How MS progresses

The first signs of MS generally appear between the ages of 20 and 40 with exception varying either way. The progress the disease takes after that varies, depending on the severity of the inflammation or how quickly the myelin breaks down.

You will notice when the central nervous system’s white matter is inflamed. This shows itself in the symptoms you get. A period like that is known as a ‘relapse’ or an ‘exacerbation’. When the inflammation dies down you will notice that the MS symptoms will lessen: this is known as ‘remission’ or ‘recovery’. The recovery usually does not mean a return to the way things were before the relapse as some symptoms may be left behind (residual symptoms)

Sometimes the symptoms may persist for several weeks In addition, there can also be a more gradual progression of the symptoms if demyelination is more in the foreground. If this is the case, you will notice a gradual loss of bodily functions, often over a period of years, without any real improvement in the meantime. The course the disease takes in any one individual enables us to make a rough distinction between different types of MS

Dividing MS into groups according to the progress of the disease is often a question of looking back over a longer period of time. And the fact that you have at the moment a particular form of the disease does not mean that we can predict how MS will progress in future.

Relapsing-remitting MS (RRMS)

This type shows clearly defined flare-ups or relapses with some amount of recovery in between. This is the most common form of MS at the time of initial diagnosis.

Secondary progressive MS (SPMS)

While technically a form of progressive MS, this type acts more like a relapsing form of MS in its early-to-mid stage, with relapses and remissions being quite common. But then a more continuous loss of physical and cognitive functions starts to take over, and flare-ups or relapses become less common. If left untreated, approximately 30% of people with RRMS will develop SPMS within 10 years of their initial diagnosis.

Primary progressive MS (PPMS)

In this type of multiple sclerosis, people experience a continuous worsening of their illness from the onset with no relapses or remissions. There are variations in rate of progression over time with occasional plateaus and temporary, minor improvements. PPMS is relatively rare.

Progressive Relapsing MS (PRMS)

A relatively rare type approximately 5% at onset. People with PRMS experience a steady worsening of the disease with clear, acute relapses with or without recovery. In contrast to RRMS, periods between relapses are characterised by continuing disease progression.