Patterns of MS

a) Clinically Isolated Syndrome (CIS)

CIS is the first episode caused by inflammation and demyelination in CNS. This episode must last for at least 24 hours. People who develop CIS may or may not go on to develop MS.

When CIS is accompanied by brain MRI lesions characteristic of MS, the person has higher likelihood of a second episode of neurological symptoms and diagnosis of relapsing – remitting MS.

b) Relapsing Remitting MS (RRMS)

The most common disease course, characterised by clearly defined attacks (also called relapses/ exacerbations) followed by periods of partial or complete recovery (remissions).

During remissions all symptoms may disappear or some symptoms may continue and become permanent but there is no apparent progression of disease.

85% of MS patients are initially diagnosed with RRMS.

c) Secondary Progressive MS (SPMS)

Most patients with an initial relapsing – remitting course have an eventual transition to secondary progressive course of neurological worsening and accumulation of disability over time.

d) Primary Progressive MS (PPMS)

PPMS is characterized by worsening neurological function from onset of symptoms, without relapse or remissions.  15 % of MS patients are diagnosed with PPMS.

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