I’ve been reading information that says there are four ‘types’ of MS (Relapsing/Remitting MS, Secondary Progressive MS, Primary Progressive MS, and Progressive Relapsing MS), however are there also two ‘forms’ of MS (Relapsing and Progressive)?
All the different terminology is confusing, and I would be grateful for some clarification.
The terminology can indeed be confusing, both for patients and health practitioners alike! Let’s start with what you have referred to as the “forms” of MS. Relapsing MS is when someone has relapsed, defined as, “An episode of new or worsening neurological dysfunction, lasting at least 24 hours and in the absence of infection or fever with complete or partial recovery.” Relapses are noteworthy by their defined onset, occurring over hours or days, after which they tend to level off and usually improve to some extent. Progression occurs more gradually and sometimes insidiously without a definite onset and worsening can occur in between relapses. People may notice their walking is worse or they feel off balance, but cannot always say that this worsened suddenly or within a certain time frame.
As for the different types of MS:
- Relapsing-remitting MS: Relapsing-remitting MS occurs in individuals who have relapses with complete or partial remission. In between relapse there may be improvement, but not gradual, progressive worsening.
- Secondary-progressive MS: In secondary-progressive types of MS there is a gradual worsening over time and there may or may not be relapses.
- Primary-progressive MS: In primary-progressive MS there are no relapses, just slow development of neurological problems such as leg weakness or fatigue, sometimes with some periods of stability, but no improvement.
- Progressive-relapsing MS: The profile of progressive-relapsing MS is to have progression as an initial feature of the disease, with relapses at a later stage in the illness.
Distinguishing the different types of MS is not always easy, even for an experienced MS health professional, but over time a pattern of the disease course may become apparent which helps to plan treatment options and to provide guidance for individuals and their families as to what they can expect in their future with MS.