Benign multiple sclerosis (MS) refers to a type of MS where someone has MS for over 15 years without developing severe disability. However, benign MS may change to a progressive form of MS.
Multiple sclerosis (MS) can vary greatly from person to person.
Benign MS is a term sometimes used to describe a form of MS in which a person has MS for several years without developing severe disability. They may have mild relapses separated by periods of no symptoms or may have no relapses at all.
However, benign MS is not currently an established medical diagnosis, though the American Academy of Neurology (AAN) is considering proposing a medical definition for the term.
Keep reading to learn more about benign MS, including how it may progress and how it’s diagnosed.
All forms of MS are unpredictable, with varying severity of symptoms. Progression of symptom onset varies also. Common symptoms of MS include:
- visual disturbances
- numbness
- impaired coordination and balance
Some people start out with mild symptoms that take decades to progress, while others experience a rapid progression of symptoms from the beginning. Most people experience something in between.
Benign MS is sometimes used to describe MS as a score of less than or equal to 3 on the Expanded Disability Status Scale (EDSS), as scored by a neurologist, after having had MS for 15 years. The EDSS scale uses half-unit increments from 0 to 10 to measure the level of disability a person experiences as their MS progresses.
Levels 0 to 3 include:
| Stage | Features |
|---|---|
| 0 | No disability. |
| 1 | Minimal symptoms affecting one functional system, but no disability. |
| 1.5 | Minimal symptoms affecting more than one functional system, but no disability. |
| 2 | Minimal disability symptoms in at least one functional system. |
| 2.5 | Mild disability symptoms in one functional system or minimal disability in two functional systems. |
| 3 | Moderate disability symptoms in one functional system, or mild disability in three or four functional systems. No difficulty walking. |
People sometimes use benign MS to describe the mildest form of the disease. They may experience symptoms, but their disabilities may not accumulate, and an MRI may not show an increase in disease activity. However, symptoms can worsen over time, and people with benign MS can potentially develop a progressive form of MS.
Read more about MS disease progression and disability levels.
The term “benign MS” can be confusing. It is not currently well-established in the neurology community.
Benign MS is not currently a medical diagnosis, though the AAN is beginning to propose a definition of this term. When you are first diagnosed with MS, it is impossible to predict how the disease may progress over time.
A person may be considered to have benign MS if they have a mild progression of the disease, even after 15 years. Even after years of relatively benign progression, a person with benign MS may begin to develop severe disability if the disease progresses later.
There’s no way to predict if or how MS will progress in the years to come.
A study in Germany found that 54% of people with MS had MS that could be considered benign 15 years after their diagnosis, but that the number dropped to 30% after 30 years.
There are different forms of MS with different disease courses.
Relapsing forms
Relapsing-remitting MS (RRMS) refers to MS that has periods known as “relapses” where neurologic symptoms worsen. These periods are followed by periods known as remissions, during which new or worsening symptoms may lessen or disappear. These symptoms may also accumulate over time and become permanent.
Like benign MS, RRMS can change its course. When RRMS transitions into progressive MS, it’s called secondary progressive MS (SPMS). There are no clear periods of remission in SPMS.
Progressive forms
People with primary progressive MS (PPMS) experience a steady worsening of symptoms from onset. There are no clear remissions, and disability accumulates over time.
There’s no cure for any form of MS. Treatment involves symptom management and disease-modifying medications.
People newly diagnosed with MS and those considered to have benign MS should discuss the pros and cons of disease-modifying drugs with their neurologists.
Learn more about treatment options for MS.
Although the diagnosis and outlook for benign MS are unclear, there are a few things to keep in mind:
- Mild symptoms at the time of diagnosis don’t necessarily indicate a benign course of the disease.
- Benign MS cannot be identified at the time of initial diagnosis and can take as long as 15 years to diagnose.
- The course of MS is unpredictable, and having benign MS doesn’t mean that it can’t progress into a more severe form of MS.
MS is a manageable disease. If you’re diagnosed with any form of it, you should weigh the pros and cons of different treatments, including disease-modifying medications, with your doctor.