Malignant multiple sclerosis
Encyclopedia
The term malignant multiple sclerosis is often used to describe MS patients who reach significant level of disability in less than 5 years from their first symptoms

The National MS Society Advisory Committee on Clinical Trials of New Agents consensus defined it as: disease with a rapid progressive course, leading to significant disability in multiple neurologic systems or death in a relatively short time after disease onset. Reaching Expanded Disability Status Scale
Expanded Disability Status Scale
The Kurtzke Expanded Disability Status Scale is a method of quantifying disability in multiple sclerosis.The EDSS quantifies disability in eight Functional Systems and allows neurologists to assign a Functional System Score in each of these....

 of 6.0 or higher, which is equivalent of needing unilateral support to ambulate (or worse) is generally considered this significant disability level.

Patients with severe forms of more common relapsing remitting or progressive MS subtypes, as well as rare Marburg variant and Balo concentric sclerosis
Balo concentric sclerosis
Balo concentric sclerosis is one of the borderline forms of multiple sclerosis.Balo concentric sclerosis is a demyelinating disease similar to standard multiple sclerosis, but with the particularity that the demyelinated tissues form concentric layers...

 could be considered malignant MS. Patients should be carefully worked up to rule out Neuromyelitis optica (Devic's disease) due to the distinctive pathophysiology and management strategies of this disease.
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