It would be futile to attempt to conceal the well known fact that MS is often a crippling disease, causing severe disability in previously healthy young adults. It has been urged on me that to described the clinical details of MS for non medical readers will inexusably cause depression and distress, but I think this is unlikely. With few exceptions I have found that patients with MS have a strong and justified desire to know the truth and are ready to face the facts bravely. I shall therefore begin by describing the typical course of a moderatly severe case. A patient, most often a woman around the age of 30, has an initial attack as described in the last chapter, retrobulbar neruitis, numbness, wekaness, double vision, or any of a great number of other less frequently encountered symptoms, either separately or in different combinations.
Recovery is complete within a few weeks and all is apperently well.
A diagnossi may no thave been made or even suspected and the disease has now become latent. After an interval of from several months to several years new symptoms develop, usually different from those of the inital attack. Thus retrobulbar neuritis may be followed by numbness or weakness of the legs and again recovery is complete. This pattern of successive relapses once or twice a year or once in two years may persist for a further three or four years, each time with less complete recovery and increasing residual symptoms. Eventually a stage is reached in which there is persistent difficulty in walking due to a combination of the spastic weakness and ataxia described in chapter 3.