I was reading a post on another online group earlier today and realized I really needed this for clarity. Maybe you do too.
Robbie
Multiple sclerosis (MS) is a chronic disease that affects the brain and spinal cord. It is thought to be an autoimmune disease. This means that the body's immune system attacks its own healthy tissue. This attack causes inflammation and damage, which in turn disrupts the communication signals between the brain and the rest of the body. There are four main types of MS, and each affects the body differently. Understanding these types can help you know what to expect and how to manage the disease.
Clinically Isolated Syndrome (CIS)
CIS is often the first sign of multiple sclerosis. This is a single episode of neurological symptoms, and can affect one or more areas of the central nervous system. Symptoms are similar to an MS relapse. They can vary but commonly include problems with vision, bladder control, coordination, and balance. You might experience difficulty walking, speaking, or swallowing.
Patients with CIS tend to be between the ages of 20 and 40. There is no one test or symptom that can lead to a diagnosis. Because of this, doctors will perform several diagnostic tests, which may include an MRI of the brain and spinal cord. If an MRI shows lesions similar to those seen in MS, there is a higher chance of developing the disease. Not everyone who experiences CIS will develop MS. Early treatment of CIS can delay or prevent the onset of MS.
Relapsing-Remitting MS (RRMS)
RRMS is the most common form of multiple sclerosis. About 85% of people diagnosed with MS will have RRMS. It is characterized by episodes of new or worsening symptoms, called relapses, followed by periods of partial or complete recovery, called remissions. During relapses, you might experience new symptoms or a return of old symptoms. These can be fatigue, numbness, tingling, muscle weakness, and difficulty with coordination and balance. These symptoms can last for days, weeks, or even months before they improve.
Most people with RRMS are diagnosed in their 20s and 30s. It also affects women between 2-3 times more often than men. Like all forms of MS, diagnosing it can be tricky. Doctors will need to perform a number of tests, and take your medical history. Often doctors use MRIs, spinal taps, and blood tests to look for damage and rule out other conditions. There are a number of approved medications for treating this form of MS. Physical therapy can also help.
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Secondary Progressive MS (SPMS)
At first, SPMS follows the same course as RRMS. Over time however, the disease worsens with fewer relapses and a more steady progression of symptoms. Although you are now less likely to experience relapses, your disability will get steadily worse with SPMS. This results in worsening neurological function. The progression can be gradual or more sudden. Symptoms include walking difficulties, muscle stiffness, cognitive decline, and increased fatigue.
SPMS can develop in people who initially had RRMS, although the reason for this is not yet understood. Without treatment, about half of people with RRMS transition to SPMS within 10 to 20 years. Treatments and therapies can help manage the progression and symptoms. Regular exercise and a healthy diet can also help manage and even improve symptoms.
Primary Progressive MS (PPMS)
PPMS is far less common form of the disease. About 15% of people with MS have this type. PPMS is characterized by a steady worsening of symptoms from the beginning. You will not have relapses, and you will not have remissions. Symptoms may include muscle weakness, problems with balance and coordination, issues with cognition, vision problems, and tremors. Periods of stability or minor improvements can happen, but there are no significant remissions.
Like the other forms, there is no one test, symptom, or physical finding that can lead to a diagnosis of PPMS. Instead, doctors will rely on a number of tests to rule out other conditions. PPMS can take 2 to 3 years longer to diagnose than RRMS. Other forms of MS are typically treated with therapies that target inflammation. Those are not effective for treating PPMS, because the disease is characterized by nerve degeneration rather than inflammation. However, there are some medicines that can be prescribed. Typical treatment also includes symptom management, rehabilitation, and healthy living adjustments.
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Multiple sclerosis affects everyone differently! Having a clear understanding of the type you have can guide your treatment. Stay informed and work closely with your healthcare team.
What the Heck do those codes Mean? 
Progressive Forms of MS
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