The most predictable feature of Multiple Sclerosis is its unpredictability. A patient’s first MS “attack” can seemingly come out of nowhere, often striking otherwise healthy individuals in their 20s, 30s, or 40s. The attack manifests as symptoms that vary widely but can include pain, numbness, blurred vision, fatigue, dizziness, and decreased mobility. For the 85 percent of patients with the most common form of the disease, Relapsing-Remitting MS (RRMS), attacks are followed by remissions—periods when symptoms subside but don’t necessarily disappear. Hard-to-avoid factors like heat or stress can cause symptoms to flare, making daily life a roller coaster ride at best. What’s more, the next attack, which introduces new symptoms, can occur at any time—weeks, months, or even years following the last one.
Within 10 years of their first attack, half of those with RRMS will transition to another form of the disease, Secondary-Progressive MS (SPMS). SPMS is one of three progressive forms of the disease where symptoms gradually worsen over time. Primary-Progressive MS (PPMS, affecting 10 percent of those diagnosed with MS) is just that—progressive from the onset—and Progressive-Relapsing MS (PRMS), the least common of the four disease courses, is characterized by relapses and remissions superimposed over a gradual decline.
The one predictable aspect of MS is that the stereotyped image of the wheelchair-bound patient is, for the majority of those afflicted, becoming outdated. FDA-approved drugs and alternative medicines are available to decrease frequency of attacks and lessen symptom severity; plus, several promising new drugs are in the pipeline.
—Julie C. Kiefer