Staging of the severity and progression of MS is characterized using a neurologic impairment scale, the Expanded Disability Status Scale (EDSS). 16 Up to one-third of MS patients can live a relatively unencumbered life despite having Ms. Generally, sensory and cranial nerve symptoms predict a more favorable outcome than those caused by motor nerve or cerebellar dysfunction. Exacerbations are to be expected in the face of significant physical and emotional stress, with disease progression occurring over decades. For those with the most severe progression, severe disability can occur over months to years. In these patients, the risk of suicide is over seven times greater than for the population as a whole. Regardless of the rate of progression, most significant complications and mortality are due either to suicide or to neurologic, pulmonary, and renal dysfunction seen with advanced disease and age. Mean life expectancy exceeds 30 to 40 years after the time of initial diagnosis.
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