There are 4 main types of multiple sclerosis (MS), which differ based on how the disease has progressed. The treatment options and long-term outlook can depend on your MS type.
Multiple sclerosis (MS) is thought to be an inflammatory autoimmune disease affecting the central nervous system and peripheral nerves. It can be unpredictable and potentially disabling. But not all forms of MS are the same.
Each type is defined by how the disease has progressed throughout the body. The type of MS you have can help determine your treatment options and long-term outlook.
The 4 main types of MS are:
The types are defined by how much the disease has progressed.
Determining the type of MS you have can help you make treatment decisions. Understanding the types of MS can also help you know what to expect throughout the course of the disease.
CIS is a single episode of neurologic symptoms that lasts 24 hours or longer.
CIS symptoms cannot be connected to fever, infection, or other conditions. Rather, they result from inflammation or demyelination in your central nervous system.
You might have only one symptom (a monofocal episode) or several symptoms (a multifocal episode).
If you have CIS, you may never experience another episode. But this episode could instead be your first MS attack.
If an MRI detects brain lesions similar to those found in people with MS, there’s an
When undergoing testing for CIS, you might receive an MS diagnosis if an MRI detects older lesions in a different part of your central nervous system. That would mean you’ve had a previous attack, even if you were not aware of it.
A doctor might also diagnose MS if your cerebrospinal fluid contains oligoclonal bands.
RRMS is the most common type of the disease. According to the National Multiple Sclerosis Society, about 85% of people with MS have RRMS at the time of diagnosis.
With RRMS, you might experience periods of increased symptoms (relapses) followed by periods of partial or complete recovery (remission).
Common symptoms of RRMS include:
- fatigue
- numbness
- motor and muscle weakness
- vision changes
- spasticity (muscle stiffness)
- bowel issues
- bladder issues
- difficulty thinking
Disease activity in RRMS is usually marked by inflammation and new lesions on your brain, but you might develop new lesions without experiencing symptoms. It’s also possible for RRMS to be stable, with no new MRI activity or worsening symptoms.
RRMS is typically diagnosed earlier in the course of the disease. Most people who receive a diagnosis of RRMS are in their 20s and 30s.
Learn more about RRMS symptoms and treatments.
About 15% of people with MS receive an initial diagnosis of PPMS.
This type of MS progresses slowly yet steadily from its onset. It can involve periods of active disease and periods of remission.
However, even during remission, you may experience increasing disability. In essence, PPMS involves a fairly continuous progression of the disease.
You might experience minor, temporary improvements over time and occasional plateaus in the progression of symptoms.
The symptoms of PPMS can overlap with those of RRMS. But PPMS typically involves difficulty walking, worsening mobility, and increasing disability.
PPMS tends to involve less inflammation than RRMS. PPMS lesions are also more likely to appear on the spinal cord, whereas RRMS lesions occur more in the brain.
On average, PPMS is diagnosed 10 years later than RRMS. PPMS affects women and men equally.
SPMS is another progressive form of MS. It’s thought of as the second phase of RRMS. That’s because it initially follows the relapsing-remitting disease course, with symptom flare-ups followed by recovery periods.
Symptoms of SPMS can overlap with those of RRMS. But SPMS involves nerve damage or loss, leading to more steady disease progression.
With SMPS, the disability of MS does not disappear between cycles. Instead, this period of fluctuation is followed by a steady progression of the condition. If you have SPMS, you might experience minor remissions or plateaus in your symptoms, but this isn’t always the case.
Without treatment, 50% of people with RRMS go on to develop SPMS within a decade, and 90% develop SPMS within 25 years.
These statistics may improve due to newer disease-modifying therapies (DMTs), but more research is needed to fully understand how DMTs may affect MS progression in the long term.
A rare type known as fulminate MS is considered the most severe form of the disease. It’s a rapidly progressive form of MS involving severe relapses within 5 years of diagnosis.
Also known as malignant MS or Marburg MS, fulminate MS may require more aggressive treatment than other forms of the disease.
Learn more about Marburg MS.
Benign MS is considered the mildest form of the disease. It’s thought of as a type of RRMS marked by
The longer someone with benign MS remains in this state, the
Early MS can be challenging for doctors to diagnose. However, identifying MS early at the relapsing-remitting stage can help ensure prompt treatment and reduce your chances of developing more progressive forms of the disease.
Early, aggressive treatment may help slow or prevent the progression of MS.