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The Four Stages of Multiple Sclerosis

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  • 17-11-2021
The Four Stages of Multiple Sclerosis

What are the four stages of multiple sclerosis? This article looks at the causes of multiple sclerosis and how MS is diagnosed.

Whether you're living with Multiple Sclerosis, or know of someone who is, understanding more about the condition and how it affects the body, will make discourse much easier.

Everyone who suffers from the condition has a unique experience, but there is support for those with it and some regularities that we can note and learn from. 

What Causes Multiple Sclerosis?

Multiple Sclerosis (MS) is a brain and spinal cord disease leading to a wide range of symptoms that affect the central nervous system (CNS). 

More severe for others, sufferers can experience progressive or relapsing MS, meaning that the condition will worsen for some. For others, they will experience milder symptoms less frequently or in bursts. 

MS is an autoimmune disease and involves the body damaging and attacking its own tissue. The nerves within the human body have a protective coating surrounding them, called myelin. The immune system attacks this myelin, which causes issues within the central nervous system, such as movement and speech.

First Signs of Multiple Sclerosis

There is uncertainty around the condition, as there is no clear and sole cause. It can be environmental and genetic, caused by teenage obesity and smoking, lack of sunlight, or sometimes is inherited by parents or other family members who suffer. 

For example, there is a correlation between those who receive less sunlight (in colder parts of the world) and an increase in MS cases than those who live nearer the equator.

People can receive an MS diagnosis at any age but is more commonly known to affect those from 20-40 and up. 

Women have higher chances of developing relapsing-remitting multiple sclerosis (RRMS), up to three times more than men. However, almost anyone can develop this condition, and it's important to notice any symptoms early on.   

What Causes Multiple Sclerosis?

How Is MS Diagnosed?

As mentioned above, a doctor may be unable to diagnose you with MS if you've only had one episode of inflammation or attack within your central nervous system. There could be other conditions at play when your CNS gets attacked or inflamed. A variety of infections and genetic disorders can provide similar symptoms to MS initially.

The process of diagnosing MS follows a series of steps and procedures. On top of your patient history and a physical examination, there are other tests. Magnetic Resonance Imaging, or MRI, will be performed as a first step. These have become commonplace in the diagnosis of MS, as an MRI will show the changes in the brain that typically happen to an MS sufferer.

What Are The Four Stages Of MS? multiple sclerosis

A Spinal Tap Procedure is also standard, especially as MS is a brain and spinal cord disease. Also called lumbar puncture, or LP, this procedure can assess the cerebrospinal fluid within your spine. Once this has been performed, doctors can determine the severity of the inflammation in the CNS. 

Another way of diagnosing MS is by taking an evoked potentials test. As the myelin around the nerves in your central nervous system gets attacked, the brain's ability to send signals becomes compromised.

Evoked potential tests measure the rate at which messages can be sent to the brain, meaning that anyone suffering from damaged nerves due to MS will result differently. This test is painless and is conducted by attaching electrodes to your scalp to detect the current.   

A widespread symptom among people with MS is optic neuritis (inflammation of the optic nerve). Due to this inflammation, the retinal nerve fiber layer (which aids in transporting fibers) can start thinning. 

An optical coherence tomography (OCT) can help doctors analyse this deterioration, which will occur much faster and more severely than a healthy counterpart. Despite this thinning of the nerve fiber layer being natural, those with MS will significantly less.  

Doctors can also take blood tests, as this identifies what condition the body is suffering from. Many diseases, illnesses, and even medicine-induced symptoms can be similar to those of multiple sclerosis. 

What are the four stages of MS?

Those who are diagnosed with MS will find themselves following a pattern or a series of stages ( healthline). Although some can experience different symptoms at different stages, knowing what is expected can be reassuring. 

Clinically Isolated Syndrome (CIS)

Although technically, this stage doesn't always count for an official MS diagnosis, it is the first point to note. Symptoms such as vision problems, muscle fatigue, or exhaustion due to inflammation and damage to the nerves and myelin can arise. If this isn't the first time, and there has been a history of other incidents in the past, then an MS diagnosis could be made. 

Relapsing-remitting MS (RRMS)

From there, it can typically develop into RRMS, which is relapsing-remitting. For some, their case of MS can stay at this point and not worsen anymore than this. Symptoms can have periods of being worse and more severe, and other instances where the condition is almost unnoticeable. 

The National Multiple Sclerosis Society (NMSS) documented 85% of MS cases begin their diagnosis with RRMS, although this can progress and develop into Secondary-Progressive MS.

Secondary-progressive MS (SPMS)

This stage is a much more aggressive version of MS, and many people do develop this. Unlike relapsing-remitting, this stage doesn't have relapses or periods of freedom from the condition.

Some people with MS can still experience remissive episodes, but they aren't as likely, and the disease is unlikely to disappear entirely in those moments. This can typically develop within ten years of the initial diagnosis. 


Primary-progressive MS (PPMS)

Perhaps one of the rarer forms of MS is primary-progressive MS. This entails a more ongoing, slower version of the condition. The progression will last a lifetime, as the disease slowly gets worse, typically with no periods of remission.

However, some MS patients at this stage can still notice minor improvements as they progress, but ultimately the condition will continue to worsen slowly, and more symptoms arise. 

Progression timeline

Although anomalies can happen, MS will become worse over time. Due to this, treatment can only help ease symptoms and bring about a better quality of life, not find a permanent cure.

Every case is unique, and people with MS will experience symptoms at their own pace and will find themselves never suffering from certain ones. 

This is why it's important to have a doctor you can trust to devise a treatment plan for you and the particular case. Knowledge of flexibility, if a specific symptom and overall health deteriorate, will help keep your mind at peace.

Primary-progressive MS (PPMS)

Advanced stages of MS

Thankfully, only approximately 1 in 3 people with MS will lose the ability to walk due to an advanced stage. For the other two, their MS won't progress and develop into something more serious, and they will balance having some control over their lives.

In severe cases where MS can advance and develop, people can experience difficulty walking, talking, writing, and sometimes even speaking. This condition can also shorten a lifespan of up to seven years but doesn't kill often. 

As the condition progresses, more help and care will be needed for the sufferer, but some level of freedom can still be achieved once the new life has been adapted to. 

What Is the Treatment for Multiple Sclerosis (MS)?

As of right now, doctors cannot cure MS. Currently, no cure exists, but treatments have been developed to help alleviate pain and reduce symptoms. The best possible thing that can be done for someone with MS is to improve their quality of life and prevent or slow the disease from progressing further. 

Depending on the type of MS and how severely it affects the individual's life, there are methods of medication that can reduce inflammation.

Injectable Medications are available, which work by keeping white blood cells away from the brain and spinal cord. If the white blood cells can be stopped from entering and attacking the myelin, less damage can be caused to the central nervous system.

Interferon Beta-1b (betaseron, Extavia)

Peginterferon Beta-1a (Plegdridy)

Gkaturaner Acetate (Copaxone, Glatopa)

What Is the Treatment for Multiple Sclerosis (MS)

There are more treatments available, and this is something to be discussed with your doctor, but these medicines help aid relapsing-remitting ms (RRMS) and secondary progressive MS (SPMS).

If a new lesion has manifested and showed up on an MRI scan, this can help calm this down and potentially slow it. The same goes for patients with a clinically isolated syndrome (CIS), as it can help prevent the condition from developing into a more aggressive form of MS.

These treatments are common for MS sufferers, as you inject them yourself. This can be shown, taught, and then repeated as often as needed, sometimes every day, three times a week (Rebif), or once a week (Avonex). 

Oral Medication, such as Cladribine or Ozanimod, is also common and can help treat and fight against the progressing disease.

When it comes to fighting the individual symptoms of MS, this can prove much more straightforward. Since the core of MS is untreatable, yet the symptoms span across many different diseases and conditions, there are more treatments available.

Antihistamines for any itches

Medicines for tremor relief

Central Nervous System stimulants to fight fatigue

Antibiotics for infections


Anti-Seizure and Nerve Pain Medication

Erectile Dysfunction medicines

Vertigo and Dizziness medication

Muscle Relaxants

When it comes to other forms of treatment (non-medical), there are other remedies that people with MS have said help them. Things such as yoga, good and frequent (where possible) exercise, acupuncture, and other relaxation techniques. 

These may not help fight against MS and the attacking of the central nervous system, but they can provide momentary relief and a better way to cope and deal with the disease.

Be sure to enquire with your doctor if you're noticing more symptoms arising, or a general worsening of the condition, as you can be moved to another medicine to help improve life.

the progression of Multiple Sclerosis

If you have questions about the progression of Multiple Sclerosis, we hope this information has been useful to you.

We offer specialist home care services and live-in care for vulnerable adults throughout London. Get in contact today if you have a loved one that would benefit from professional multiple sclerosis care at home.