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Nat Rev Neurol. 2015 Jul;11(7):379-89. doi: 10.1038/nrneurol.2015.85. Epub 2015 Jun 2.

Aggressive multiple sclerosis: proposed definition and treatment algorithm.

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Division of Neurology, Ottawa Hospital Multiple Sclerosis Research Unit, University of Ottawa, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.


Multiple sclerosis (MS) is a CNS disorder characterized by inflammation, demyelination and neurodegeneration, and is the most common cause of acquired nontraumatic neurological disability in young adults. The course of the disease varies between individuals: some patients accumulate minimal disability over their lives, whereas others experience a rapidly disabling disease course. This latter subset of patients, whose MS is marked by the rampant progression of disability over a short time period, is often referred to as having 'aggressive' MS. Treatment of patients with aggressive MS is challenging, and optimal strategies have yet to be defined. It is important to identify patients who are at risk of aggressive MS as early as possible and implement an effective treatment strategy. Early intervention might protect patients from irreversible damage and disability, and prevent the development of a secondary progressive course, which thus far lacks effective therapy.

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