Multiple sclerosis (MS) is a complex condition that manifests in several ways. In most cases, each person with multiple sclerosis has various illnesses. Although the condition is always accompanied by nerve injury, each person’s pattern is unique.
The International Advisory Committee on Clinical Trial of MS recognized many categories of MS in 2013 to aid in understanding and classifying the severity of the diseases and the efficacy of treatments. Here is some greater detail about the various types and how each develops.
Clinically Isolated Syndrome (CIS)
Clinically isolated syndrome is the first episode of neurologic symptoms brought on by inflammation and demyelination in the central nervous system. CIS is a characteristic of multiple sclerosis; by definition, it is an episode that lasts for at least 24 hours.
Some medical professionals believe that this episode does not yet match the MS diagnosis criteria because people who experience a CIS might not necessarily develop MS. For a CIS attack to quality as MS, an MRI has to detect an MS-like lesion.
Relapsing-Remitting MS (RRMS)
Relapsing-remitting multiple sclerosis is the most prevalent type of MS, affecting almost 80%-85% of the patients diagnosed with MS. This type of MS is marked by temporary periods known as flare-ups or exacerbations when new symptoms manifest. People with RRMS frequently encounter discrete attacks of a developing or deteriorating neurologic disease. Periods of partial or total remissions can follow these relapses.
RRMS symptoms may or may not disappear during MS recovery or remission, and if they don’t go away, they could end up being permanent. RRMS does not appear to progress while patients are recovering.
Secondary-Progressive MS (SPMS)
If replace-remitting MS is left untreated, about 50% of the time, it will progress to secondary-progressive MS within 10 years. The symptoms grow more steadily with time, despite the initial relapsing-remitting course. Neurologic function progressively deteriorates over time, and this decline is usually more severe than in RRMS.
Primary-Progressive MS (PPMS)
Primary-progressive multiple sclerosis is a type of MS that is described as a worsening condition without relapses or remissions. It also meets two other criteria: two or more identical spinal cord lesions and a brain lesion typical of MS. Typically, after being diagnosed with PPMS, a person’s neurologic function gradually deteriorates. PPMS affects 10% of MS patients, with the rate of MS development changing overtime, occasionally plateauing and improving.
Other Types of MS
There are a number of other types of multiple sclerosis that are less common and have very specific diagnostic criteria.
Progression-Relapsing MS (PRMS)
This type of MS is the least common form of the illness. Similar to primary-progressive MS, this type is defined by a continuously worsening condition from the moment it manifests. Furthermore, it occasionally relapses with worsened symptoms comparable to relapsing-remitting multiple sclerosis. In PRMS, nerve damage leads to steady deterioration, while inflammation causes relapse episodes.
Fulminant MS
Fulminant MS, also known as malignant or Marburg MS, is rapidly progressive and characterized by severe relapses in the first five years. Unlike other types of MS, the malignant type may require more aggressive treatment.
Inactive or Benign MS
This type of multiple sclerosis is innocuous. If you go more than 15 years with little to no symptoms, you might be experiencing inactive or benign MS. You must, however, proceed with medical procedures carefully because your MS could reactivate.
Burn-Out MS
Burn-out multiple sclerosis refers to MS whose progression drastically slows down and becomes inactive over time.
Balo Disease
This multiple sclerosis variation is progressive and uncommon; as a result, most diagnoses occur in adults. Balo Disease differs from typical multiple sclerosis in that it often progresses quickly instead of waxing and waning. Some of its symptoms include progressive paralysis, headaches, cognitive decline, convulsions, and uncontrollable muscle spasms.
Radiologically Isolated Syndrome (RIS)
The term “radiologically isolated syndrome” is used when magnetic resonance imaging (MRI) reveals MS-type lesions, but the patient is symptom-free. More than half of patients displaying RIS will develop MS within ten years.
What does MS progression look like?
Each person with multiple sclerosis has a unique case of the disease. The symptoms that MS causes vary not only from person to person, but also over the course of a person’s life. Because of this, it can be difficult to diagnose.
What is the outlook for each type of MS patient?
MS diagnosis is based on a collection of symptoms, not a single test. There is no current method of forecasting how a patient’s condition will change over time. You’ll better understand how MS will impact you in the future once your physician knows what form of MS you have.
- Clinically Isolated Syndrome: CIS is neither infectious nor inheritable. Therefore, from the ages of 20 to 40, anyone could develop the illness. Not all people with this syndrome go on to develop MS. The identification of neurologic events, and the chance that CIS would lead to MS, require careful diagnosis.
- Relapsing-Remitting MS: This type of MS is characterized by inflammatory attacks on myelin and nerve fibers. Immune cells stimulated after an attack cause a limited affected region to exhibit MS symptoms. Neurological testing and MRIs are excellent tools for monitoring this condition. To recommend treatment, your doctor will determine whether you have RRMS that is active and progressing.
- Secondary-Progressive MS: SPMS symptoms vary across individuals, whether there is evidence of illness activity or not. When it comes to treatment, your provider must characterize your condition at different points in time. Doctors monitor the disease activity and progression via MRIs and neurologic examinations.
- Primary-Progressive MS: When stable, PPMS can appear with or without new MRI activity or a relapse. MRI and neurologic testing can be used to evaluate its activity and development. The sort of treatment you receive will vary depending on whether your PPMS is active or stable, and whether it accompanies a relapse or new MRI activity.
Which type of MS is the most aggressive?
As previously indicated, Fulminant MS progresses quickly and is characterized by severe relapses within five years following diagnosis. This type of MS may require that it be treated more aggressively than others.
How is the progression of MS monitored?
Doctors monitor multiple sclerosis by MRI. In essence, MRI scans track the brain and spinal cord damage caused by MS. It can also spot disease activity and damage to nerve cells.
Is it possible to have MS and not know it?
The short answer is: yes. People experience the condition differently and have different symptoms. Some people have MS so subtly that they are completely unaware of it, while others are seriously affected. In reality, MS lies on a spectrum.
The Best Rehabilitation Center for Multiple Sclerosis
Brooks Rehabilitation is equipped with advanced technology that supports our health experts as they monitor your multiple sclerosis. Our primary aim is to help you stay on the road to recover. Contact us today to learn more about our services and to schedule an appointment. You don’t have to walk this journey alone.