In our first article in this series on multiple sclerosis we discussed what the disease itself was. In this articles we're going to go over the different types of multiple sclerosis.

There are actually four different variations of multiple sclerosis. This was defined by an independent survey of neurologists in 1996.

The first form of multiple sclerosis is what is known as relapsing remitting, or as Jed Bartlett calls it in "The West Wing," the "good kind." Whether or not there is a good kind of any disease is open for debate. The characteristics of this form of multiple sclerosis are that old symptoms can disappear completely and new ones can come into play, or the old symptoms can still be present or even worsen. After this happens there are periods called remissions where the symptoms completely disappear. The relapsing part is where old symptoms worsen as new symptoms appear and the remitting part is when the symptoms disappear. This is why it is called relapsing remitting, and it usually runs in cycles. Remissions can last for many years or only a few weeks. Recovery can take years or sometimes happen instantly. That is why this is such an unpredictable disease. The majority of the people affected by multiple sclerosis are first diagnosed as having relapsing remitting MS. This usually happens when they are in their 20's or 30's. The ratio of women to men who have this form is about 2 to 1.

The next stage of multiple sclerosis is what is called secondary progressive. This stage usually comes many years after the initial diagnosis of relapsing remitting. The characteristics of this stage are the worsening of symptoms between relapses. In the early stages the person may have some relapses and remissions but as this stage progresses the symptoms reach a point where they just progressively get worse each day. This is why it is called secondary progressive. People with secondary progressive have their good and bad days but aside from the occasional relapse, the is no real recovery. It usually takes about 10 years for people with relapsing remitting to move into the secondary progressive stage.

The third stage of multiple sclerosis is what is called Progressive Relapsing Multiple Sclerosis. This form of multiple sclerosis is progressive right from the moment it is diagnosed, meaning that symptoms continually worsen as the disease itself progresses in time. There is a significant recovery period in this stage but when symptoms return they are progressively worse.

the fourth stage of multiple sclerosis is what is called Primary Progressive. This is the worst form of the disease. It is characterized by a gradual progression of the disease right from the start with no remissions at all. There may be periods where the disease levels off and doesn't worsen but never a time where the person suffering goes into remission. Other differences between this stage and the other three stages is that primary progressive usually hits a person in their late 30's or early 40's and men are just as likely to get primary progressive as women. Initially the disease attacks the spinal cord but eventually makes its way to the brain. However it is less likely to damage the brain as the other stages.

In our last article in this series we'll discuss treatments for multiple sclerosis.