Relapsing-Remitting Multiple Sclerosis: MS Types

There are 4 MS disease courses or types — the most common of which is relapsing-remitting multiple sclerosis.

These four courses of the disease were developed to both highlight differences in the progression of MS and identify the diagnostic criteria for the disease. There are two core elements to these different types: 1) the disease activity; and 2) the disease progression.

At any given moment in time, MS can be active or not active. It can also be stable or getting progressively worse. Depending on the status of the disease, MS can be defined using the four classifications developed by the International Advisory Committee on Clinical Trials of MS:

1. Clinically Isolated Syndrome (CIS)
2. Relapsing-Remitting MS (RRMS)
3. Primary Progressive MS (PPMS)
4. Secondary Progressive MS (SPMS)

Note: Progressive Relapsing MS (PRMS) was removed as a course when these classifications were redefined in 2013. PRMS would now be considered primary progressive MS.

What defines relapsing-remitting MS (RRMS)?

The majority of people who are diagnosed with MS will receive a diagnosis of relapsing-remitting MS. In fact, according to the National Multiple Sclerosis Society, “approximately 85% of people with MS are initially diagnosed with RRMS.”

In relapsing-remitting MS, there are flare-ups of the disease (relapses) and periods of remission when symptoms may or may not be present. In this way, some symptoms may become permanent. Relapses are acute periods where neurological functioning gets measurably worse.

Your MS treatment team, likely your neurologist, looks for activity using MRIs. They will be looking for new gadolinium-enhancing lesions or growing T2 lesions during a specific timeframe.

In addition to measuring the current relapsing-remitting MS activity, clinicians will measure your level of disability. This is used to track the status of MS.

Taken together, these measures help your treatment team evaluate the treatment plan and track the progression of the disease. Most people with RRMS will eventually transition to secondary progressive MS.

Symptoms of relapsing-remitting MS

Relapsing-remitting MS is generally marked by relapses that last at least 24-hours. During a relapse, the symptoms may get worse. Common symptoms of RRMS include one or more of the following:

• Sensitivity to heat
• Difficulty seeing or vision problems
• Fatigue
• Muscle weakness
• Numbness, particularly in the feet
• Memory problems
• Difficulty thinking clearly
• Depression
• Difficulty walking or balancing
• Urgently needing to urinate

Diagnosing relapsing-remitting MS

There are a variety of tests your physician may use to help diagnose RRMS. Your physician will ask you a series of questions about your symptoms; keep in mind that these questions are important in order to help rule out any other diseases, such as rheumatoid arthritis, that may cause similar symptoms.

Additionally, a clinician will also check your sense of balance, vision, and cognition. This helps in the diagnostic stage and can serve as a benchmark for future comparisons.

Finally, you will also need an MRI scan of your spine and brain. This is used to determine if there are areas of damage in your spinal cord and/or brain that may indicate you have MS.

The results of these tests, questions, symptoms, and observations are all used to determine the appropriate diagnosis.

Managing relapsing-remitting MS

NOTE: If you believe that you may have multiple sclerosis, you should bring up your concerns and begin the diagnostic process with a doctor. While there is not a cure for MS, clinicians can accurately identify the disease and develop a personalized treatment plan.

Your physician may prescribe medications to help ease muscle spasms, depression, and/or fatigue when battling RRMS. In addition to medications, the following lifestyle changes may help manage symptoms:

• Attending physical therapy
• Eating a diet low in saturated and trans fats
• Avoiding smoking
• Exercising a moderate amount
• Getting plenty of sleep
• Trying to avoid becoming overheated