Four Flavors of Multiple Sclerosis

MS comes in four varieties.

By far the most common is called Relapsing-remitting MS (RRMS). Approximately 85% of people with MS have this type. It’s main characteristic is that the individual has symptoms that come and go.  After a flare-up or exacerbation of a symptom, the symptom will partially or completely go away.  Early on, this gives many people false hope that the disease has passed them by.  Unfortunately, the symptom or new ones will eventually come back.

Most people with RRMS eventually progress to Secondary-progressive MS (SPMS).  The individual’s symptoms may have remitted and relapsed for 10 or 15 years, but reached a point where they stopped going away. Typically from this point on, the symptom or symptoms gradually get worse going forward.

The third type is Primary Progressive MS (PPMS).  With this version the patient does not have distinguishable flare-ups, nor do their symptoms ever go away.  There is just a steady progression of the disability.

The fourth type is also the least common.  Progressive-relapsing MS (PRMS) is characterized by steady deterioration as in PPMS, but with occasional flare-ups on top of it.  The flare-ups may or may not improve, but the basic disability underlying it continually progresses.

There are a few common differences between RRMS and PPMS.  That will be the topic of my next post as we try to determine which variant I have and the path of my treatment.

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