The multiple types of multiple sclerosis

Multiple sclerosis (MS) means "many scars" and is so named because it causes lesions or scars to form throughout the brain and spinal cord. MS is believed to be an autoimmune disorder, a disease in which the immune system mistakes healthy cells for foreign substances it must destroy. MS causes damage to the nervous system, and as a result, nerves can’t communicate necessary information to perform normal functions.

What are the symptoms of MS?

Multiple sclerosis can cause a wide variety of neurological problems and symptoms. For many, the initial symptoms are vision problems, such as seeing double, blurred vision, or red-green color distortion. Other common symptoms of MS include:

• Fatigue
• Numbness
• Prickling or “pins and needles” sensation
• Pain
• Muscle weakness
• Problems with balance and coordination
• Problems with bladder control
• Sexual dysfunction
• Cognitive issues, such as problems with memory or reasoning
• Emotional changes
• Depression

Symptoms and the severity of symptoms will vary from person to person.

Who does MS affect?

Women are three times more likely to develop MS than men. Most often, diagnosis occurs between ages 20 and 40, though MS can affect people who are older or younger.

White people have a higher risk of MS than people of other races and ethnicities. The incidence of MS increases as you move away from the equator, leading researchers to speculate that exposure to sunlight and vitamin D levels may play a role in its development. Worldwide, it’s estimated that about 2.8 million people are living with MS.

What are the different forms of MS?

Multiple sclerosis has four common patterns, depending on how it occurs, how often it flares up, and how it progresses. Knowing what type of MS you have is important when deciding on treatment.

Relapsing-remitting MS (RRMS)

RRMS is the most common form of MS. Flare-ups or relapses occur and may last for days or months, after which there is complete or near-complete recovery. Incomplete recovery with no progression of disease is still considered to fall within this pattern of MS.

Secondary-progressive MS (SPMS)

Relapses and partial recoveries may occur with this type of MS, but neurologic function gets progressively worse with time. Many people with RRMS eventually develop this form of the disease. The disease steadily progresses with each attack.

Primary-progressive MS (PPMS)

This form of MS affects about 15 percent of people with the disease. Isolated attacks rarely occur. Instead, right from the onset, the disease progresses steadily, with no remission.

Clinically isolated syndrome (CIS)

CIS is characterized by one episode of neurological symptoms, and then a total or almost-total recovery. It’s often accompanied by brain lesions visible on MRI, which may indicate a higher risk of developing MS. Research suggests that receiving treatment early following CIS can slow MS onset.

How is MS treated?

There is no cure for MS, but there are many treatments available that can help manage attacks, slow disease progression, and improve quality of life. Among other factors, treatment will depend on the type of MS, symptoms, severity, and co-existing health conditions. Deciding on a treatment plan involves working closely with a healthcare provider.

Treatment may include:

• Corticosteroids. These drugs are prescribed to reduce inflammation and quiet the immune system in the days following an attack. They’re taken for only a few days and don’t affect MS in the long term.
• Disease-modifying therapies (DMTs). These are drugs that modify how the immune system works. They may reduce MS activity and slow disease progression.
• Other therapies. Additional medications may be prescribed to help cope with symptoms such as pain, fatigue, and bladder/bowel control problems.
• Physical therapy, occupational therapy, and cognitive rehabilitation. These are often used to help patients with the limitations and challenges that arise from MS.

You can also take steps at home to support MS treatment. Eating a healthy diet, avoiding damaging habits like smoking, and remaining physically active are an important part of maintaining overall health while living with MS.