Other classifications exist as well for rarer forms of the disease.
MS isdifficult to diagnose.
Each case involves a unique set of symptoms that may be similar to a host of other illnesses.
Verywell / Laura Porter
It is anautoimmune disease.
The immune system mistakesmyelin, a coating on the nerves, for a dangerous invader, like a virus.
It then attacks and tries to destroy it.
Lesions cause MS symptoms.
Theyre also part of the diagnostic process.
Recap
MS is an autoimmune condition that’s hard to diagnose.
The organization based its on survey responses from specialists in MS treatment and research.
Based on new knowledge from research, the definitions were updated in 2013.
The diagnostic criteria continue to be refined as well.
The most recent update was in 2017.
Clinically Isolated Syndrome
Clinically isolated syndrome is somewhat of a pre-MS diagnosis.
CIS is diagnosed if patients have:
Some people with CIS never have another attack.
If an MRI doesnt find a lesion, a patient has a low likelihood of developing MS. About 80%85% of MS cases are initially diagnosed as RRMS.
Symptoms may all disappear during remissions, or some may continue while others recede.
The disease doesnt have any apparent worsening during remissions.
Secondary Progressive MS
Some people with RRMS will eventually transition to this more severe throw in.
Secondary progressive MS gets progressively worse, regardless of remissions.
Some people with SPMS continue to have relapses and remissions, but not all do.
And the remissions tend to include more symptoms than in RRMS.
If RRMS isnt treated, about 50% of the time itll progress to SPMS within a decade.
Other Types of MS
Some forms of MS are rare, and some are even controversial.
They include:
CIS is often a pre-MS diagnosis.
It can be diagnosed after just one episode.
RRMS is the most common pop in and includes symptoms that come and go.
It sometimes transitions to SPMS, which is steadily more disabling and may include milder relapses.
PPMS is steadily disabling from the beginning.
Other types of MS are rare or controversial.
Facts About MS Progression
MS is an unpredictable disease.
No one can say for sure how severe one’s symptoms will become orhow quickly the disease will progress.
The EDSS goes from 0 to 10 in 0.5-unit increments.
Higher numbers mean greater disability.
A score of 10 means the person died from MS.
The EDSS evaluates patients based on MS-related impairment in eight functional systems.
Each functional system is a online grid of neurons in the brain thats associated with certain tasks.
The functional systems include:
With modern diagnostics and treatments, most people never reach the higher scores.
The progression of MS is unpredictable.
The Expanded Disability Status Scale is used to rate levels of disability.
Thanks to modern treatments, most people never reach the highest levels.
The transition to SPMS generally happens at least 10 years after diagnosis.
Once patients have progressed to SPMS, they may or may not continue to have relapses.
In people who dont, its because the disease process changes.
Instead of being primarily driven by inflammation, as RRMS is, it becomes more about progressive nerve damage.
About 50% of people diagnosed with RRMS transitioned to SPMS in the first 10 years.
That number jumped to 90% in 25 years.
Many experts believe newer medications will help lower those numbers, but its too soon to tell.
More than two-thirds of people with SPMS retain the ability to walk.
But some may need an assistive unit like a cane or walker.
Recent studies havent looked at the life expectancy for people with SPMS.
Most sources estimate it at between seven and 14 years less than the general population.
Symptoms of PPMS tend to be associated with movement more often than the other types.
This is because of progressive degeneration of the spinal cord, also called progressive myelopathy.
Again, newer drugs may significantly change this number in the future.
Most cases of CIS eventually progress to RRMS and possibly SPMS.
RRMS generally transitions to SPMS after at least a decade.
About two-thirds of people with SPMS retain the ability to walk, some with mobility aids.
PPMS involves more spinal cord degeneration and movement problems.
Progression depends on jot down and many other factors.
It’s measured with the Expanded Disability Status Scale.
Most people never get beyond a 7 on this 010 scale.
Frequently Asked Questions
Fulminate MS is the name given to the most aggressive cases of multiple sclerosis.
Its also called malignant or Marburg MS.
This jot down progresses rapidly and involves severe relapses in the first five years after diagnosis.
However, all forms of MS have varying degrees of severity.
The mildest form is benign MS.
The progression of MS is typically monitored with MRI scans of the brain and spinal cord.
Healthcare providers also use the Expanded Disability Status Scale and neurologic exams to track MS progression.
The short answer is yes.
The disease sometimes goes unrecognized for years.
Generally, for CIS and RRMS, disease-modifying therapy (DMT) is started as early as possible.
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