It seems that no two people experience MS in quite the same way.
There is good news, though.
When itsdiagnosed earlyand theres not a huge delay, most patients do very well.
The types of MS are all a little different, but you can still live a full, active life.
MS is an immune-mediated disorder, which means your own immune system mistakenly attacks healthy tissue.
But why does MS vary so much from person to person?
First, its important to understand what demyelination means.
To explaindemyelination, we first need to talk about what myelin is and what it does.
National Library of Medicine.
Nerve cells carry messages throughout the body so you might see, move, and think with little effort.
For example, you want to walk across the room and barely give it a thoughtyou just do it.
Inflammation due to MS can damage myelin, a process known as demyelination.
MS is the most common demyelinating disease, according to theMayo Clinic.
At first, the body can repair minor damage, a process called remyelination.
But over time some nerve cells can die, resulting in permanent damage.
Symptoms vary based on where the damage occurs.
What are the different types of MS?
Heres what to potentially expect:
How is MS actually diagnosed?
So, youve had some strange symptoms that you think could be attributed to MS. What happens next?
The first thing that will likely happen is your doctor will order a few tests.
The diagnostic criteria have evolved over the years along with medical advances.
How does MS typically progress?
MS progression is different for everybody and difficult to predict.
Dr. Harrington says its even possible that your MS wont progress.
Even so, you might transition from CIS to RRMS and from RRMS to SPMS.
People with PPMS can also experience disease progression.
What are the stages of MS?
The dividing lines between these stages arent obvious and may only become apparent in retrospect.
If you have CIS, there is a chance that youll go on to have RRMS.
But according to Dr. Sy, CIS isnt really a different stage.
Its a place where were not yet certain about the diagnosis.
But at some point, it might meet the criteria of RRMS.
SPMS is a different stage of MS defined mostly by age and disease duration, Dr. Sy adds.
And PPMS is its own entity in many ways.
In PPMS, disability progresses slowly over time without a prior relapsing-remitting history.
What is the Expanded Disability Status Scale (EDSS)?
Neurologists can use the EDSS to monitor your level of disability over time.
The scale ranges from 0 to 10 to represent degree of disability, according to theMultiple Sclerosis Trust.
So, if your score is higher than last time, it doesnt necessarily mean its permanent.
But it can still be useful in understanding the progression of disability due to MS over time.
What are the treatment options for the different types of MS?
Although theres no cure, there are lots oftreatments for MS, including disease-modifying therapies (DMTs).
These drugs are designed to reduce relapses, delay progression, and limit new disease activity.
Were doing a better job in controlling it, Dr. Harrington says.
Frequent UTIs or pneumonia could become a problem, Dr. Harrington says.
The future of MS treatment is in the details, Dr. Sy says.
Its the idea of precision medicine, but were still lacking in this, he says.
DMTs work to stop disease progression, but they dont treat symptoms.
Dont worry, though, experts are on top of that too.
These medications keep most people stable for many years.
Thats why CIS and RIS are important.
If they really are early signs, you’re free to start MS treatment.
And, hopefully, being aggressive early on reduces conversions from RRMS to SPMS.
For people with progressive types of MS, Harrington suggestsclinical trialsas a good option.
You may benefit from treatments that arent mainstream yet.
(Its just like knowing the cool band before they were famous, but for science.)
If youre not sure where to start, talk with your doctor.
They might actually be involved in a clinical trial or know of one that would be a good fit.
Its not a death sentence, nor does it mean severe disabilities are in your future.
We have therapies to offer patients who are doing great after 20 or 30 years.
It certainly varies, but theres a lot more hope and new options and exciting research in the field.
