Clinical Course

Four subtypes of MS are currently described—relapsing remitting, secondary-progressive, primary progressive, and progressive-relapsing. Relapsing-remitting MS accounts for about 85% of the initial diagnosis of MS patients and is characterized by acute attacks followed by full recovery. The interval between relapses can be variable and is characterized by a lack of disease progression. Secondary-progressive MS is characterized by a pattern that is initially relapsing-remitting but then evolves into a pattern of progressive neurologic decline. MRI demonstrates more extensive lesions, and approximately 50% of patients initially diagnosed with relapsing-remitting MS will develop secondary-progressive disease. Primary-progressive MS, characterized by a gradual disease progression from the initial onset, accounts for approximately 10% of MS diagnoses and has limited treatment options. Progressive-relapsing MS demonstrates a pattern of steady progression from the time of onset that may be punctuated by clearly defined relapses. The patients may or may not fully recover from these acute relapses.

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