What Are The Four Types of Multiple Sclerosis?

What is Multiple Sclerosis?

You must be familiar with Multiple Sclerosis, but here is a simple definition of this disease in case you are not.

Multiple sclerosis is a disease in which our body’s immune system attacks the covering of nerves (Myelin) in the body, leading to demyelination. It can result in various symptoms such as muscle weakness, foot drop, loss of vision, imbalance, etc.

Multiple sclerosis is a disabling disorder in which the nerves and some brain parts become affected/damaged at several sites. If a nerve that controls vision becomes affected, a person suffers from problems with vision. Similarly, if nerves controlling muscles are affected, the person faces muscle weakness and sometimes paralysis.

Types of Multiple Sclerosis

There are four types of Multiple sclerosis based on the pattern of presentation of this disease. One must keep in mind that there is no definite pattern of symptoms of this disease. It can cause different symptoms in different individuals.

Here are the four major types of multiple sclerosis.

Relapsing-Remitting Multiple Sclerosis (RPMS)

Progressive multiple sclerosis: pathology and pathogenesis | Nature Reviews  Neurology

It is the most common type of Multiple Sclerosis, and it affects more than 80% of people who have Multiple Sclerosis. One can understand this disease’s pattern by looking at two words used in its name, i.e., Relapse and Remitting.

Relapse means deterioration in health due to disease, and remitting means getting back to a normal state. In this type of multiple sclerosis, a person suffers from a relapsing phase that affects his body, followed by a remitting phase in which symptoms decrease, and it can last from months to years. Another attack may occur (relapsing phase) that again affects the body but this time to a greater extent, followed by a remitting phase.      

Secondary Progressive Multiple Sclerosis (SPMS)

Secondary Progressive Multiple Sclerosis (SPMS) is a type that is similar to the type mentioned above (Relapsing-Remitting MS) in the early phase of the disease. After this, there is a constant decline in the body’s functions, and no remitting phase occurs.

Consider that if a person’s nerves supplying the eyes are affected in SPMS. In that case, the vision gets affected at the beginning of the disease, followed by some improvement (Remitting phase). But then there comes the point when there is a constant decline in the vision with no improvement.

Primary Progressive Multiple Sclerosis (PPMS)

Primary Progressive Multiple Sclerosis is the third type of multiple sclerosis.

In this type, there is a constant decline in the body’s function as time passes. There is no remitting phase in this type, unlike the two types mentioned above.

For example, if a person’s foot muscles are affected, their strength decreases. In the PPMS, the strength will continue to deteriorate with time, ultimately leading to paralysis of those muscles.

Progressive Relapsing Multiple Sclerosis (PRMS)

The last type is similar to primary progressive Multiple sclerosis (PPMS). There is a constant decline in the body’s function. There are, however, superimposed periods in which the disability occurs even faster than in PPMS.

MS of any type can be difficult to diagnose in its early stage. And even if most of the people suffering from MS don’t have severe disabilities. Understanding the signs and symptoms will help the patients get prompt treatment without causing further damage. 

What Are The Signs And Symptom Of Multiple Sclerosis

Multiple Sclerosis – What is it

Multiple sclerosis is a disease that affects your brain, spinal cord, and nerves. It is an autoimmune disease in which the person’s immune system attacks the covering of nerves (myelin sheath). When this covering (myelin sheath) of nerves is damaged, the signals (sensory and motor) transmission within the body are affected.

There are four types of Multiple Sclerosis.

  • Relapsing-Remitting Multiple Sclerosis (RPMS)
  • Secondary Progressive Multiple Sclerosis (SPMS)
  • Primary Progressive Multiple Sclerosis (PPMS)
  • Progressive Relapsing Multiple Sclerosis (PRMS)

The symptoms can occur depending on the affected structure and the type and course of the disease. It can range from mild muscles weakness to paralysis. The most common symptoms of multiple sclerosis are as follows.

  • Fatigue
  • Visual problems
  • Sensory disturbances
  • Muscles weakness
  • Dizziness
  • Pain
  • Balance and Gait problems
  • Speech problems
  • Swallowing problems
  • Urination and defecation problems
  • Sexual problems

Let’s have a look at the common symptoms of Multiple Sclerosis one by one.

Fatigue

Fatigue is a common symptom of Multiple Sclerosis. A person having MS would have an overall feeling of tiredness or lack of energy. Performing tasks, even the minor ones, can make the affected individual short of breath. Pain and body aches can also accompany the fatigue.

Visual Problems

Visual problems occur when the disease affects the optic nerve, which is responsible for controlling vision. Visual problems can also arise when the occipital lobe of the brain is affected. This area receives the sensory input of vision.

The problems that can occur vary from person to person. It can be double vision (diplopia), blurred vision, partial loss of vision, or complete vision loss. Repetitive and uncontrolled eye movements (Nystagmus) can also occur due to Multiple Sclerosis.

Sensory Disturbances

Our body is able to sense different things because of sensory nerves. These nerves carry the sensory signals from your body to the brain’s sensory cortex, and that’s how you can sense touch, pressure, vibration, etc.

As Multiple Sclerosis affects the covering of nerves, signal transmission speed is affected, and some sensory disturbances are also seen. The patient may feel numbness, tingling sensations in their hands, arms, legs, feet, etc. Abnormal sensations (paresthesia) are also common symptoms of Multiple Sclerosis.

Muscles Weakness

As mentioned above, Multiple Sclerosis affects the nerves in your body. When the nerves controlling the sensory function are affected, sensory disturbances are seen. Similarly, when the nerves controlling the muscles (motor nerves) are affected, it leads to muscles weakness.

It can involve your foot muscles, leg muscles, hip muscles, arm muscles, upper body muscles, etc., depending upon the affected nerves. Weakness in muscles can lead to problems with performing daily activities and ambulation.

If the damage to the nerves is severe, it can lead to muscles paralysis—the paralysis of muscles controlling the upward movement of the foot results in Foot Drop. 

Dizziness

Another common symptom of Multiple Sclerosis is “Dizziness.” The affected individual may feel a range of sensations, such as feeling faint, weak, or unsteady. 

It sometimes creates the false sense that you or your surroundings are spinning or moving. This condition is sometimes called “vertigo.”

Pain

Pain is the most common symptom of Multiple Sclerosis. Pain is an unpleasant sensation that is sensed by the sensory nerves and perceived by the brain. As this disease affects the neurons (basic structure of the nervous system), the whole of the nervous system is affected.

The intensity of pain can vary from mild to extreme. Painful sensations can be accompanied by numbness and tingling sensations. The intensity of pain is also related to the type and course of the disease.

Balance and Gait Problems

The balance of the patients with Multiple Sclerosis is also affected. It can either be due to decreased muscles strength of legs or damage to centers in the brain responsible for balance control. The body’s muscles may get excessively tight (spasticity). Impaired gait (ataxia) is also typical in Multiple Sclerosis patients.

Speech Problems

Problems in speech result when the nerves controlling the articulation muscles are affected. Speech problems can be due to damage to speech centers present in the brain. It can cause slurred speech (dysarthria) or absence of speech (aphasia).

Swallowing Problems

Muscles are responsible for swallowing food. When the nerves controlling these muscles are affected, swallowing becomes difficult. This condition is called Dysphagia. It can affect eating habits of the patient.

Urination and Defecation Problems

Voluntary control of urination and defecation is lost in patients with advanced Multiple Sclerosis. This happens because of damage to the nerves responsible for controlling urination and defecation. This can result in leakage of urine (dribbling), urinary incontinence, and fecal incontinence.

Sexual Problems

Decreased sexual desire (libido) and erection problems are also symptoms of Multiple Sclerosis. This again is due to the damage to the neurons in the patient’s body.

Cognitive and Psychological Problems

As mentioned before, Multiple Sclerosis affects the brain also. This can result in several cognitive and psychological problems. Common mental and psychological symptoms that are seen in Multiple Sclerosis patients are short-term memory deficits, diminished executive function, diminished attention or concentration, etc. Anxiety and depression can also be present depending upon the type and course of the disease. 

TIPS OF MULTIPLE SCLEROSIS PATIENTS

Here are some essential tips for Multiple Sclerosis patients that they can follow for taking care of their body.

  • Try to have a balanced diet. According to researches, eating a low-fat and vitamin-rich diet can benefit people with multiple sclerosis. Eating a healthy diet can help to maximize your energy levels and support your bowel and bladder movement. 
  • Perform regular exercises. Walking for 20-30 minutes can improve a Multiple Sclerosis patient’s gait and balance.
  • Avoid heat. People with MS should avoid taking hot baths and going out in hot weather. Patients should also wear cooling collars when exercising.
  • Stay connected to your friends and family. Socializing can decrease many of the tensions and worries. Friends and family can support the patients in their hard times. This helps to reduce stress and anxiety.