Health care professionals have identified several variances of multiple sclerosis.  In reality, these variances are not differing forms of the disease but severity and progression thereof.  Categorization is important as it is used as a marker of how severe the disease currently with a person and time involved in progression as well as what therapies might be used to assist in combating the disease.

Types of Multiple Sclerosis:

  • MS Types TableRelapsing-Remitting MS (RRMS)
  • Secondary-Progressive MS (SPMS)
  • Primary-Progressive MS (PPMS)
  • Progressive-Relapsing MS (PRMS)
  • Benign MS
  • Malignant or Fulminant MS

The most common form of Multiple Sclerosis is relapsing-remitting (RRMS).

Relapsing-Remitting MS (RRMS)

Relapsing-Remitting MS (RRMS) is the most common form of the disease.  It is estimated that 80% – 85% of people with Multiple Sclerosis have this form of the disease.  The disease often appears when a person is between the ages of 20 – 30 years of age but also may appear later in life.  For example, I was diagnosed at 44 years of age.

Relapsing-remitting multiple sclerosis is signified by disease activity resulting in damage to the Central Nervous System (CNS) followed by periods of time with seemingly no activity.

I recently attended a seminar where a neurologist stated that relapsing-remitting is an improper term for RRMS.  Remission as a term is often heard in cancer where the disease seems to have stopped.  Multiple sclerosis does not move into remission hence the term he stated should be relapsing-reoccurring might be more appropriate.

Attacks or exacerbation’s with RRMS can be quite severe or appear to be quite limited.  Symptoms of an attack can be quite variable from weakness to cognition or memory problems, vision loss or impacts, walking problems and more.  Some of the more common symptoms are listed below this section.

Myelin Attack Computer Imagery
Myelin Attack Computer Imagery

Relapsing-remitting MS often has a recovery period after an exacerbation.  The body begins to repair the impacted areas where myelin damage has occurred.  There are many studies that have taken place and are currently taking place in respect to re-myelination.  Some research suggests that too much damage cannot be repaired, others suggest that the time required for the body to naturally repair damaged areas takes longer than the frequency between attacks.  Stem cell therapy as well as other research to try speed the bodies natural processes are well underway.

Complete recovery from an attack may not and often does not occur and time between relapses all vary significantly from individual to individual as well.

RRMS seems to affect women more so than men with the statistical known ratio being nearly 3 to 1.

Statistically is has also been said that 50% of people who have relapsting-remitting MS will move on to the next stage of the disease called secondary progressive multiple sclerosis (SPMS). Time to progression to secondary progressive MS also varies, statistically it ranges from 10-15 years from onset of the disease.

Many disease modifying treatments or therapies (DMT’s) now exist for those afflicted with RRMS.

These therapies target slowing or attempting to stop progression of the disease.  The medications vary in how they attempt to slow progression and effectiveness of the medications vary from individual to individual.

Secondary Progressive MS (SPMS)

Secondary Progressive MS (SPMS) is the natural progression of relapsing-remitting MS.  Nominally it has been stated by health care professionals that SPMS usually begins in the 10th – 15th year of having lived with RRMS.  Secondary progressive multiple sclerosis is signified by a more steady rate of relapses and less recovery from damage caused by the disease. It is unclear as to why the disease becomes more activated but medical science has acquired some knowledge in this respect.
The older a person appears to be when first diagnosed the shorter the time before RRMS moves to SPMS appears statistically. Additionally, individuals who have little recovery from exacerbation’s in RRMS generally move towards SPMS sooner.

With some individuals treatments intended for relapsing-remitting MS may help however in many people seem to have no effect at all.  Most individuals will have problems using their bodies and acuity in ways they were accustomed to once entering into this phase of the disease.  SPMS is often accompanied by attacks to a person’s spinal cord resulting in physical disabilities.

Significant research is taking place in respect to secondary progressive MS and some promising medications are currently being explored.

Primary Progressive MS (PPMS)

MRI Image
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Primary Progressive MS (PPMS) has no well-defined symptoms of attacks.  From the onset of the disease, it gradually continues to get worse over time and there is little to no recovery.

About 10% of those diagnosed with MS have this form of the disease.  Further, the treatments that presently exist do not tend to be very effective with this form of the disease.

There are some facets of PPMS that make it different from the other types of the disease.  People with PPMS are usually older when they are diagnosed with an average age of 40-50 years of age.

Statistically, the numbers between men and women are equal whereas with other types of the disease women outnumber men.

Lastly, PPMS usually results in severe disability earlier than the common form of MS being Relapsing Remitting MS (RRMS).

For some time it was thought that there was little that could be done in trying to manage primary progressive multiple sclerosis.  There are some promising new therapies on the near horizon that have shown a positive result in helping manage PPMS.  While the efficacy of these new therapies is not as profound as the medications in relapsing-remitting MS for the first time there is real hope that real progress can be made with this type of MS.

Progressive Relapsing Multiple Sclerosis (PRMS)

Progressive Relapsing MS (PRMS) is the least of the common forms of the disease. Relapses or attacks happen at indeterminate rates and times however symptoms continue and get worse between these relapses. As with PPMS there is a fairly steady progression from the onset of the disease often with acute symptoms yet short times of sparse activity between flare-ups. This type of the disease is rather rare so medical science knows fairly little about it.  Perhaps 3% – 5% of those afflicted with MS have this form of the disease.  In ways it appears similar to PPMS yet has some facets that differ.Woman With MS

Benign Multiple Sclerosis

This form of MS is less common that the four types discussed above.  There are few attacks and little to no disability even after 20 years.

People with benign MS can live seemingly decades without serious symptoms, but many develop more severe symptoms over long periods of time.

Back in 2009, a study was conducted in respect to benign MS.  63 people diagnosed with benign MS showed that some 30% of them worsened over a five year period.  Strangely, the study also showed that males with benign MS were almost three times more likely to have worsening symptoms and progression than women.

As is the case with any form of multiple sclerosis the disease is subject to change and statistics make understanding Multiple Sclerosis demographics very variable.

Malignant or Fulminant Multiple Sclerosis

Symptoms of Fulminant MS are similar to those of Relapsing-Remitting Multiple Sclerosis (RRMS). The main difference between the two conditions is speed. Fulminant MS develops rapidly, while RRMS can develop over the course of many years.

Individuals may experience these symptoms quite suddenly and without much warning.  After the first onset of symptoms, patients generally, experience more relapse episodes and rapid deterioration of their neurological and physical abilities over a short period of time.