Course of the Disease
People with MS will most likely experience one of four disease courses, each of which might be mild, moderate, or severe. Since no two people have exactly the same experience of MS, the disease
course may look very different from one person to another. And, it may
not always be clear to the physician—at least right away—which course a
person is experiencing.
Relapsing-Remitting MS (Click here for more info) People with this type of MS experience clearly defined attacks of worsening neurologic function. These attacks— which are called relapses, flare-ups, or exacerbations—are followed by partial or complete recovery periods (remissions), during which no disease progression occurs . Approximately 85% of people are initially diagnosed with relapsing-remitting MS.
Primary-Progressive MS (Click here for more info) This disease course is characterized by slowly worsening neurologic function from the beginning—with no distinct relapses or remissions. The rate of progression may vary over time, with occasional plateaus and temporary minor improvements. Approximately 10% of people are diagnosed with primary-progressive MS.
Secondary-Progressive MS (Click here for more info) Following an initial period of relapsing-remitting MS, many people develop a secondary-progressive disease course in which the disease worsens more steadily, with or without occasional flare-ups, minor recoveries (remissions), or plateaus. Before disease-modifying medications became available, approximately 50% of people with relapsing-remitting MS developed this form of the disease within 10 years. Long-term data are not yet available to determine if treatment significantly delays this transition.
Progressive-Relapsing MS (PRMS) (Click here for more info) In this relatively rare course of MS (5%), people experience steadily worsening disease from the beginning, but with clear attacks of worsening neurologic function along the way. They may or may not experience some recovery following these relapses, but the disease continues to progress without remissions.
(These figures are adapted from Fred D. Lublin, MD, and Stephen C. Reingold, PhD, Neurology, April 1996; 46: 907911).
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