Five Types of Multiple Sclerosis
Last week I discussed the causes of multiple sclerosis and there were many. This week I’m going to cover the types of multiple sclerosis and there are not nearly as many to go over in this category. Overall, the disease itself is the same. It is an autoimmune condition where your body attacks the myelin that coats the neurons, which creates the disability. What is different in each of the five types, is the severity of the progression and disability. Let’s dive in and take a look at each of the five.
Clinically Isolated Syndrome
Clinically isolated syndrome or CIS is the first episode of symptoms that someone experiences that is caused by inflammation and demyelination of either the brain or spinal cord. This has the same criteria of a relapse, needs to last for at least 24 hours, but is missing some other diagnostic criteria of MS. Individuals who are diagnosed with CIS, have a higher chance of being diagnosed with MS later in life but won’t always be diagnosed. As imaging and testing improves, I can imagine that the diagnosis of CIS will become rare. If there is evidence of prior activity, then the diagnosis of CIS would not apply.
Relapsing remitting MS type is the most common form of MS. This is when individual has two distinct periods, disease progression and disease remission. During disease progression, an individual would have a relapse and subsequent symptoms, then the symptoms will eventually fade and they will return to their baseline state. The two periods are very clearly defined and switch back-and-forth as the years go on. During the remission phase, all symptoms may disappear or some may linger and become permanent.
Primary progressive MS type is defined by the persistent worsening of function from the beginning of experiencing symptoms, without experiencing the relapses or remissions. This form will progress steadily from the time of onset. Individuals will experience worsening of their symptoms at varying rates but the progression will be constant. At times the progression my reach a plateau as well, then will pick up again.
Secondary progressive MS type initially starts out as relapsing remitting then will begin to follow a progressive course. Many people who start out with relapsing remitting will eventually transition to secondary progressive. At one point in time it was thought that after about 10 years of having relapsing remitting you would progress into secondary progressive. However, this data was taken before the widespread use of medications. I actually just recently asked my own neurologist about this statistic, as I just reached my eight year anniversary. He was very adamant that this was not the case anymore due to having such a wide array of medications that are available for so many people. This was very encouraging to me! He also stated that due to my lifestyle factors, diet and exercise, I’m also doing myself a world of good at preventing any further progression.
Progressive relapsing MS is exactly what it sounds like. There is a steady worsening of symptoms over the years with periods of acute exacerbation’s. This is a very rare type, thank God, but still one to be aware of. About 5% of individuals with MS have this type. Sometimes all of the progressive types of MS are lumped together and called “Chronic progressive MS”.
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Image source: https://www.nationalmssociety.org/What-is-MS/Types-of-MS