Multiple sclerosis: continuous progression or intermittent relapses?

The multiple sclerosis (MS) is a chronic inflammatory disease that affects the central nervous system, including the brain and spinal cord. This disease most commonly occurs in young adults, and a significant portion of patients live with disabilities 10-15 years after diagnosis. It can cause a variety of different symptoms, the diversity and variability of which are characteristics of the disease. Two main clinical forms of MS are distinguished: relapsing-remitting and primary progressive types.

Challenges of the relapsing-remitting form

The relapsing-remitting form is the classical presentation of multiple sclerosis, during which the initial symptoms can encompass a wide spectrum. These may include visual disturbances, limb paralysis, dizziness, and balance disorders. This type is characterized by autoimmune inflammation, which can also involve periodic improvements, meaning that symptoms can spontaneously alleviate. This phenomenon allows patients to live a normal life during certain periods, even if the disease flares up again later. However, if the patient does not receive appropriate treatment, subsequent attacks may leave residual symptoms, thereby accelerating the progression of the disease.

In relapsing-remitting MS, the frequency and severity of attacks increase over time. Patients often found themselves in wheelchairs decades ago, and later became bedridden. Thanks to modern treatments, however, the rate of clinical relapses has decreased by 60-70%, and the degree of disability has also significantly reduced. The course of relapsing-remitting disease can be extremely variable; some patients may retain their independence for several decades, while others may lose their abilities more quickly. Long-term treatment and rehabilitation are essential, as the progression of the disease may require significant lifestyle changes.

To prevent the occurrence of relapses, vaccination against respiratory diseases is recommended, and the likelihood of relapses also increases during the postpartum period. Continuous medical supervision and the establishment of a proper lifestyle are important in the management of the disease.

Characteristics of the primary progressive form

The primary progressive form of multiple sclerosis is a more severe and unfavorable variant of the disease. Patients suffering from this category do not experience remission, and while new symptoms appear, previous ones remain with unchanged severity. This form typically occurs in older men, and after diagnosis, patients often quickly become disabled. Treatment of the primary progressive form is more challenging, and the effectiveness of therapeutic options is lower, so doctors often adopt a more aggressive approach, which may have serious side effects.

Previously, patients with primary progressive multiple sclerosis often became completely immobile within a few years, and due to the progression of the disease, death occurred soon after. However, thanks to advancements in modern medicine, more treatment options are now available, which can moderate the course of the disease.

In the case of the primary progressive form, patients require continuous medical care and rehabilitation to maintain the best possible quality of life. The progression of the disease affects not only physical condition but also mental health, so psychological support is also an important part of the treatment. The medical community is continuously working on developing more effective therapies to improve the quality of life for patients with primary progressive MS.