Dec 10, 2002
by Paul G. Donohue, M.D.
DEAR DR. DONOHUE: Please explain the difference between progressive multiple sclerosis and relapsing-remitting MS. The general public has no idea that there are different kinds of MS and different prognoses for them. -- R.F.
ANSWER: Multiple sclerosis -- literally translated as "multiple scars" -- is an illness where scar tissue appears in the brain and spinal cord. An immune system attack on myelin, the insulating material of nerves, accounts for scar formation. The scars short-circuit nerve transmission and are responsible for MS symptoms, some of which are double vision, sight impairment, muscle weakness, an unstable walk and either a loss of feeling or the onset of pain.
There are four MS varieties, but the two most common kinds are relapsing-remitting MS and primary progressive MS.
About 85 percent of MS patients have the relapsing-remitting variety. Initial symptoms greatly improve or completely disappear for months and even years. That is the "remission" part of relapsing-remitting. Then they return, and often they are different from the original symptoms. That is the "relapsing" part of the name. This kind of MS strikes people at younger ages -- the 20s or 30s.
Roughly 10 percent have primary progressive MS. Here, symptoms do not go away. There is a steady progression to greater impairment of muscle control. This kind of MS comes on later in life -- in the 40s and older.
Not so long ago, doctors had few medicines for their MS patients. Cortisone drugs could often slow MS progress. Those drugs are still effectively used today. In addition, four relatively new drugs are available: Avonex, Betaseron, Copaxone and Novantrone. No cure drug exists. But these drugs are often effective in improving symptoms and quality of life.
Primary progressive MS does not respond to treatment as well as relapsing-remitting
© 2002 North America Syndicate Inc