Different types of MS

As I have previously mentioned, I have Relapsing Remitting MS (RRMS) as did the two TV characters I mentioned as well, Dr Richard McCaig from Casualty and President Bartlett from West Wing. However, unfortunately this is not the only type of MS, there are four other types:

• Primary Progressive MS (PPMS)
• Secondary Progressive (SPMS)
• Progressive Relapsing (PRMS)
• Benign MS 

The course of MS is unpredictable and every individual will experience a different combination of symptoms. Again it’s important to remember that no two individuals with MS are the same in symptoms and the way their individual bodies deal with the illness.

Another important thing it to remember, never to compare yourself with others or let other people compare you with their friends/family who have MS.  Because while others may be severely debilitated, others may feel and seem health for many years following diagnosis.

Relapsing-remitting MS

In RRMS, there are unpredictable exacerbations or attacks (relapses) during which new symptoms appear or existing symptoms become more severe. This can last for varying periods (days or months) and there is partial or total recovery (remission). The disease maybe inactive for months or years. About 85% of people are initially diagnosed with relapsing-remitting MS.

Primary progressive MS

Approximately 10% of individuals are diagnosed with this form of MS, which is characterised by a lack of distinct attacks, but with slow onset and steadily worsening symptoms. There is an accumulation of disability which may level off at some point or continue over months and years.

Secondary Progressive MS

For most individuals who initially have relapsing-remitting MS, there is the development of progressive disability later in the course of the disease often with superimposed relapses and no definite periods of remission.

Progressive relapsing MS

This is the least common subtype (approximately 5%). Individuals show a steady neurologic decline with a clear superimposition of attacks. There may or may not be some form of recovery following these relapses, but the disease continues to progress without remissions.

Benign MS

Some people live with MS for many years without accumulating disability. This group has so-called benign MS. It is the mildest form of MS that is clinically apparent. People with benign MS have a minimal amount of physical disability after ten years or more of the disease. Early identification of benign MS is important in deciding who should or should not take lifelong disease-modifying treatments.

However, benign MS cannot be diagnosed at the onset of the disease but only becomes clear over time. Moreover, long-term follow-up has found that many people with benign MS do go on to develop progressive disease, and therefore labelling someone as having benign MS too early in the disease course may be misleading.