The Forms of MS
MS is frequently characterised by distinct attacks (also called relapses, episodes, exacerbations or flares). These attacks are when new disease symptoms arise and last for more than 24 hours, or when previous disease symptoms worsen distinctly after having not occurred for at least one month.
Relapsing-remitting MS course
If the person with MS experiences partial or total recovery (remission) after attacks (relapse), then this is called a relapsing-remitting course of the disease. Frequently the patient can live normally, free of symptoms, between attacks.
Secondary-progressive MS course
Secondary-progressive MS occurs when the degree of disability persists and/or worsens between attacks.
Further relapses may or may not still occur. 30-50% of MS patients who initially have the relapsing-remitting form develop secondary-progressive MS within 10 years 1
Primary-progressive MS course
More uncommon is the primary-progressive form of MS. Here the disability and symptoms worsen continuously right from the start, without attacks and without interim remission of impairment.
Benign MS course
Independent of this classification is a so-called benign MS course when the patient lives without essential constraints in everyday life for more then 15 years after being diagnosed with MS. This form of MS does not worsen with time after initially one or two attacks with complete recovery and no permanent disability is experienced. Benign MS can only be identified when there is minimal disability 10 to 15 years after onset and initially would have been categorised as relapsing-remitting MS. Benign MS tends to be associated with less severe symptoms at onset, for example, sensory. The exact number of patients with benign MS is difficult to determine. Autopsy studies have shown approximately 20% of clinically diagnosed MS cases are benign.2 Other authors claim that up to 20-30% have a relatively benign form of MS and are minimal affected 10 and 15 years or more.3
References:
1 Gold R & Rieckmann P. Pathogenese und Therapie der Multiplen Sklerose. Uni-Med Verlag, Bremen, 2000, 109 p.
2. Kesselring J. Multiple Sklerose. Kohlhammer, Stuttgart, 1993, 242 p.
3. Hawkins CP & Wolinsky JS. Principles of Treatments in Multiple Sclerosis. Butterworth-Heinemann, Oxford, 2000, 324
