The Types of Multiple Sclerosis

How Your MS Type Affects Treatment

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To predict how severe the symptoms of multiple sclerosis (MS) is likely to be for a patient, and whether a certain treatment will work, doctors have identified four types of MS.  

These identified types (or sometimes referred to as phenotypes) explain the course of your disease and are an important part of the diagnosis process.

The Types of Multiple Sclerosis

Depending on the symptoms, and the length and duration of relapses (also called “flares,” “exacerbations” or “attacks”) and remissions, your doctor will assign a disease type to your condition.

Although each person living with MS experiences the illness differently, and each type may have a mild, moderate or severe course and even change types over time, being aware of which type your MS falls into can help you and your doctor to plan your course of treatment and manage your care.

Relapsing-Remitting MS (RRMS)

This type of MS is marked by a series of relapses (periods when symptoms get worse) and remissions (periods when symptoms are better). The course is a back-and-forth switch between a worsening and an improving of symptoms.

During the relapse phase, a person will notice a loss of function and often develop new symptoms. During the remission period, these symptoms fully or partially disappear. Corticosteroids are often used to shorten the duration of relapses. 

Relapsing-remitting MS is the most common type of MS, representing 85percent of new diagnoses.

Primary Progressive MS (PPMS)

In this type of MS, people experience a slow but steady worsening of symptoms. Generally, people gradually become worse over time, though the rate of worsening varies greatly among people. About 10 percent of MS is primary progressive.

Secondary Progressive MS (SPMS)

People with secondary progressive MS were originally diagnosed with relapsing-remitting MS. These people have stopped having periods of remission and experience a slow but steady worsening of symptoms. This category varies greatly for each individual, though symptoms usually steadily worsen over time.

About 50 percent of people with relapsing-remitting MS developed secondary progressive MS within ten years. However, this was before the widespread use of disease-modifying medications. Researchers are still waiting to learn the effects of these medications on the progression of MS.

Progressive-Relapsing MS (PRMS)

People with progressive-relapsing MS have a steady worsening of symptoms along with exacerbations. A steady worsening of symptoms without the periods of remission found in relapsing-remitting MS. About 5 percent of all people with MS have progressive-relapsing MS.

Other Descriptions Associated With MS

In addition to the types mentioned, there may also be subtypes of MS that your doctor may categorize your condition under. For example, some people with SPMS still have occasional relapses, and this is termed "active" disease. When there are no more relapses, the disease is called "not active."

Also, before you are even diagnosed with MS, there is another type, called Clinically Isolated Syndrome (CIS).

CIS refers to the occurrence of the first episode of neurological symptoms due to inflammation in the central nervous system and demyelination (damage to the protective covering that surrounds nerve fibers in the brain and spinal cord).  For CIS, the following must take place:

  • The episode must last for more than 24 hours
  • Have characteristics of multiple sclerosis but not yet meet the criteria for a diagnosis of MS 
  • People who experience a CIS may or may not go on to develop MS
  • Individuals with CIS who are considered at high risk for developing MS may be treated with an FDA-approved disease-modifying therapy as early treatment has been shown to delay the onset of MS.

A Word From Verywell

The type of MS you have is important to know because it does affect how your doctor treats you. That being said, it is probably best to not get too bogged down in the nuances of one type versus another. In the end, MS is a variable illness, so even two people with the same type of MS likely have quite unique symptoms and experiences with their disease.

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Article Sources

  • Lublin, FD et al. Defining the Clinical Course of Multiple Sclerosis: The 2013 Revisions. Neurology 2014 Jul 15; 83(3): 278–286.
  • National Multiple Sclerosis Society. Types of MS.