The 7 types of Multiple Sclerosis (causes and symptoms)

Pathologies that affect both the central and peripheral nervous systems make up the group of neurological diseases. Some disorders that, although they are not always serious, do have a high incidence in the world (some 700 million people suffer from migraines, for example) and, in addition, they are conditions that, although they can be treated, are incurable.

Alzheimer's, migraine, epilepsy, Parkinson's, Guillain-Barré syndrome, ALS ... There are many diseases that, in one way or another, affect the physiology of the nervous system, the one in charge of generating and processing nerve impulses as well as transmitting them, through the synapse between neurons, throughout the body.

But of all of them, there is one that is especially relevant at a clinical level due to the confusion it generates, especially considering that it is a disease like ALS. We are talking about multiple sclerosis, a neurodegenerative disease of autoimmune origin that affects the central nervous system.

And in today's article, from the hand of the most prestigious scientific publications and with the aim of solving all the doubts you may have about the nature of this pathology that affects 1 in 3,000 people, we will explore the clinical bases of multiple sclerosis and see in what ways it can be expressed.

What is Multiple Sclerosis?

Multiple Sclerosis (MS) is a neurodegenerative disease of autoimmune origin that affects the central nervous system: brain and spinal cord. Due to a genetic error, the immune system attacks the myelin sheath that surrounds the axons of neurons, the cells of the nervous system. This damage to myelin hinders synaptic communication between neurons, which gives rise to the symptoms of the pathology.

The clinical signs, then, are due to the loss of the protective sheath of the nerve fibers and depend on the magnitude of the injury at the neurological level, the nerves that are being attacked by the immune cells and the speed at which it occurs. this loss of myelin. And this is what causes, in turn, there are different manifestations of multiple sclerosis, which we will analyze later.

It is estimated that today there are 2.8 million people in the world who suffer from the disease, something that translates into an incidence of 1 case for every 3,000 people. And of these, 75% are diagnosed in women, a population that shows a higher incidence than males. Also, multiple sclerosis is the most common neurological disease in young adults.

In fact, it is generally diagnosed between the ages of 18 and 35. But even though we mistakenly associate it with Amyotrophic Lateral Sclerosis (ALS), multiple sclerosis is not a deadly disease. Life expectancy is practically the same as that of a person without the disease, although statistics indicate that a person with MS lives, on average, seven years less, but with causes of death not associated with the disease.

It is not a hereditary disease, much less contagious. However, Although it is not fatal, it does cause symptoms that, in some people and depending on the exact form of the disease, can alter the quality of life: numbness of extremities, tremors, unsteady gait, dizziness, problems in bowel function, problems in sexual life, alterations in bladder functionality, loss of coordination, sensation of electric shocks in the neck, vision problems and, now in more severe cases, epilepsy, depression or paralysis.

As we have said, as it is a neurological disease, it has no cure as such. The person will have to live with the disease. But just because it is incurable does not mean that it is not treatable. In fact, current treatments make it possible to control symptoms and even change the course of the disease so that the patient enjoys a practically normal quality of life. And, as we say, their life expectancy is very similar to that of a person without the disorder.

What kinds of Multiple Sclerosis are there?

We have already understood the general clinical bases of multiple sclerosis. But as we have already warned, each case follows a certain progress and presents specific symptoms. For this reason, it has been important to differentiate between different types of multiple sclerosis in order to address the situation in the most optimal way possible. So let's look at the five clinical manifestations of multiple sclerosis.

1. Clinically isolated syndrome

By clinically isolated syndrome (ACS) we understand that form of multiple sclerosis that manifests with a single episode of neurological symptoms due to inflammation and loss of the myelin sheath in the nervous system. It is an isolated syndrome that does not have to progress into a multiple sclerosis disease as suchTherefore, it is not considered that a person with this episode suffers from the pathology.

This first episode has to last a minimum of 24 hours to be considered ACS, with symptoms that usually include vision problems, numbness in some part of the body and difficulty walking. It is not accompanied by a fever and a partial or complete recovery follows. In case it is not an isolated case and there is another episode, then multiple sclerosis will already be diagnosed in one of the four ways that we will see below.

2. Recurrent remitting MS

Recurrent-remitting multiple sclerosis (RRMS) is the most common form of the disease, representing 85% of cases. Symptoms of pathology appear in the form of outbreaks that appear suddenly and unpredictably and last a more or less long period of time (usually days, sometimes weeks and even months) but then they improve until they disappear.

Thus, it is that form of the disease that manifests itself with periods of relapse that are followed by periods of partial or complete remission. Although the clinical signs can leave sequelae (there are people who fully recover), there is no continuous progression of the disease, but rather it is expressed in the form of outbreaks that take more or less time to appear and that can worsen in consequent appearances or stay stable.

3. Primary progressive MS

Primary progressive multiple sclerosis (PPMS) is that form of the disease characterized by a progressive and gradual worsening of neurological function due to autoimmune damage from the onset of the pathology. Between 10% and 15% of cases correspond to this type and it is based on the accumulation of disability from the onset of symptoms, without episodes of relapses and remissions.

The disease does not manifest itself, even in the initial phase, with the appearance of outbreaks. The deterioration is continuous although unique for each patient, as there may be periods in which the symptoms seem to stabilize and others where the damage accelerates. The important thing is that, unlike RRMS, there are no periods of improvement or flare-ups.

4. Secondary progressive MS

Secondary progressive multiple sclerosis (SPMS) is that form of the disease in which between 50% and 70% of patients with RRMS enter and which consists of a stage in which the worsening of neurological function stops occurring in the form of flares and happens gradually and gradually, with damages that are accumulating without phases of improvement.

Therefore, unlike PPMS, there is an initial phase where the pathology manifests itself in the form of outbreaks. However, in the same way as in primary school, periods of stability and stages with relapses can also be observed. It is a relatively common evolution of the relapsing-remitting form in which the symptoms stop manifesting with outbreaks separated in time and alternated with periods of emission and begin to appear with a progression that is sustained over time.

5. fulminant EM

Fulminant multiple sclerosis (EMF) is that manifestation of the disease that has a very rapid progress, with severe outbreaks that rapidly worsen the state of health. It is also known as malignant sclerosis and the progression may be most affected in as little as five years after the first symptom. Therefore, it requires a more exhaustive and aggressive treatment.

6. MS inactive

Inactive multiple sclerosis (IMD) is the mildest manifestation of the disease. Also known as benign multiple sclerosis, it is one in which up to 15 years can pass without a palpable worsening of symptomatology. There is always the possibility that it will get worse and progress over time, but it does not require as aggressive a treatment as the fulminant.

7. Recurrent progressive MS

We reached the end of the trip. For the last position we have reserved the least frequent manifestation of pathology: relapsing progressive multiple sclerosis (EMPR). It is a form of the disease that, like the primary one (PPMS), manifests itself with a gradual and progressive worsening of symptoms. But, unlike this, there are also outbreaks in which, within this gradual worsening, there is an intensification of the symptoms.