Multiple sclerosis: spontaneous course, natural history.

Globally, the course and prognosis of multiple sclerosis are heterogeneous, and generally considered to be unpredictable. Advances in statistical tech niques have made it possible to analyze representative cohorts of patients to clearly delineate the overall prognosis of the disease, beyond individua l variations. For each individual however, there appears to be a steady pro gression as shown by serial quantified neurological examinations. At the pr esent time early prediction of outcome remains impossible. In the near futu re, new imaging techniques may provide a solution to this problem allowing selection of patients at risk who could benefit from early treatment.