Multiple Sclerosis? What Type Are You?

Some of the medical community believe a clear progression since the beginning with clear relapse and recovery periods is actually a variation of PPMS, if no identifiable period of Relapsing/Remitting preceded it. A period of this type also describes the overlap between RRMS and SPMS, easing the change from Relapsing/Remitting to Secondary Progressive.

These types of MS are recognized internationally. However, there are other terms used when diagnosing or just talking about MS.

Benign
Benign MS is characterized by a long period of little activity after the first attack. In Benign MS, people may remain fully functional though an MRI shows evidence of lesion. After an initial attack, MS may be considered benign after 10 or 15 years of no advanced functional disability. When symptoms flare, it is often reclassified as Secondary Progressive. The benign period may actually be nothing more than a long remission in a form of Relapsing/Remitting MS.

Benign is possibly a misleading term because it implies the severity of the disease is minimal. It may actually indicate that the severity is simply being delayed. As many as 20% of all MSers are considered Benign.

Malignant
The malignant form is extremely rare and may also be called Marburg's Variant or Acute MS. It is a particularly aggressive form of Primary Progressive that progresses quite fast and results in severe disability.

Transitional Progressive
This term is also used only rarely, characterized by an initial attack followed by a long remission, then an obviously progressive course.

Devic's Disease or Syndrome
Devic's Syndrome is characterized by severe optic neuritis in both eyes and severe inflammation in a single section of the spinal cord. As the disease progresses, symptoms include motor difficulties, urinary, bowel, and sexual problems. Although at one time it was considered a type of MS, now it is generally considered a separate disease closely related to MS.

Balo's Concentric Sclerosis
Again, this is a disease separate but very similar to MS. It is identified by an MRI that shows concentric rings of intact myelin and demyelinized zones. It is very rare, and prevalent mostly in the Far East.

Next time I'll talk in more detail about Primary and Secondary Progressive.

Notes and Sources:
Gertrude Stein first used the phrase in a poem, Sacred Emily.

MS Types by Occurrence chart by GRJenkin
NMSS Includes charts representing typical disease courses for each type.
Geocities - Geocities presents a nice summary of MS types.
Health Care Guides - Another clear summary of types.
Revised McDonald Criteria http://www.mult-sclerosis.org/DiagnosticCriteria.html