Multiple Sclerosis (cont.)
What are the types of multiple sclerosis?
There are different clinical manifestations of multiple sclerosis. During an attack, a patient experiences a sudden deterioration in normal physical abilities that may range from mild to severe. This attack, sometimes referred to as an
exacerbation of multiple sclerosis, typically lasts more than 24 hours and generally more than a few weeks (rarely more than
four weeks).
About 65-80% of patients begin with Relapsing-Remitting (RR) MS,
the most common type. In this type, patients experience a series of attacks
followed by complete or partial disappearance of the symptoms (remission) until
another attack occurs (relapse). It may be weeks to decades between relapses.
In Primary-Progressive (PP) MS, there is a continuous, gradual decline in a patient's physical abilities from the outset rather than relapses. About 10%-20% of patients begin with PP-MS.
Patients beginning with RR-MS can then enter a phase where relapses are rare but more disability accumulates, and are said to have the
Secondary-Progressive (SP) type of
multiple sclerosis. About 50% of RR-MS patients will develop SP-MS within 10 years. Progressive-Relapsing (PR) MS is a type of
multiple sclerosis characterized by a steady decline in abilities accompanied by sporadic attacks. There are cases of of
multiple sclerosis that are mild and can be recognized only retrospectively after many years and also rare cases of extremely rapid progression of
multiple sclerosis symptoms (sometimes fatal) known as malignant or fulminant (Marburg variant)
multiple sclerosis.
What are the symptoms of multiple sclerosis?
Symptoms of multiple sclerosis may be single or multiple and may range from mild to severe in intensity and short to long in duration. Complete or partial remission from symptoms occurs early in about 70% of
multiple sclerosis patients.
- Visual disturbances may be the first symptoms of multiple sclerosis, but they usually subside. A patient may notice blurred vision, red-green distortion (color desaturation), or sudden monocular blindness (blindness in one eye).
- Muscle weakness with or without difficulties with coordination and balance may occur early.
- Muscle spasms, fatigue, numbness, and prickling pain are common symptoms.
- There may be a loss of sensation, speech impediment (typically a problem articulating words), tremors, or dizziness.
Fifty-percent of patients experience mental changes such as:
- decreased concentration,
- attention deficits,
- some degree of memory loss,
- inability to perform sequential tasks, or
- impairment in judgment.
Other symptoms may include
- depression,
- manic depression,
- paranoia, or
- an uncontrollable urge to laugh and weep.
As the disease worsens, patients may experience sexual dysfunction or reduced bowel and bladder control. Heat appears to intensify
multiple sclerosis symptoms for about 60% of patients.
Pregnancy seems to reduce the number of attacks.
Next: How is multiple sclerosis diagnosed? »
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