By Connie Brichford | Medically reviewed by Cynthia Haines, MD

Did you know that there are four basic types of MS, each affecting patients in unique ways? Here’s what to expect from the different kinds of MS.

Some people have a single attack of multiple sclerosis (MS) — and never have another one again. Known as benign MS, this form of the autoimmune disease accounts for about one-fifth of MS cases. But the nearly 400,000 people in the United States who do experience that second (and third, fourth, and fifth) attack fall into one of four main multiple sclerosis categories.

Your MS diagnosis will be based upon the frequency of relapse (in multiple sclerosis terminology, “relapsing” describes the appearance of new symptoms, or the return of old symptoms for more than 24 hours). Also called a flare-up, acute attack, or exacerbation, a relapse can be a minor inconvenience or an event intense enough to disrupt your daily routine.

“The ultimate goal of multiple sclerosis treatment is to prevent disability, both from relapse and from progression,” says Tanuja Chitnis, MD, associate neurologist at Brigham and Women’s Hospital in Boston. Over the last 10 years, scientists have learned a great deal more about the treatment of multiple sclerosis and there are now a number of medications available that can slow progression of the disease.

The Four Basic Types of MS

After the first appearance of significant multiple sclerosis symptoms, you will probably be diagnosed with one of the following forms of the disease:

  • Relapsing-remitting MS. The most common form, relapsing-remitting multiple sclerosis affects about 85 percent of those first diagnosed with the disease and affects around 60 percent of people living with MS. While most new diagnoses of multiple sclerosis are categorized as relapsing-remitting, an individual may develop another form of the disease over time.In relapsing-remitting multiple sclerosis, patients experience a period of active symptoms, called relapsing, followed by periods that are symptom-free, called remitting. Treatment, often intravenous steroids delivered through a vein (also known as an “IV”), can help ease the symptoms of an MS relapse, either partially or entirely. Some people with relapsing-remitting multiple sclerosis go a year or more between relapses; others have them more frequently.
  • Secondary-progressive MS. Relapsing-remitting patients often develop secondary-progressive multiple sclerosis somewhere between 10 and 15 years after their initial diagnosis of relapsing-remitting multiple sclerosis, Dr. Chitnis says.Once diagnosed with secondary-progressive multiple sclerosis, people will notice a change in the pattern of their disease. While some acute attacks (exacerbations) and periods of remission may still occur, they happen less frequently, recovery is less complete, and symptoms become chronic, gradually worsening over time. Some medications are currently available to help slow the progression of the disease; other medications for this type of MS are now being tested in clinical trials.
  • Primary-progressive MS. According to Chitnis, 10 percent of MS patients are diagnosed with primary-progressive multiple sclerosis. In this more serious form of multiple sclerosis, the exacerbations, or attacks, seen in people with relapsing-remitting MS are rare, if they occur at all. Instead, MS symptoms worsen over time, gradually leading to disability. As with secondary-progressive multiple sclerosis, medications are available to slow this deterioration process.
  • Progressive-relapsing MS. Progressive-relapsing MS is the least common type of multiple sclerosis. Like primary-progressive MS, this form of multiple sclerosis is characterized by a gradual worsening of symptoms over time, but patients with this type of MS will also experience exacerbations and remissions. Unlike relapsing-remitting MS, however, people with progressive-relapsing multiple sclerosis do not typically regain complete functioning after a symptom relapse. In progressive-relapsing MS, disability is caused by the combination of disease progression and incomplete recovery after an attack. While progressive-relapsing MS is harder to manage than the other types of MS, treatments are available. Talk with your doctor or specialist to learn more about existing medications and recent scientific advances.


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