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December 1967

Forms of Benign Multiple Sclerosis: Report of Two "Clinically Silent" Cases Discovered at Autopsy

Author Affiliations

Chicago; New York
From Northwestern University Medical School, Chicago Wesley Memorial Hospital, and Veterans Administration Research Hospital, Chicago, and Veterans Administration Hospital, Hines, Ill (Dr. Mackay); and Laboratory Division, Montefiore Hospital and Medical Center, New York (Dr. Hirano).

Arch Neurol. 1967;17(6):588-600. doi:10.1001/archneur.1967.00470300030007

MULTIPLE SCLEROSIS is so often inevitably progressive, despite its tantalizing remissions, that both the profession and the public have come to consider it uniformly hopeless. In fact, if a neurologic disease seems at length to be nonprogressive, the diagnosis of multiple sclerosis is more than likely to be discarded. Yet, a wide clinical experience with this exceedingly pleomorphic disease strongly suggests that it may on occasion be a mild disorder indeed—mild in its onset, in its pattern of evolution, or in its ultimate results. It may even remain "clinically silent" for years—or forever.

The uniformly evil reputation of multiple sclerosis results from two simple facts: first, it is indeed a malignant disease at one end of its spectrum of severity, and, second, physicians see a biased selection of the "bad" cases but tend to miss or lose the more benign ones. On the one hand, the onset may be

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