What is MS?
Multiple sclerosis (MS) is a chronic condition that causes nerve damage. The four main types of MS are:
- clinically isolated syndrome (CIS)
- relapsing-remitting MS (RRMS)
- primary-progressive MS (PPMS)
- secondary-progressive MS (SPMS)
Each type of MS leads to different prognoses, severity, and treatment methods. Keep reading to find out how PPMS differs from RRMS.
What is PPMS?
PPMS is one of the rarest types of MS, affecting about 10 percent of everyone diagnosed with the disease. While other MS types are characterized by acute attacks, called relapses, followed by periods of non-activity, called remission, PPMS causes gradually worsening symptoms.
PPMS can change over time. A period of living with this condition can be classified as:
- active with progression if there are worsening symptoms or new MRI activity or relapses
- active without progression if symptoms or MRI activity is present, but symptoms have not become more severe
- not active without progression if there are no symptoms or MRI activity and no increasing disability
- not active with progression if there are relapses or MRI activity, and the symptoms have become more severe
Who gets PPMS?
People tend to get diagnosed with PPMS in their 40s and 50s, while those diagnosed with RRMS tend to be in their 20s and 30s. Both genders are diagnosed with PPMS at the same rates, unlike with RRMS, which affects mostly women. People with PPMS tend to have a worse prognosis compared to those with RRMS.
What causes PPMS?
The causes of MS are unknown. The most common theory suggests that MS begins as an inflammatory process of the autoimmune system that causes damage to the myelin sheath. This is the protective covering that surrounds the nerves of the central nervous system.
Another theory is that it’s an immune response triggered by a viral infection. Later, nerve degeneration or damage occurs.
Some evidence suggests that primary-progressive MS is part of the clinical spectrum of MS and isn’t different from relapsing MS.
What is RRMS?
RRMS is the most common type of MS, affecting around 85 percent of all people diagnosed with MS. Most people are first diagnosed with RRMS. But that diagnosis typically changes after several decades to a more progressive course.
The name relapsing-remitting MS explains the course of the condition. It typically involves periods of acute relapses and periods of remissions. During relapses, new symptoms can present, or the same symptoms can flare up and become more severe. During remissions, people can have fewer symptoms, or the symptoms can be less severe for weeks, months, or years. Some RRMS symptoms can become permanent. These are called residual symptoms.
RRMS is classified as:
- active when there are relapses or lesions found on an MRI
- not active when there are no relapses or MRI activity
- worsening when symptoms get progressively more severe after a relapse
- not worsening when symptoms do not get progressively more severe after a relapse
What is the outlook for RRMS?
This condition affects each person differently. Some people may live a relatively healthy life with only rare relapses that don’t cause worsening disability. Others may have frequent attacks with progressive symptoms that eventually lead to severe disability.
What are RRMS treatments?
There are several FDA-approved medications available for RRMS. These medications tend to reduce the occurrence of relapses and the development of new lesions. They also slow the progression of RRMS.
Understanding what to expect in each stage of MS can help people get a better idea of how the disease is progressing so they can seek the best treatment.
Treatment involves managing symptoms and slowing down the progression of the disease. Ongoing scientific research aims to find new ways to treat MS.
Additionally, eating a healthful diet, reducing stress levels, and exercising regularly may all help support an MS treatment plan.
By working directly with a doctor, many people can find a treatment plan that makes it easier to manage their symptoms and track the progress of the disease.
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