Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology 2014; 83:278=286.
The new classification supplants the 1996 version by Lublin et al. with four types of MS. Old system has PPMS, RRMS, @PMS, and progressive relapsing.
New classification adds CIS, NOT RIS
deletes progressive relapsing
Active MS is those who have clinical relapses or worse MRI's in one year time frame.
worsening MS is impairment due to relapses
progression is progression of disability in a patient with progressive MS independent of relapses
Thus patients may have relapsing MS that is active or inactive, with or without worsening
and may have primary or secondary progressive disease that is active or inactive with or without progression
Confirmed worsening specifies a time perido and replaces sustained worsening.
Benign and malignant MS are retained but to be used sparingly
