• relapsing-remitting MS;
• secondary-progressive MS;
• primary-progressive MS; and
• progressive-relapsing MS.

MS disease categories are useful in helping people with MS and their healthcare providers make appropriate treatment decisions.

Relapsing-Remitting MS (RRMS) is characterized by clearly defined acute attacks with either full recovery or some remaining or residual deficit after resolution of an acute episode. Disease symptoms do not appear to progress between relapses. Approximately 70% to 75% of people with MS are diagnosed initially with RRMS. There is partial or complete recovery between attacks. The course of RRMS can last up to 10 years with minimal accumulation of disability.

Secondary-Progressive MS (SPMS) is characterized by an initial relapsing-remitting disease course, followed by disease progression that includes occasional relapses and minor remissions and plateaus or periods of symptom free activity. Of the 70% to 75% of people who are initially diagnosed as having RRMS, approximately 50% will develop SPMS within 10 years. Ninety percent of these individuals will develop SPMS within 25 years of symptom onset. Patients who have adjusted and learned to cope with RRMS often face a difficult time seeing their disease progress and their symptoms worsen.

Primary-Progressive MS (PPMS) is characterized by progression of symptoms and disability from the onset, without plateaus or remissions or with occasional plateaus and temporary minor symptom improvement. 15% of people with MS are diagnosed with PPMS.

Progressive-Relapsing MS (PRMS) is the least common form of MS. The person with PRMS shows progression of symptoms from the onset of the disease but with distinct acute relapses with or without full recovery. Approximately 6% to 10% of people with MS have PRMS at the time of diagnosis.

Instant Feedback:
The majority of people with MS are initially diagnosed with the primary-progressive form of the disease.

Life Span: Data derived from a study of more than 1000 Canadian patients followed for a mean of 25 years indicates that the lives of MS patients are shortened about 5-7 years less than the uninsured general population. Suicide is one factor that contributed to the overall reduction in cohort lifespan.

Disability: Many tools have been developed to measure the progressive disability that often accompanies a diagnosis of MS. None of these tools can fully capture the physical and mental toll exacted by MS .

With that said, the EDSS (extended disability status score) has often been used in clinical studies to measure treatment outcomes. The EDSS was developed and refined by the eminent MS neurologist, Dr. John Kurtzke. The scale assists clinicians to assign a value to a patient's condition and follow the progression of MS over time. Critics of the EDSS point to the lack of cognitive and psychological assessment. We offer this version simply as a series of markers on the roadmap of MS progression.

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