WHAT TYPES OF M.S. ARE KNOWN ?



Multiple sclerosis is a multifactorial disease and there are immunological subtypes.
The medical profession actually doesn't know how many subtypes there are.
THERE IS NO CONSENSUS AMONG THE NEUROLOGISTS

MULTIPLE SCLEROSIS WHAT IS THE PROGRESSION?

MULTIPLE SCLEROSIS Return to M.S. INDEX

HEALTH OPINIONS Return to HEALTH OPINIONS INDEX

DIRECTORY  Return to the NAVIGATION HUB for these sites.

(BMS) Benign MS—(20% of RRMS cases) Not everyone with MS will develop a more progressive form of the disease. In 10 percent to 15 percent of patients, symptoms are mild to moderate, don't worsen and don’t lead to permanent disability. Benign MS Patients stay relatively unimpaired for many years after an initial attack.  Approximately 20 per cent of patients have this form of disease with no permanent disability.  The most common symptom is sensory (33%) and Optic Neurtis (33%).  The younger the Dx usually indicates a more favorable course.  However Canadian research in 2007 suggests it maybe silently progressing and pop up in 10, 20 even 30 years and progress from that point in time..
 

(RRMS) Relapsing-Remitting MS.—(85% of total cases) This is the usual pattern of disease in the first 20 years experienced by around  85 per cent of patients. They experience periodic attacks associated with some degree of impairment which subsequently resolves to a large degree if not completely.  Around 25–35 per cent of patients have this pattern at any one time.  About 85 percent of  people with MS begin with this form, and more than half have this form of the disease at any one time. It is characterized by one or two flare-ups every 1 to 3 years, followed by periods of remission.  Such flare-ups, which may include any of the symptoms of MS alone or in combination, typically appear suddenly, last a few weeks or months, and then gradually disappear. Symptoms may worsen with each  recurrence.

Most cases of MS start with a relapsing-remitting (RR) character that refers to short periods when new symptoms appear or old ones increase (attack or exacerbation) and long intervals when symptoms improve somewhat or stabilize (remissions). On average it would appear a typical case involves about one attack a year (Sibley, 1992). Notably it has been found through MRI studies that lesion-forming activity occurs even during remissions (Lai et al., 1996)

More than 50% of R/R MS progress to the second stage (secondary progressive phase). Secondary progressive — Usually after years of having relapsing-remitting MS, at least half will enter a stage of continuous deterioration.  Sudden relapses may still continue to occur.

CSF profiles and CSF analysis differ between RRMS and SPMS, it’s not 100% accurate but very impressive.

(SPMS) SECONDARY PROGRESSIVE MS—This form of the disease represents a continuum with relapsing–remitting MS and is marked by fewer remissions occurring after attacks and accumulating disability between relapses. An estimated 40 per cent of MS patients are in this category. Cerebrospinal fluid can usually differentiate between RRMS and SPMS.

(TPMS) TRANSITIONAL PROGRESSIVE MS  is a progressive course beginning after an isolated bout.  TPMS is very similar to SPMS but is closer to PPMS.  TPMS is usually assigned to SPMS or PPMS depending on the neuro (neurologist) involved.

Some researchers believe that PPMS & PRMS differs immunologically from RRMS  &  SPMS

(PPMS) PRIMARY PROGRESSIVE  or NEUROMYELITUS OPTICA (Devic’s) (10% of cases)

Primary progressive — From the first appearance of symptoms, neurological function deteriorates without periods of remission. About 10 percent to 15 percent of patients begin with this disease pattern.

This is characterized by a gradual, insidious and progressive deterioration with disability developing from the onset of disease without remissions.  PPMS generally has onset at a later age (40yrs), has a lower female preponderance and is predominantly motor onset compared with other sub-groups of MS.  The levels of impairment, disability and handicap are high and visual loss is rare (3.6%).

Research in Norway suggest PRMS is a very different disease than RRMS-SPMS

(PRMS) PROGRESSIVE RELAPSING — This is primary progressive MS with the addition of sudden episodes of new symptoms or worsened existing ones. This form is quite rare, accounting for less than 5 percent of cases.

CPMS is likely a different disease than the other types of MS

(CPMS) CHRONIC PROGRESSIVE (20% of cases) – There are no clear relapses and remissions, only gradual deterioration.  30% of those diagnosed with chronic progressive MS stabilize after two years.

There are interferon differences between CPMS and ASMS
 

(AS) ACCUTE SCLEROSIS MS, rapid course, death in months, severe axonal loss.

The Mayo Clinic does not presently list CPMS, ASMA or TPMS as differing types of MS. (January 1999)  ASMs is often confused with ADEM = Acute Disseminated Encephalomyelitis.
 
 

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