What are the different types of Multiple Sclerosis?

 Multiple Sclerosis (MS) is a chronic inflammatory condition of the central nervous system. It is an autoimmune demyelinating disease, which means the immune system mistakenly attacks normal tissues — in this case, the myelin or protective covering around nerve fibers. This leaves scarred tissues or lesions in multiple areas, disrupting electrical impulses throughout the body. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.

MS can impair the brain, spinal cord, and optic nerves. It can lead to problems with vision, balance, muscle control, and other basic functions of the body. However, symptoms vary from person to person. Some people may have mild symptoms that do not warrant intense treatment, whereas others may have trouble going about daily tasks. Symptoms depend on what part of the central nervous system has been attacked.

Based on progression, four basic disease courses (also called types or phenotypes) have been defined by the International Advisory Committee on Clinical Trials of MS:

●     Clinically Isolated Syndrome

●     Relapsing-Remitting

●     Secondary Progressive

●     Primary Progressive

Clinically Isolated Syndrome

Clinically Isolated Syndrome (CIS) is generally the first episode of neurologic symptoms caused by inflammation and demyelination in the central nervous system. CIS is said to last for at least 24 hours and lesions are identified through an MRI scan. CIS alone does not qualify for a diagnosis of MS unless accompanied by lesions. Although CIS is an indication of the progression of the disease to the next stage, those affected may or may not go on to develop MS.

Relapsing-Remitting Multiple Sclerosis

Relapsing-Remitting Multiple Sclerosis (RRMS) is the most common type in the course of the disease. Approximately 85 percent of people with MS are initially diagnosed with RRMS. It is characterized by clearly defined episodes of new or worsening neurological symptoms. These new attacks are also called relapses or exacerbations. They are followed by periods of partial or complete recovery (remissions). During remissions, either all symptoms disappear or some continue and become permanent. However, there is no evident progression of the disease during the periods of remission. After many years, most people with RRMS go on to develop secondary progressive MS.

Secondary Progressive Multiple Sclerosis

Secondary Progressive Multiple Sclerosis (SPMS) follows an initial relapsing-remitting course before it reaches the point leading to progressive deterioration. Some people diagnosed with RRMS eventually transition to a secondary progressive course in which there is an incremental worsening of neurological function, resulting in disability accumulation over time.

Primary Progressive Multiple Sclerosis

Primary Progressive Multiple Sclerosis (PPMS) differs from SPMS in that the characteristic worsening of neurological functions, unlike the latter, begins right from the onset of symptoms without periods of remissions in between. About 15 percent of people with MS are diagnosed with PPMS.

Treatment for Multiple Sclerosis is based on a case-by-case comprehensive analysis. The main aim is to improve and maintain an individual’s functioning and work toward enabling active community participation. Various methods, viz. Stem Cell Therapy, physical therapy, occupational therapy, speech, and language therapy can be used in the treatment for Multiple Sclerosis, depending on the severity of the condition.

Stem Cell Therapy, using autologous mesenchymal stem cells from the patient’s bone marrow, has given a new ray of hope to those suffering from MS. Physiotherapists provide training in the use of adaptive tools and devices to simplify tasks and concentrate on strengthening the body to maintain function and movement. Occupational therapists help make necessary modifications at home and the workplace to ensure safety, accessibility, and convenience. Speech language pathologists use different treatment strategies for improving cognitive skills and enhancing patients’ ability to think, remember, and reason. On the whole, a regenerative rehabilitation program can significantly make life easy for persons with MS.