Types Of MS

There are four types of multiple sclerosis you may have heard of — however, diagnosing a type can be difficult, and people with MS can change type as the years go by. These definitions also change as we learn more about MS. 

Here are the main types of MS, if you click on the links below you can read further information:

With up to 85% of people with MS diagnosed with this type of MS initially, it is by far the most common form. People with RRMS have temporary periods of time when new symptoms appear, and these periods are called relapses. There are ways of treating and managing the symptoms and it’s best to start treatment as soon as you are diagnosed. 

People with SPMS can experience symptoms that worsen over time without relapses and remissions. There are ways of managing the symptoms and slowing progression.

This type of MS is not as common (approximately 10-15%) . People with PPMS can experience worsening symptoms from the beginning (primary), with no remissions or relapses as symptoms progress. However, the future for those with PPMS is optimistic with new DMD Ocrelizumab to control the symptoms and changes in lifestyle to improve strength and mental and physical health. Other drugs for PPMS are currently being researched.

Old terms:

A rare form of MS, PRMS sees worsening symptoms from the beginning, with acute relapses but no remissions, with or without recovery.

'Benign' means 'something doesn't cause any harm' and was often used to describe relapsing remitting MS with very mild symptoms and long periods of time with no symptoms. This is thought to apply to 10-15% of people with MS but could be much lower in reality. Recent studies have found that although there may be minimal MS symptoms, 45% of people diagnosed with so-called benign MS have problems with cognitive function, like problem solving, word finding and information processing. 

There are now some new terms which refer to the disease activity

Non-active —  used to describe low levels of disease activity e.g MRI scan remained largely unchanged.

No evidence of disease activity (NEDA) —  A new goal emerging in multiple sclerosis treatment. The aim is for people with relapsing remitting MS (RRMS) to reach a point where they are having no relapses, no increase in disability (as measured by EDSS) and no new or active (enhancing) lesions on their MRI scans.

Active —  used to describe disease activity e.g.  recent new areas of damage showing on MRI 

Highly active (HA) —  used to describe disease activity, not any particular ‘type’ of MS. There is no agreed definition, but includes frequent relapses with incomplete recovery, and/or high increase in lesions on MRI, rapidly worsening disability.

Rapidly evolving severe relapsing remitting MS (RES) — two or more relapses in one year, with signs of increasing or new lesions between two consecutive MRI scans. This is mainly used to determine options for treatment with disease modifying therapies and balancing risks with . Often used in relation to drugs natalizumab and fingolimod. 

How are the different types of MS labelled?

Labelling the disease by type helps doctors characterize how it is affecting an individual, but no test can confirm a type.  MS, whatever the type, varies greatly in course and in symptoms from person to person.

People with MS can also change types: relapsing remitting MS can progress to secondary progressive MS, for others their MS may be reclassified as a pattern emerges in their symptoms over time, e.g. from RRMS to PPMS. 

Many people on the OMS Recovery Program are now living with stable, non-active MS and NEDA.

Unfortunately damage can still be occurring even when a person shows no obvious symptoms or increase in disability.  That’s why it is especially important to start lifestyle changes such as the 7-Step Recovery Program as early as possible, to stabilise the disease and to minimize damage during periods of apparent remission. Take an active approach to MS for a happier, healthier life! 

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