Why is the first attack of MS severe for some people and mild for others? Does the severity of the first attack predict the future?
We do not know why the first attack can be severe for some people and mild for others, in fact we really do not know why any attack is severe or mild. It partly depends on where in the brain, spinal cord or nerves to the eyes the attack occurs and how much damage occurs. But why these vary between people and even between attacks in the same person is unknown. When looking at lots of people with MS, the type and severity of the first attack is one thing that seems to help predict the course MS will follow. People whose first attack is just sensory symptoms (numbness and tingling) or optic neuritis tend on average to have a milder form of MS than people who have weakness or imbalance with their first attack. However, this applies only to large groups of people and there are lots of exceptions. So it is very difficult to predict how severe an individual’s MS is going to be based just on how severe or mild the first attack is.
