Multiple Sclerosis Types
When media or the public refer to multiple sclerosis, they generally refer to the degenerative nerve disease with that name, or abbreviate it to MS. There are, however, four distinct types of MS, which have different progressions. When a patient is diagnosed with MS, however, they will generally be diagnosed with one of three specific types of MS. Which type a person has can shift over the course of their disease.
Relapsing-Remitting Multiple Sclerosis (RRMS)
RRMS is the most common course of multiple sclerosis to be diagnosed. It is defined by episodic neurological symptoms that are clearly defined; the disease relapses and goes into remission at seemingly random intervals; it may appear in one area, disappear, and recur in a completely different area of the body or mind. During remission periods, patients may be asymptomatic, or some symptoms may remain.
RRMS is defined as active or not active and worsening or not worsening. Roughly 85% of multiple sclerosis diagnoses are of RRMS.
In SPMS, the patient often initially has relapsing and remitting symptoms. Over time, their level of functioning, even in periods of the remission of certain symptoms, becomes progressively worse. The relative worsening of neurological function is also referred to as “accumulation of disability.”
SPMS is defined as active or not active and with progression or without progression. Most patients initially diagnosed with RRMS will eventually move to an SPMS diagnosis.
Primary-Progressive MS (PPMS)
In SPMS, the patient initially has periods of remission. With PPMS, the patient begins to experience the accumulation of disability or worsening of neurologic function very early after their diagnosis. Those early relapses and remissions do not happen; the disease primarily progresses. There may be periods where the disease is stable – function remains the same but does not generally improve – without worsening.
PPMS is defined as active or not active, with progression or without progression. 15% of patients diagnosed with MS have a PPMS diagnosis.
Multiple Sclerosis History
The history of multiple sclerosis as a defined medical condition dates back to 1868; when Jean-Martin Charcot observed a case of tremors in a young woman. Although the “father of neurology” was the first doctor to describe the plagues on the brain that are the clear scars of MS, medical researchers can identify what appear to be clear cases of MS back through recorded history.
Although Charcot could clearly identify some of the characteristic symptoms of MS in his patient – slurred speech, abnormal eye movements, and the specific type of tremor – medical science was not sufficiently advanced for him to begin to speculate about a cause. The immune system hadn’t been identified yet.
In 1906, when Dr. Camillo Golgi and Dr. Santiago Ramon y Cajal won the Nobel Prize in Medicine for their ability to enhance nerve cells under a microscope, the possibilities for MS research increased dramatically. In 1916, researchers could see the inflammation of blood vessels within the brain, as well as the myelin damage. By 1919, spinal fluid abnormalities were noted, and by 1925, electrical recordings of nerve impulses laid the groundwork for understanding how the nervous system works.
A number of different probable causes for MS have been suggested over the disease’s history, from the classic “bad humours” to a virus, to a toxin or poison that damaged the nerves and their sheathes, to problems with circulation. It was after the Second World War that the National Multiple Sclerosis Society was formed to advance the cause of research and treatment for MS. Multiple researchers around the world were awarded grants to study the progress of MS. Advancements, including the beginnings of an understanding of how autoimmune diseases function, began to shed light on the disease’s progression.
MS is one of the most common nervous system diseases. Doctors know that it is more likely to affect women, young people, and those who live in northern latitudes. They know a great deal about how the disease causes its symptoms, as well as some genetic factors that appear to contribute to a vulnerability to the myelin damage that is characteristic of MS. Researchers have not been able to identify, however, an ultimate trigger that causes the immune system to attack the body in this distinctive way. With rapid advancements in the treatment of the disease in the last two decades, however, researchers hope they are drawing closer to an answer.