The course of multiple sclerosis varies. It often takes years before a doctor can be certain of an MS diagnosis and have some idea of how the disease will progress.
MS takes four courses:
- Relapsing-remitting MS: characterized by unpredictable acute attacks, called "exacerbations," with worsening of symptoms followed by full, partial, or no recovery of some function. Recovery from an attack takes weeks, sometimes months. The disease does not worsen in the periods between the attacks.
- Primary-progressive MS: characterized by a gradual but steady progression of disability, without any obvious relapses and remissions. This form occurs in just 15% of all people with MS, but it is the most common type of MS in people who develop the disease after age 40.
- Secondary-progressive MS: initially begins with a relapsing-remitting course, but later evolves into progressive disease. The progressive part of the disease may begin shortly after the onset of MS, or it may occur years or decades later.
- Progressive-relapsing MS: This is the least common form of the disease and is characterized by a steady progression in disability with acute attacks that may or may not be followed by some recovery.
Most people with MS are diagnosed between the ages of 20 and 40, but the unpredictable physical and emotional effects of the disease continue throughout the person's life.
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