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Multiple Sclerosis – How Doctors Classify Different Types of MS

More and more people are become disabled because of Multiple Sclerosis – MS.  In 2013, the International Advisory Committee on Clinical Trials of MS in 2013, adopted new Disease-Course Descriptions (what used to be called “types of MS”) based on advances in the understanding of the disease process in MS and in MRI technology.  For those who suffer from Multiple Sclerosis disability, it is helpful to understand the new Disease-Course Descriptions to both manage their MS, and to understand how and why MS can be disabling.

Chart showing types of Multiple Sclerosis

Changes in Multiple Sclerosis Disease-Course (or “Type”) Descriptions. Source: National Multiple Sclerosis Society

Someone who suffers from Multiple Sclerosis has one of four different types of Disease-Courses of MS, as follows:

Clinically Isolated Syndrome (CIS)

When a person first experiences neurologic symptoms caused by inflammation and demyelination in the central nervous system, they are diagnosed with CIS. To qualify as CIS, the episode must last for at least 24 hours, but would not yet meet the criteria for a diagnosis of MS because people who experience a CIS may or may not go on to develop MS.If physicians obtain MRI (magnetic resonance imaging) studies which document lesions on a brain MRI that are similar to those seen in MS, a person diagnosed with CIS has a higher likelihood of a second episode of neurologic symptoms and a diagnosis of relapsing-remitting MS. If CIS is not accompanied by MS-like lesions on a brain MRI, the likelihood of developing MS is lower.

Relapsing-remitting MS (RRMS)

Roughly 85 percent of people suffer from MS have RRMS.  This type of MS is characterized by clearly defined attacks of new or increasing neurologic symptoms. These attacks – called relapses or exacerbations – are followed by periods of partial or complete recovery (called “remissions”). When someone is in remission, all of their symptoms may vanish or some symptoms may continue and become permanent.
A key indicator of RRMS is that the MS symptoms do not progress during the periods of remission. Physicians will further classify RRMS as “active” (with relapses and/or evidence of new MRI activity) or “not active.” Physicians will also assess whether the RRMS is “worsening” (a confirmed increase in disability over a specified period of time following a relapse) or “not worsening.”

Primary progressive MS (PPMS)

About 15 percent of MS sufferers have PPMS.  PPMS is marked by neurologic function (accumulation of disability) that worsens from the onset of symptoms, without early relapses or remissions. PPMS is described as “active” (an occasional relapse and/or evidence of new MRI activity) or “not active,” and as “with progression” (evidence of disease worsening on an objective measure of change over time, with or without relapse or new MRI activity) or “without progression.”

Click here to learn more about PPMS

Secondary progressive MS (SPMS)

The SPMS diagnosis comes after an initial relapsing-remitting course of MS. The majority of people who suffer from RRMS will eventually transition to SPMS marked by a progressive worsening of neurologic function (accumulation of disability) over time.
Like PPMS, SPMS is described by doctors as either “active” (with relapses and/or evidence of new MRI activity) or “not active,” and as “with progression” (evidence of disease worsening on an objective measure of change over time, with or without relapse or new MRI activity) or “without progression.”  
If you suffer from MS or have an MS disability claim, call (866) 282-5260 to schedule a free consultation with one of our disability insurance attorneys to discuss your rights.  
 
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