Answers to Common Neuromuscular Health Questions

Premier Health providers answer frequently asked questions about neuromuscular health.

Are there different types of MS?

This is a complicated question. Based on pathology studies of the lesions, we think there are probably four distinct types of MS, but for the most part we treat it as one disease. In clinical terms, though, there are different patterns of disease progression. 

The most common pattern is relapsing-remitting MS, with 85 percent of patients having this pattern at the beginning of the disease. As patients age, their immune systems also age, and the clinical presentation of the disease changes. The majority of patients will at some point stop having relapses, or the relapses will become much less prominent. Patients instead experience a steady decline in function. This is called secondary progressive MS. We also see patients who never present with clear events or "relapses," but who show a progressive worsening of function from the beginning. This is termed primary progressive MS. 

Patients with "progressive" forms of MS can still have mild relapses, and the delineation from one category to another is often fuzzy. The point at which someone who was "relapsing-remitting" becomes "secondary progressive" is often not clear. Primary progressive MS can occur with or without a tendency toward the inflammation seen on MRIs. The small percentage of patients who have primary progressive MS without inflammation tend to be the most resistant to treatment. Many MS specialists believe this may be a distinctly different disease than the other forms of MS.

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Source: Tracy Eicher, MD, Clinical Neuroscience Institute