IS THE CLINICAL OUTCOME IN MULTIPLE-SCLEROSIS PREDICTABLE

Three characteristic features describe our understanding of the clinic al course and outcome in multiple sclerosis: a validated statistical m odel of disease progression, wide interindividual variability, and a f ixed rate of progression in an individual patient. However for and ind ividual patient it is still impossible to derive a precise and exact p rediction of disease outcome. the only reliable method is the determin istic approach developed by Fog and Linneman in 1970 which consists in objective quantitative neurological examinations performed at three m onth intervals over several years in the same patient in routine pract ice, this method in rather unrealistic. Bran MRI data with conventiona l techniques are also poorly discriminant. Conversely, it may be antic ipated that new magnetic resonance techniques, more sensitive to axona l loss, demyelinization and gliosis, will provide reliable answers to this issue upon which therapeutic decisions depend.