WHAT IS MS? Multiple Sclerosis
(MS) is the most common disabling
neurological condition affecting young
adults. Around 85,000 people in the UK have
MS. |
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Relapsing-Remitting MS (RRMS) is the most common form of the disease. It is characterized by clearly defined acute attacks with full recovery (1a) or with residual deficit upon recovery (1b). Periods between disease relapses are characterized by a lack of disease progression. Approximately 85% of people with MS begin with a relapsing-remitting course. Figure 1a Figure 1b
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Primary Progressive MS (PPMS) PPMS is characterized by progression of disability from onset, without plateaus or remissions (2a) or with occasional plateaus and temporary minor improvements (2b). A person with PPMS, by definition, does not experience acute attacks. Of people with MS are diagnosed, only 10% have PPMS. In addition, the diagnostic criteria for PPMS are less secure than those for RRMS so that often the diagnosis is only made long after the onset of neurological symptoms and at a time when the person is already living with significant disability. Figure 2a Figure 2b
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Secondary-Progressive MS (SPMS) SPMS begins with an initial relapsing-remitting disease course, followed by progression of disability (3a) that may include occasional relapses and minor remissions and plateaus (3b). Typically, secondary-progressive disease is characterized by: less recovery following attacks, persistently worsening functioning during and between attacks, and/or fewer and fewer attacks (or none at all) accompanied by progressive disability. According to some natural history studies, of the 85% who start with relapsing-remitting disease, more than 50% will develop SPMS within 10 years; 90% within 25 years. More recent natural history studies (perhaps because of the use of MRI to assist in the diagnosis) suggest a more benign outlook that these numbers suggest. Nevertheless, many patients with RRMS do develop SPMS ultimately. Figure 3a Figure 3b
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Progressive-Relapsing MS (PRMS) PRMS, which is the least common disease course, shows progression of disability from onset but with clear acute relapses, with (4a) or without (4b) full recovery. Approximately 5% of people with MS appear to have PRMS at diagnosis. Not infrequently a patient may be initially diagnosed as having PPMS and then will experience an acute attack, thereby establishing the diagnosis of PRMS. Figure 4a Figure 4b
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Benign MS If you have a small number of relapses followed by a complete
recovery, you may be described as having benign MS. It is only
possible to make a diagnosis of benign MS once you have
experienced little or no disability for a period of 10 to 15
years. However, a diagnosis of benign MS does not guarantee that
you will be free of problems; a relapse may occasionally occur
after many years in which your MS has been inactive. |
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Do we know the cause of MS? |
MS was first recognised over 130 years ago. In spite of this, we still do not fully understand the cause of MS. There has been a great deal of research on what actually triggers MS and a number of theories have been proposed over the years. The theory that is widely held now is that MS is an autoimmune disease. That's where the body's immune system, which should in theory only attack invading germs, turns on the body's own tissues. Other autoimmune conditions include rheumatoid arthritis, where the lining of joints become inflamed, and Crohn's Disease which affects the wall of the intestines. In the case of MS, the immune system attacks the nerve coverings in the central nervous system, known as myelin. The reason for this reaction is unknown but it is thought that the genetic make up of some people means that MS can be triggered by an infectious agent or agents The physical damage caused by MS only happens in the brain or spinal cord. However, as these organs control the functions of the whole body, symptoms can affect many different areas. How MS affects an individual depends on where damage occurs in the central nervous system and which nerve messages are interrupted or blocked. As well as the variety of symptoms, the severity and duration will also vary considerably from person to person |
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