Multiple sclerosis, or MS, is an autoimmune disorder in which the nervous system attacks the protective coverings (myelin) of nerve fibers. This distorts communication between the brain and body, resulting in damage to brain, spinal cord, and optic nerve function, and even gradual loss of mobility in many cases.
According to the progression of symptoms, there are 4 main types of multiple sclerosis that require the services of a neurologist.
Table of Contents
1- Relapsing-Remitting MS (RRMS):
RRMS is the most commonly diagnosed form of MS, affecting almost 85% of people diagnosed with the condition. This particular sub-type is characterized by two alternate phases: relapse or flare-up, and remission.
Both phases are temporary, with symptoms worsening during a relapse phase, while disappearing partially or completely in the remission phase, with a halt in disease progression.
Relapses are generally short, with a remission lasting anywhere between weeks, months, and years. However, the degree of damage, as well as rate and extent of recovery depend from person to person. Initial RRMS symptoms usually appear in the early 20s.
2- Primary-Progressive MS (PPMS):
The second most common form of progressive MS, PPMS covers approximately 10-15% of all diagnosed cases. Unlike RRMS, this particular form of MS continues to progress at a steady pace, with very short, minor remission stages in between.
Some people may experience a few plateau phases regarding certain symptoms, i.e. their symptoms remain constant for a short time period before re-starting their progress.
PPMS does not present any clearly-defined symptoms, is usually diagnosed around age 40, and leads to disability much earlier than RRMS.
3- Secondary-Progressive MS (SPMS):
Like PPMS, Secondary-Progressive MS initially follows the progression pattern of RRMS, i.e. a period of symptom flare-ups followed by a remission period. However, the symptoms do not disappear, but remain constant, and soon start to steadily worsen, as with PPMS.
SPMS rarely occurs on its own, but is rather the result of untreated RRMS. In fact, over 50% of people initially diagnosed with the relapsing-remitting variety go on to develop SPMS between 10-20 years after diagnosis.
The older you are at the age of initial diagnosis, the faster it will progress to SPMS. Also, nerve damage after transitioning from relapsing-remitting to secondary-progressive shifts from increased inflammation to altering the way nerves function.
4- Progressive-Relapsing MS (PRMS):
This particular type of MS is highly rare; affecting only 5% of people diagnosed with the condition. While the condition follows the steady progression pattern of PPMS and SPMS, symptoms start worsening from the very beginning, with major relapse phases without any remission period.
Moreover, although relapses do not happen frequently, symptoms continue to worsen in the period between two relapses.
5- Clinically Isolated Syndrome (CIS):
A CIS refers to an ‘attack’ that mimics the symptoms of MS. It may be the first sign before clinically diagnosable MS, or may even occur as a single isolated episode. The symptom, or symptoms, must last for at least 24 hours and must not be associated with a fever, infection, and other illness to receive a CIS diagnosis.
People who experience an episode of CIS have a 60-80% chance of a recurrence or an MS diagnosis within a few years of the initial episode. The chances increase if older lesions (myelin damage and scarring) in the brain or other parts of the central nervous system are detected via MRI.
Early MS detection can be difficult due to generalized symptoms that are also shared with other conditions. However, consult with your doctor immediately if you experience any symptoms, as early treatment can help delay progression; especially since major MS damage is caused in the first year of onset. Read about the symptoms here.
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