After the active stage of relapse and remission lasting for about five years the pattern often changes and there are no more acute attacks adn no more spontaneoius recovery. Symptoms often fluctuate a great deal from day to day and in the course of the day, being influenced by fatgiue, temperature, and other unknown factors. These variations are quite different in timing and in significance to the acute relapse lasting for several weeks. Many patietns now experience a long period extending over many years during which their symptoms and degree of disability do not change significantly beyond these expected fluctiations. They can walk, although not easily, can drive a suitable vehicle, and can work or cope with the houshold and children with no more than family support.
Life is a struggle but by no means intolerable.
Eventually if the disease is indeed in the severe form this static period will be followed by a progressive stage. Walking becomes increasingly difficult. Sticks are no longer adequate support and recourse must be had to a walking frame or to holding on to furniture. A wheelchair becomes necessary for outdoor excursions and eventually at home as well. Bladder control is increasingly lost with resulting incontinence but some degree of bowl control is usually retained, although constipation my be uncomfortable.