Multiple Sclerosis Types

Did you know that more than 1 million people in the United States live with multiple sclerosis? Multiple Sclerosis (MS) is a chronic immune system disorder of the central nervous system and has a huge impact on your quality of life.

It occurs most frequently in people of Northern European descent, but anybody can get MS. There are four different multiple sclerosis types that can damage your central nervous system and affect mobility.

Keep reading to learn about the different types of multiple sclerosis and how they affect the human body.

Table of Contents

What Is Multiple Sclerosis?

Multiple Sclerosis (MS) is a disease that affects the brain and spinal cord in the central nervous system. With MS, the immune system starts to attack nerve fibers. It also attacks the fatty substance surrounding these nerve fibers called myelin sheathing.

Inflammation then alters and destroys the nerve cell process. This ultimately alters the electrical messages that go to the brain.

MS doesn’t follow a predictable course and affects each person differently. Some people are mildly affected and can still carry on daily activities, while others lose their ability to walk, write, and speak.

The four different types of multiple sclerosis include:

Clinically Isolated Syndrome

Clinically Isolated Syndrome (CIS) is one of the first episodes with inflammation of the central nervous system and damage to nerves.

To be considered CIS, the episode must last for 24 hours and resolve on its own. Symptoms include fatigue, weakness, and numbness.

If you experience CIS, it doesn’t always mean you’ll develop multiple sclerosis. But if brain lesions are seen during an MRI, it’s more likely you’ll experience further episodes that lead to an MS diagnosis.

Multiple sclerosis is diagnosed by an MRI of the brain and spine based on the following criteria:

Two CIS attacks lasting at least 24 hours, 30 days apart
Two CIS attacks and one lesion in the central nervous system
One attack and two lesions, or a new lesion found in a new scan

Other criteria include a CIS attack with one lesion or worsening symptoms and lesions over time.

Relapsing-Remitting Multiple Sclerosis

Relapsing-remitting multiple sclerosis (RRMS) is the most common type. At least 90% of people will experience this type in their disease course.

RRMS has neurological symptoms that flare up over a period of hours to days. Symptoms of RRMS include:

Fatigue and weakness
Tingling
Numbness
Unsteady gait
Blurred vision or loss of vision

Symptoms of RRMS often last for days to weeks, then disappear entirely or partially with treatment. People can remain symptom-free for weeks, months. or years and go into remission. Treatment is essential at this stage, as symptoms will gradually worsen over time without it.

Secondary-Progressive Multiple Sclerosis

Over time relapsing-remitting MS changes to the point where you don’t have noticeable remissions and relapses. At that point, it transitions to secondary-progressive MS (SPMS).

Everyone who develops SPMS begins the disease with the relapsing-remitting course. SPMS continues with symptoms worsening that does not ease up.

You can experience periods where symptoms are more stable, but the overall course of MS continues to worsen over time, even with treatment.

Primary-Progressive Multiple Sclerosis

Some people have a gradual worsening from their MS disease course called primary-progressive multiple sclerosis. In primary-progressive MS, there is a gradual change in walking and mobility over time.

There is a heaviness and stiffness in the lower limbs, and symptoms stay steady without a break or relapse of worsening symptoms.

Primary-progressive MS usually involves more spinal cord lesions and fewer brain lesions. Primary-progressive MS is also diagnosed with other criteria such as:

A brain lesion
Two or more lesions in the spinal cord
Immune system activity in the central nervous system

Multiple Sclerosis Treatment

There is no cure for multiple sclerosis. Treatment is focused on recovering from attacks, slowing the progression of the disease, and symptom management. Medications for MS attacks include:

Corticosteroids such as prednisone or intravenous steroids are given to reduce nerve inflammation and minimize symptoms.

Plasma exchange includes taking the liquid part of your blood called plasma and removing and separating it from your blood cells. These cells are then mixed with a protein solution called albumin and placed back into your body. Plasma exchange is mainly used if you have new or severe symptoms that haven’t responded to steroids.

Medications to Help With Disease Progression

Treatments for relapsing-remitting MS include oral and injectable medications such as:

Interferon-beta medications are the most common medications used and are injected into the muscle. These medications can reduce the severity and frequency of relapses. Side effects of these medications include flu-like symptoms. You’ll also need frequent blood tests to check your liver function.

Other medications include Copaxone and Glatopa, which help block your immune system from attacking your central nervous system. Daily oral medications such as Gilenya and Tecfidera help reduce relapse rates and symptoms.

Medications for Symptom Management

Medications to reduce symptoms include muscle relaxants like Gablofen or Zanaflex. These medications control muscle stiffness or spasms in the legs.

People also need medications like Provigil or Ritalin to help reduce MS-related fatigue and drowsiness. Many people also need to take medication for depression or anxiety.

Finally, you can take medications that increase walking speed and reduce pain. Other medications can help with sexual dysfunction, bladder control, and insomnia.

Other Treatments

It’s also essential to build muscle strength and endurance to ease symptoms of MS. Physical therapy teaches daily stretching and strengthening exercises, making it easier to perform everyday tasks.

Physical therapy combined with a mobility aid can help with leg weakness and problems with gait. Help is available, so don’t be afraid to Google and look for mobility scooters near me to see what devices can help you the most.