign course; the majority went on to develop more significant disability. 

To diagnose benign MS, neurologists use the Expanded Disability Status Scale (EDSS), which gauges a person's degree of disability. A low EDSS score (usually 3 or below, which equates with some disability while still being able to walk) ten or more years after a diagnosis of MS is the standard criterion for benign MS. 

"Benign MS" Controversy

Many neurologists and researchers do not use the term "benign MS," as there is so much controversy over the exact definition and the amount of people that could be classified as having it. In addition, critics note that other disease factors prevalent in MS, such as fatigue, depression, and cognitive difficulties, aren't included in the diagnostic criteria for benign MS.

As researchers Maria Pia Amato and Emilio Portaccio write in their paper, "Truly benign multiple sclerosis is rare: let’s stop fooling ourselves-Yes," there are many debilitating symptoms of MS, and many of them are not factored into the definition of benign multiple sclerosis: "The definition of BMS has been mainly focused on the preservation of motor abilities of the patients, usually relying on the Expanded Disability Status Scale (EDSS) that is particularly influenced by ambulation and lacks sufficient association with important manifestations of MS, such as inability to perform daily living activities, reduction in quality of life, loss of gainful employment, hopelessness and cognitive dysfunction."

Still, some researchers maintain that the data cannot be ignored: Some patients do end up having minimal neurological and neuropsychiatric disability with MS, even when they have abnormal MRI findings. And because of the side effects of current disease-modifying therapies, patients with very mild disease may be better served deferring treatment unless their disease becomes more active. 


23rd Congress of the European Committee for the Treatment and Research in Multiple Sclerosis: Parallel session 7 (85). Presented October 13, 2007.

Maria Pia Amato and Emilio Portaccio. Truly benign multiple sclerosis is rare: let’s stop fooling ourselves-Yes. Multiple Sclerosis Journal. January 2012. 


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