What You Must Know About Relapsing MS

Did you know that about 85% of individuals with multiple sclerosis (MS) are initially diagnosed with what is known as relapsing-remitting MS (RRMS)? RRMS is the most common type of MS and here is what you need to know…

MS, which is common with over 200,000 cases per year in the United States, is a chronic, progressive condition that affects the central nervous system. Your immune system attacks the protective layer around the nerve fibers, also known as myelin.

This attack damages myelin and causes the nerves to become inflamed, making it difficult for your brain to communicate with the rest of your body.

RRMS describes the inflammatory attacks on the myelin and nerve fibers, indicated by relapses of new or worsening symptoms with intervals of remission or recovery in between.

When these attacks happen, localized, small areas of damage leading to the production of MS symptoms are caused by activated immune cells.

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RRMS can be active (relapses and/or evidence of new magnetic resonance imaging (MRI) activity over a specified period), not active, worsening (confirmed increase in disability following relapse), or not worsening.

The attacks are followed by partial or complete remission periods. During the remission period, all symptoms may disappear, or some symptoms may continue and become permanent. 

How is RRMS Any Different From MS?

Progressive forms of MS involve fewer attacks, while RRMS involves attacks or relapses of new MS symptoms. In addition, those with more progressive forms of MS are also usually diagnosed in their 40s or 50s, while those with RRMS are diagnosed earlier, usually in their 20s and 30s. Other differences that occur in RRMS:

• Individuals with RRMS tend to develop more new brain lesions, or scars, on MRI scans.
• Individuals with RRMS tend to have more inflammatory lesions on MRI scans, which can be seen with the use of gadolinium dye.
• Women with RRMS are affected two to three times more than men (with progressive forms of MS, the effects on women in comparison to men are pretty much equal).

Symptoms of RRMS can be unique and different in each person, but some of the most common symptoms include:

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• Bowel and bladder problems
• Cognition problems (learning and memory/information processing)
• Fatigue (Episodic bouts)
• Numbness
• Stiffness or spasticity
• Vision problems

With RRMS, new symptoms may disappear without causing an increase in the level of disability after a relapse; new symptoms may disappear partially, resulting in an increase in disability. New lesions on MRI often occur as part of a relapse, but new MRI lesions indicating MS activity may also occur without symptoms.

What You Can Do?

Seek out a neurologic exam and MRI, which can evaluate disease activity at regular intervals. In characterizing RRMS at these different intervals, an MS care provider can assist you by going over treatment options and possible outcomes and expectations of those options.

With active and worsening RRMS, the treatment options will differ than if the RRMS is not active or worsening. Discuss with your MS care provider the difference in the approaches in treatment taken.

If, while on your treatment routine, your RRMS is stable, this is a positive sign that the treatment is working in your favor, with no signs of worsening or MRI activity.

If symptoms are worsening or there is evidence of new disease activity on your MRI while on your current treatment, it is time to discuss another treatment option with your MS care provider.