End stage of multiple sclerosis

A concrete final stage does not exist in multiple sclerosis. The severity of the symptoms varies from patient to patient. Thus, the clinical picture of MS in the period before the patient’s death is also different.

The more moderate the course and the better the care, the more probable is the absence of a condition that could be called an end stage. Today, even more severe courses of disease remain largely within the bounds of modern drug therapy approaches. However, if an end stage had to be described, it would probably be represented by extreme symptoms.

The multiple (many) lesions that have developed in the brain and spinal cord during the course of the disease result in extensive and diverse limitations. Movement is difficult or no longer possible. There are severe sensory disorders and the patient may experience pain.

Language also changes, since the facial muscles can no longer coordinate in an orderly fashion. This can go so far that the ability to speak is completely lost. In the late course of the disease, dementia can also occur, which is a consequence of the reduction of brain mass.

Life expectancy

The symptoms are different for each patient, but have a great influence on mortality. If there are no severe handicaps due to the nerve damage, life expectancy can be close to that of a healthy subject. MS patients often die several years earlier.

If there are severe disabilities or if vital centers in the brain (brain stem) are too severely damaged by the inflammation, the patient may die earlier.Any age at which the disease exists is possible – from 20 to 70 years, with early death being extremely rare. A particular example, which is associated with premature death and low life expectancy, is the so-called Marburg variant of multiple sclerosis. This form is characterized by an extremely aggressive course with severe disabilities, but occurs extremely rarely.

How multiple sclerosis presents itself after 10 years of illness varies from individual to individual. Even after such a period, it is possible to be symptom-free with proper treatment of the relapses and comprehensive care. Also, no symptoms can be determined which have appeared or exist in all patients after 10 years.

However, there are symptoms that often occur at the beginning of the disease and thus make it more likely that they will be present after 10 years of illness. For example, the nerves that control the eye muscles may be damaged, leading to double vision (strabismus). Sensory disturbances in the face or limbs may occur.

Imprecise pronunciation, hoarseness or difficulty swallowing can also be symptoms of long-term MS. After 10 years, many reflexes are weakened and difficult to trigger. In addition, the course of multiple sclerosis can change after 10 or 15 years of illness. It has been observed in the past that some patients who have suffered from relapsing-remitting MS suddenly develop a progressive component. The resulting secondary progressive MS is accompanied by increased symptoms.