Materiały źródłowe

• #1 Multiple sclerosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

  Multiple sclerosis is a disease that causes breakdown of the protective covering of nerves. Multiple sclerosis can cause numbness, weakness, trouble walking, vision changes and other symptoms. It’s also known as MS. In MS, the immune system attacks the protective sheath that covers nerve fibers, known as myelin. This interrupts communication between the brain and the rest of the body. Eventually, the disease can cause permanent damage of the nerve fibers. Symptoms of MS depend on the person, the location of damage in the nervous system and how bad the damage is to the nerve fibers. Some people lose the ability to walk on their own or move at all. Others may have long periods between attacks without any new symptoms, called remission. The course of the disease varies depending on the type of MS.

• #2 Multiple Sclerosis (MS): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17248-multiple-sclerosis

  Multiple sclerosis (MS) damages the protective cover around nerves called myelin in your central nervous system. It can cause muscle weakness, vision changes, numbness and memory issues. While there isnt a cure, treatment options can help you manage symptoms and slow disease progression. […] Myelin damage can occur in your brain, spinal cord and nerves that supply your eyes. Theres no cure for MS, but treatment is available to help minimize ongoing damage and help you manage symptoms. […] Early signs and symptoms of MS include: Changes to your vision (optic neuritis, double vision, vision loss), Muscle weakness (usually affecting one side of your face or body, or below your waist), Numbness or abnormal sensations (usually affecting one side of your face or body, or below your waist). […] Common symptoms of MS include: Fatigue, Clumsiness, Dizziness, Difficulty with bladder regulation, Loss of balance and coordination, Difficulty with cognitive function (thinking, memory, concentration, learning and judgment), Mood changes, Muscle stiffness and muscle spasms (tremors).

• #3 Multiple sclerosis – Wikipedia

  https://en.wikipedia.org/wiki/Multiple_sclerosis

  Multiple sclerosis (MS) is an autoimmune disease resulting in damage to myelin the insulating covers of nerve cells in the brain and spinal cord. As a demyelinating disease, MS disrupts the nervous system’s ability to transmit signals, resulting in a range of signs and symptoms, including physical, mental, and sometimes psychiatric problems. Symptoms include double vision, vision loss, eye pain, muscle weakness, and loss of sensation or coordination. MS takes several forms, with new symptoms either occurring in isolated attacks (relapsing forms) or building up over time (progressive forms). In relapsing forms of MS, symptoms may disappear completely between attacks, although some permanent neurological problems often remain, especially as the disease advances. In progressive forms of MS, bodily function slowly deteriorates once symptoms manifest and will steadily worsen if left untreated.

• #4 Multiple Sclerosis: It’s Not The Disease You Thought It Was

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1069023/

  Multiple sclerosis (MS), the most common disabling neurologic disease of young people, afflicts approximately a quarter of a million Americans. The symptoms of MS result from recurrent attacks of inflammation in the central nervous system, which probably occur through an autoimmune mechanism. […] The most common symptoms are listed in table 1. Symptoms that arise directly from damage to neurons (that is to say, gray matter symptoms) occur so rarely that their appearance casts doubt on the diagnosis of MS. […] Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery.

• #5 Symptoms of Multiple Sclerosis | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/ms-symptoms

  The symptoms of multiple sclerosis are variable and unpredictable. No two people have exactly the same symptoms, and symptoms can change or fluctuate over time. One person might experience only one or two of the possible symptoms. Another may experience many more. […] Bladder dysfunction occurs in about 80% of people living with MS. […] Address bowel issues with the correct diet, adequate fluid intake, physical activity and medication. […] Changes in cognitive function are common in people living with MS. […] Depression is a common MS symptom. Paying attention to your mental health and practicing wellness strategies can help. […] Changes in your emotions can be a reaction to the stresses of living with MS and the result of neurologic changes. […] For many people living with MS, fatigue is the most prominent symptom.

• #6 Multiple sclerosis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/symptoms-causes/syc-20350269

  Symptoms of a relapse usually come on over 24 to 48 hours, last for a few days to a few weeks and then improve in the region of 80 to a 100 percent. Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties. […] In multiple sclerosis, the protective coating on nerve fibers, known as myelin, in the central nervous system is damaged. Depending on the location of the damage in the central nervous system, symptoms may happen, including numbness, tingling, weakness, visual changes, bladder and bowel troubles, memory troubles, or mood changes, for example. Multiple sclerosis symptoms vary depending on the person. Symptoms may change over the course of the disease depending on which nerve fibers are affected. Common symptoms include: Numbness or tingling. Electric-shock sensations that happen with certain neck movements, especially bending the neck forward. This sensation is called Lhermitte sign. Lack of coordination. Trouble with walking or not being able to walk at all. Weakness. Partial or complete loss of vision, usually in one eye at a time. Vision loss often happens with pain during eye movement. Double vision. Blurry vision. Dizziness and a false sense that you or your surroundings are moving, known as vertigo. Trouble with sexual, bowel and bladder function. Fatigue. Slurred speech. Troubles with memory, thinking and understanding information. Mood changes.

• #7 Multiple Sclerosis (MS): What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17248-multiple-sclerosis

  Multiple sclerosis (MS) damages the protective cover around nerves called myelin in your central nervous system. It can cause muscle weakness, vision changes, numbness and memory issues. While there isnt a cure, treatment options can help you manage symptoms and slow disease progression. […] Myelin damage can occur in your brain, spinal cord and nerves that supply your eyes. Theres no cure for MS, but treatment is available to help minimize ongoing damage and help you manage symptoms. […] Early signs and symptoms of MS include: Changes to your vision (optic neuritis, double vision, vision loss), Muscle weakness (usually affecting one side of your face or body, or below your waist), Numbness or abnormal sensations (usually affecting one side of your face or body, or below your waist). […] Common symptoms of MS include: Fatigue, Clumsiness, Dizziness, Difficulty with bladder regulation, Loss of balance and coordination, Difficulty with cognitive function (thinking, memory, concentration, learning and judgment), Mood changes, Muscle stiffness and muscle spasms (tremors).

• #8 Understanding Multiple Sclerosis: Symptoms, Diagnosis, and Treatment Options

  https://www.ouhealth.com/blog/2025/march/understanding-multiple-sclerosis-symptoms-diagno/

  Multiple Sclerosis (MS) is a disease where the immune system attacks the brain, spinal cord, and optic nerves. This attack targets the myelin, the protective coating of nerve cells, which helps electrical signals travel quickly. When myelin is lost, it forms scar tissue known as sclerosis, also referred to as plaques or lesions. This damage prevents nerves from conducting electrical impulses properly to and from the brain. This can lead to symptoms like numbness, weakness, vision problems, and imbalance. […] Symptoms lasting more than 24 hours are called relapses or exacerbations, which can last from a day to several months. While myelin can often repair itself, severe inflammation can damage the nerves permanently, potentially leading to lasting disability. […] Multiple sclerosis (MS) symptoms vary by person and can change over time. Common symptoms include: Numbness or tingling, Electric-shock sensations with neck movements (Lhermitte sign), Lack of coordination, Trouble walking or inability to walk, Weakness, Stiffness and spasticity, Vision loss in one eye, often with pain, Double or blurry vision, Dizziness or vertigo, Sexual, bowel, and bladder issues, Fatigue, Slurred speech, Memory and thinking problems, Mood changes.

• #9 Symptoms of Multiple Sclerosis | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/ms-symptoms

  An MS hug is a squeezing sensation around the torso that feels like a blood pressure cuff when it tightens. […] Numbness of the face, body or extremities (arms and legs) can be an early symptom of MS. […] Pain syndromes are common among people living with MS, possibly affecting up to half of all people living with MS. […] Damage to the nervous system and changes in roles and responsibilities may affect your sex life. […] Common experiences of spasticity include muscle stiffness or involuntary contractions. […] People living with MS may feel lightheaded or that their surroundings are spinning. […] If you live with MS, a change in your vision may have been your first symptom. […] Muscle weakness, spasticity, loss of balance, sensory deficit or fatigue can cause mobility challenges.

• #10 Symptoms of Multiple Sclerosis | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/ms-symptoms

  People living with MS may use their muscles less or experience damage to nerves that stimulate muscles. […] MS can weaken the muscles that support the lungs and make breathing harder. […] About 6% of people who live with MS complain of impaired hearing. […] About 25% of people living with MS experience diminished taste. […] Seizures are not a common symptom of MS. But they can be challenging for individuals who experience them. […] Speech difficulties occur in approximately 25%-40% of people living with MS. […] Swallowing issues result from damage to the nerves controlling the small muscles in the mouth and throat. […] Tremor can occur in various parts of the body because of damage to the nerve pathways responsible for coordination of movements. […] Primary symptoms are the direct result of damage to the central nervous system. They can cause secondary symptoms. For example: Bladder dysfunction can cause repeated urinary tract infections. Inactivity can cause loss of muscle tone and decreased bone density. Immobility can cause pressure sores. It is best to avoid secondary symptoms by addressing the primary symptoms. Work with your care team to treat all symptoms.

• #11 Multiple Sclerosis in Children | Symptoms, Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/m/multiple-sclerosis

  Multiple sclerosis (MS) is a type of autoimmune disease. The bodys immune system protects it from foreign objects. With an autoimmune disorder, it doesnt recognize its own healthy tissue and attacks it. MS affects the brain, spinal cord and optic (eye) nerve. It harms a protective cover, called the myelin sheath, around neurons (nerve cells). This damage prevents the nerves from sending signals to the body to move, sense or function. […] The most common type of MS in children is called relapsing-remitting. That means there are times when the condition is quiet, with few or no symptoms. This remission can last months or years. At other times, the MS symptoms flare up. A relapse could last for days or weeks. […] Common symptoms for MS in children include: Weakness, tingling and numbness, often on one side of the body at a time; Problems with balance and coordination; Eye problems, such as double vision, pain when moving the eyes and vision loss; Tremors (shaking); Muscle stiffness and spasms, which can be painful; Problems with bowel and bladder control; Slurred speech.

• #12 Stages of Multiple Sclerosis: Progression, Timeline, and More

  https://www.healthline.com/health/multiple-sclerosis/stages

  Progressive phase: Symptoms become progressively more severe. […] Common early symptoms may include: vision changes due to optic neuritis, numbness and tingling, fatigue, loss of balance, dizziness, pain, muscle stiffness or spasms, tremor, bladder problems, bowel problems. […] For many people with MS, their symptoms will come and go over time. […] According to the National Multiple Sclerosis Society (NMSS), an MS flare-up lasts at least 24 hours and occurs at least 30 days after the previous flare-up. […] Flare-ups may last weeks or months. […] In this phase, MS symptoms become progressively worse. […] You may not experience any improvement or remission. […] In the past, doctors have talked about RRMS becoming progressive MS, but this may be a stage that some people reach while others dont.

• #13 MS Symptom Listing | MSAA

  https://mymsaa.org/ms-information/symptoms/ms-symptoms/

  Individuals with multiple sclerosis (MS) may experience one or more of a variety of symptoms, possibly affecting individuals physically, emotionally, mentally, psychologically, and/or in ways that others cant see (the invisible symptoms of multiple sclerosis). The types and severity of symptoms differ greatly between people with multiple sclerosis, so one persons experience with this disorder may be very different from anothers. […] Common Physical Symptoms of Multiple Sclerosis include Balance Problems, Bladder Dysfunction, Bowel Problems, Mobility and Walking Issues, Sexual Dysfunction, Spasticity (Stiffness), Speech Difficulties, Swallowing Disorders, and Tremor. […] Common Emotional and Psychological Symptoms of Multiple Sclerosis include Anxiety, Cognitive Changes, Depression, and Pseudobulbar Affect (PBA). […] Common Invisible Symptoms of Multiple Sclerosis include Dizziness and Vertigo, Fatigue, MS Hug, Numbness, Pain, Sleep Issues, Uhthoffs Syndrome, Visual Disorders, and Weakness.

• #14 Understanding Multiple Sclerosis: Symptoms, Diagnosis, and Treatment Options

  https://www.ouhealth.com/blog/2025/march/understanding-multiple-sclerosis-symptoms-diagno/

  Small increases in body temperature can temporarily worsen MS symptoms. These are known as pseudorelapses. […] Without treatment, many with relapsing-remitting MS will develop secondary progressive MS, which gets worse over time. This can take 7 to 30 years. About 10% never develop progressive disease without treatment, but it’s hard to predict who. The good news is that treatment can help manage MS and reduce the risk of disability. […] These medications not only help reduce the frequency and severity of relapses, but they may also slow the progression of the disease.

• #15 Primary progressive MS | MS Trust

  https://mstrust.org.uk/a-z/primary-progressive-ms

  Some symptoms of MS such as fatigue and altered sensations, aren’t always obvious to other people even though they may have a significant impact on your life. […] Although progression does mean that disability will continue to increase over time, for many people it will occur slowly over many years and doesn’t mean that you will inevitably experience a rapid decline in your health or capabilities. […] However, regrettably for some people, primary progressive MS can lead to significant disability.

• #15 Primary progressive MS | MS Trust

  https://mstrust.org.uk/a-z/primary-progressive-ms

  About 10-15 in 100 people diagnosed with MS are diagnosed with primary progressive MS (PPMS). […] In this type of MS, symptoms gradually worsen and accumulate over time, known as progression. […] With PPMS it’s rare to have any relapses. […] The rate at which symptoms become more severe varies, but typically the changes are slow and gradual over a number of years, though for some it can be more rapid. […] In more than 8 out of 10 people with primary progressive MS, the first symptom experienced is difficulty walking. […] Bladder problems or bowel problems are quite common in primary progressive MS. […] Some other common symptoms are: fatigue this is not normal tiredness but an exhaustion which is out of all proportion to what you’ve been doing, it can be mental or physical tiredness; spasticity and spasms stiffness of the muscles; cognitive problems which might include problems with concentration, memory or planning; emotional difficulties feelings of anxiety or altered mood; altered sensations unusual feelings in the skin such as numbness, tingling or burning sensations, including a type of pain known as neuropathic or nerve pain.

• #16 Stages of multiple sclerosis: Types and their progression

  https://www.medicalnewstoday.com/articles/stages-of-multiple-sclerosis

  People with multiple sclerosis (MS) may have symptoms that relapse, steadily progress over time, or progress from the onset of symptoms. […] Different types of MS can progress in different ways. […] MS always progresses. However, depending on the type of MS, there may be no progression for long periods. Additionally, progression can be very gradual or more rapid. […] People with RRMS may go for years without any relapses, and disability may not progress in severity. […] The nature of progressive types of MS means the disease progresses at a faster rate, although the timeframe can vary. […] RRMS usually develops into SPMS, but the time frame can vary. […] SPMS can follow RRMS. People with SPMS experience a steady change in their abilities over time, but symptoms can progress differently for each person.

• #17 MS Progression Chart: Stages of MS, Disability Scale, and More

  https://www.healthline.com/health/progressing-ms/ms-progression-chart

  A more visual explanation of the progression of MS can be helpful for understanding your symptoms and the type of MS you currently have. […] People with MS generally experience a progression of MS symptoms and severity throughout their lives. […] There are four types of MS. Theyre defined by the frequency and progression of symptoms: clinically isolated syndrome, relapsing-remitting MS, secondary progressive MS, primary progressive MS. […] The early stages of MS might only cause mild symptoms in one or two of the functional systems. As MS progresses, more systems are more severe, and more systems are affected. […] For example, some people with relapsing-remitting MS (RRMS) never progress to any other type of MS. They might not have severe symptoms or notice any progression of their MS. Other people might experience a steady worsening of their symptoms.

• #18 Relapsing-remitting MS (RRMS) | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/types-of-ms/relapse-remitting-ms

  Multiple sclerosis is an unpredictable disease of the central nervous system that disrupts the flow of information within the brain and between the brain and body. Relapsing-remitting multiple sclerosis (RRMS) is the most common course of MS. If you have RRMS, you will experience clearly defined relapses of new or increasing neurologic symptoms. These relapses — also called „attacks” or “exacerbations” — are followed by periods of partial or complete recovery (remissions). During remissions, all symptoms may disappear, or some symptoms may continue and become permanent. However, there is no apparent progression of the disease during the periods of remission. RRMS can be characterized as either active (with relapses and/or evidence of new MRI activity over a specified period of time) or not active, as well as worsening (a confirmed increase in disability following a relapse) or not worsening. Approximately 85% of people with MS are initially diagnosed with RRMS.

• #19 How to Manage Multiple Sclerosis (MS) Relapses > News > Yale Medicine

  https://www.yalemedicine.org/news/how-to-manage-multiple-sclerosis-ms-relapses

  Yale MS expert says a newer treatment is 98% effective in preventing new relapses. When a person has multiple sclerosis (MS), their immune system mistakenly attacks the protective myelin sheath that covers the nerves in the central nervous system. This damages nerves in the brain and spinal cord, causing symptoms like vision loss, stiff muscles, and/or fatigue. But not every case of MS is the same, as nerves are affected in different ways, resulting in a variety of symptoms. […] Most people with MS roughly 85% of patients are initially diagnosed with relapsing-remitting MS, a form of the disease in which flare-ups, or relapses, of neurological symptoms, such as muscle weakness, balance problems, or vertigo, occur. Then, after a period of time, their symptoms partially or completely resolve, or go into remission. The frequency of relapses varies, ranging from less than one relapse per year to more than two relapses per year.

• #20 Relapsing-remitting MS (RRMS) | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/types-of-ms/relapse-remitting-ms

  The most common symptoms reported in RRMS include bouts of: bowel and bladder problems, fatigue, numbness, problems with cognition (learning and memory or information processing), spasticity or stiffness, and vision problems. People with progressive forms of MS are also more likely to experience problems with walking and mobility that gradually worsen over time, along with whatever other symptoms they may have. […] The criteria for diagnosing relapsing-remitting MS require evidence of at least two separate areas of damage (“dissemination in space”) in the central nervous system that have occurred at different points in time (“dissemination in time”). The diagnostic criteria utilize MRI results in combination with a history of symptoms as well as findings on the neurological examination to help make the diagnosis.

• #21 Understanding Multiple Sclerosis Relapses

  https://www.verywellhealth.com/multiple-sclerosis-relapse-2440699

  Multiple sclerosis relapses refer to the development of new symptoms or the worsening of existing symptoms. Relapses are typically confirmed by the development of a lesion on your brain or spinal cord and are considered a sign that your disease is progressing. […] If you develop new symptoms or if the symptoms you’ve been having get worse, it’s called a relapse. These symptoms may be mild or severe. […] MS relapses are connected to a wider range of symptoms that may be mild or severe. […] Common flare-ups may include the following symptoms: Loss of bladder or bowel control, Difficulty focusing or remembering information, Fatigue, Dysesthesia, a squeezing sensation around the torso, Numbness or tingling in the extremities or face, Involuntary spasms or stiffness, Vision problems, Loss of balance and difficulty walking. […] Relapse symptoms may last one day or may persist for a few days, weeks, or months. […] Specific symptoms associated with flare-ups vary from person to person. They may only last a short time, but in some cases, they may cause long-term residual disability.

• #22 Secondary-Progressive Multiple Sclerosis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/secondary-progressive-multiple-sclerosis.html

  Multiple Sclerosis (MS) is a disease of the central nervous system (CNS), which is made up of the brain, spinal cord and optic nerve. This disorder causes destruction of the coating (myelin) that surrounds and protects nerve fibers (axons). As a result, the damage disrupts the normal flow of messages (nerve impulses) from the CNS, causing a reduction or loss of body function. In many cases, the nerve fibers (axons) are also destroyed. […] Secondary-progressive multiple sclerosis (SPMS) is the form of the disease that develops from relapsing-remitting multiple sclerosis (RRMS). The MS disease course varies across individuals and not all patients who have RRMS will develop SPMS. […] Patients with SPMS generally have fewer relapses than they would with RRMS, because the inflammation has decreased. However, because nerves have begun to be damaged or lost at this stage of the condition, a worsening of the condition is generally experienced.

• #23 Science-Backed Ways to Slow Multiple Sclerosis Progression – Hoag

  https://www.hoag.org/featured-news/40385/

  It’s possible for people with RRMS to develop secondary progressive MS. […] As the name suggests, secondary progressive MS (SPMS) is the progressive phase of MS. […] Estimates of how many people with RRMS progress to SPMS vary. […] Before DMTs came into the picture in the 1990s, studies found that an estimated 50% of those diagnosed with RRMS would transition to SPMS within 10 years, and 90% would transition within 25 years. […] But new medication has helped to slow progression and a recent study found only 25% of patients with RRMS had progressed to SPMS 10 years after their diagnosis (and 50% after 20 years). […] According to the National MS Society, the transition from RRMS to SPMS typically happens in people who’ve had RRMS for at least 10 years. […] During the SPMS stage of MS, patients may still have relapses caused by inflammation, but the disease course changes from an inflammatory process in RRMS to a steadily progressive phase, involving nerve damage or loss. […] For standalone primary progressive MS (PPMS), neurologic function starts worsening from the initial diagnosis and patients usually don’t experience early relapses or remissions.

• #24 Secondary-Progressive Multiple Sclerosis | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/secondary-progressive-multiple-sclerosis.html

  Symptoms of SPMS are similar to those of primary-progressive multiple sclerosis (PPMS). The main symptom of both forms of the condition is gradual worsening of disability. […] Patients with SPMS may experience relapses and remission of symptoms, but the remissions aren’t complete and symptoms often remain present during these times. […] There is no cure for secondary-progressive multiple sclerosis. If a patient has SPMS with relapse episodes, corticosteroids can be given to shorten and lessen the severity of the relapse. Symptoms of SPMS can affect a patient’s daily life and physical and occupational therapy may be used to manage symptoms and adjust patients to living and working situations.

• #25 Types of MS | MS Trust

  https://mstrust.org.uk/information-support/about-ms/types-ms

  Many people who are initially diagnosed with relapsing remitting MS find that, over time, their MS changes. They have fewer or no relapses but their disability increases. As this follows an initial (primary) relapsing remitting phase, this is known as secondary progressive MS. […] Studies that have monitored people with MS over a long period of time suggest that after 19 years, half those people who were diagnosed with relapsing remitting MS will have developed secondary progressive MS. […] Between 10 and 15 in 100 people with MS are diagnosed with primary progressive MS (or less commonly chronic progressive MS). In this type of MS disability increases from the beginning, and it is rare to have any relapses. […] Although disability increases in progressive MS, the rate at which this happens varies from person to person and you may have times of improvement and times when symptoms stay the same.

• #26 Multiple sclerosis – Wikipedia

  https://en.wikipedia.org/wiki/Multiple_sclerosis

  The course of symptoms occurs in two main patterns initially: either as episodes of sudden worsening that last a few days to months (called relapses, exacerbations, bouts, attacks, or flare-ups) followed by improvement (85% of cases) or as a gradual worsening over time without periods of recovery (10-15% of cases). A combination of these two patterns may also occur or people may start in a relapsing and remitting course that then becomes progressive later on. […] The prognosis of MS depends on the subtype of the disease, and there is considerable individual variation in the progression of the disease. In relapsing MS, the most common subtype, a 2016 cohort study found that after a median of 16.8 years from onset, one in ten needed a walking aid, and almost two in ten transitioned to secondary progressive MS, a form characterized by more progressive decline. In untreated PPMS, the median time from onset to requiring a walking aid is estimated as seven years. In SPMS, a 2014 cohort study reported that people required a walking aid after an average of five years from the onset of SPMS, and were chair or bed-bound after an average of fifteen years.

• #27 Primary Progressive Multiple Sclerosis | UMass Memorial Health

  https://www.ummhealth.org/health-library/primary-progressive-multiple-sclerosis

  Multiple sclerosis (MS) is a disease that interferes with your brain’s ability to control your body. […] With primary progressive multiple sclerosis (PPMS), nervous system problems get worse from the beginning. There are no symptom flare-ups (relapses or attacks). And there is no recovery (remission). How fast the disease gets worse may vary. There can be times when things are stable. And there can be periods of short-term (temporary) minor improvements. But nervous system problems steadily get worse. […] About 1 in 10 people diagnosed with MS have PPMS. On average, people with PPMS start having symptoms between ages 35 and 39. […] Symptoms can include: Pain, such as pain in the legs and feet, back pain, and muscle spasms […] Trouble walking […] Vision problems […] Muscle weakness

• #28 MS Progression Chart: Stages of MS, Disability Scale, and More

  https://www.healthline.com/health/progressing-ms/ms-progression-chart

  In SPMS, MS progresses over time with a sporadic, unpredictable pattern. You might still have times of remission, but there will be a worsening of your symptoms with each relapse. […] The disease progression in PPMS is slow and unpredictable. There are no remission periods. Symptoms might plateau for a period of time and be easier to manage, but they will not disappear. […] MS is a chronic condition that can change and progress with time. Every case of MS is unique. Not everyone will go through every stage of progression, and there is no set timeline. Knowing the type of MS you have can help you know what to expect and help you manage your condition. […] With the right tools, you can slow the progression of your MS and get symptom relief.

• #29 Stages of Multiple Sclerosis: Progression, Timeline, and More

  https://www.healthline.com/health/multiple-sclerosis/stages

  Multiple Sclerosis (MS) is usually classified into four types. However, some researchers are starting to measure disease progression in phases, or stages. […] MS occurs when your immune system mistakenly targets your central nervous system (CNS). […] Researchers are still working to understand how MS progresses. […] The condition is usually classified into types. However, research suggests MS may also be classified into stages. […] MS is usually classified into four types, partly based on how the condition progresses. […] RRMS involves periods in which symptoms worsen, called flare-ups, and then improve. […] Between flare-ups, the changes that cause symptoms dont appear to progress. However, RRMS may eventually progress to secondary progressive MS. […] Some people with RRMS will go on to develop SPMS, a more aggressive form of MS.

• #30 Types of MS | Ohio State Medical Center

  https://wexnermedical.osu.edu/brain-spine-neuro/multiple-sclerosis/types-and-stages

  No two patients will have the same MS journey. […] MS generally falls into one of four types, or stages. […] CIS is most frequently caused by inflammation in the optic nerve (causing visual loss in one eye), spinal cord (causing numbness or weakness in one or more limbs, often with bladder control difficulties) or brainstem (causing symptoms such as double vision, vertigo and gait imbalance). […] Your MS may progress to something called relapsing-remitting MS (RRMS) if you develop new neurologic symptoms that start and stop multiple times or have rapid worsening of existing symptoms, followed by full or partial recovery. […] Most people diagnosed with MS have a relapsing-remitting phase of the condition early on. […] In some individuals but not all secondary progressive MS (SPMS) follows RRMS, typically starting after 15-20 years of relapsing, remitting episodes. SPMS is marked by steady, gradual worsening of one or more neurological disabilities, usually weakness or numbness in one or more limbs, gait imbalance or memory difficulties.

• #31 Multiple Sclerosis Progression | OurParents

  https://www.ourparents.com/senior-health/multiple-sclerosis-progression

  While every person diagnosed with the disease will have their own MS progression timeline, there are four MS progression types, also called courses or phenotypes. CIS is an isolated episode of neurological symptoms caused by nerve inflammation and demyelination followed by recovery. CIS is a recognized potential precursor of MS, but its occurrence does not always mean a person will develop MS. If CIS is associated with MRI-detected brain lesions, theres a high likelihood a person will develop relapsing-remitting MS. RRMS is the most common type of MS progression: 85 percent of people with MS are diagnosed with it. RRMS patients experience clearly defined attacks of new or increasing neurologic symptoms, according to the National MS Society, with periods of recovery or even remission. SPMS may follow RRMS, as the disease moves from the inflammatory lesion stage to the more progressive stage of nerve damage and loss. Disability gradually increases over time, with or without evidence of disease activity (relapses or changes on MRI), the National MS Society reports. In PPMS, neurologic function progressively worsens without relapses or remissions. The inflammation type is also different in PPMS than with the other types, as lesions more often affect the spinal cord than the brain, causing more difficulty with walking and increased disability.

• #32 MECHANISMS UNDERLYING PROGRESSION IN MULTIPLE SCLEROSIS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337978/

  In multiple sclerosis (MS), currently approved disease-modifying treatments are effective in modulating peripheral immunity and, coherently, in reducing clinical/radiological relapses, but still, they perform poorly in preventing disease progression and overall disability accrual. […] Clinical progression in MS is likely related to the accumulation of neuro-axonal loss in a lifelong inflammatory CNS environment (both adaptive and innate) and relative un-balance between damage, repair and brain functional reserve. […] A critical driver appears to be the T and B-cell mediated compartmentalized inflammation within the leptomeninges and within the parenchyma. […] The neuropathological and biological understanding of disease progression in MS have progressed in the last few years. […] Clinical progression in MS is also related to reduced repair potential with age and in a lifelong oxidative stress environment (due to the persistent inflammatory drive as described above).

• #33 MECHANISMS UNDERLYING PROGRESSION IN MULTIPLE SCLEROSIS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7337978/

  Neuro-axonal dysfunction and death are final pathways of tissue injury leading to a disconnection syndrome, that is clinically eloquent especially in the spinal cord. […] Demyelinated axons are vulnerable due to the loss of the trophic support provided by the myelin sheath and oligodendrocytes. […] Although the compartmentalized T and B-cell mediated inflammation likely remains the fundamental driver of clinical progression in MS, recent perspective highlighted the role of the CNS tissue response to such lifelong inflammatory injury as the critical player for both pathological and clinical outcomes.

• #34 Science-Backed Ways to Slow Multiple Sclerosis Progression – Hoag

  https://www.hoag.org/featured-news/40385/

  Recently approved medications, including Ocrevus (ocrelizumab), Kesimpta (ofatumumab), and Mayzent (siponimod) not only prevent new inflammation, they can also slow down the progression of symptoms that MS patients can experience, Dr. Ntranos says. […] That said, always consult your doctor about new therapies, because they may or may not be right for your individual situation. […] All current MS treatments are designed to stop new disease activity in the central nervous system, Dr. Nntranos says. […] They can prevent the accumulation of lingering inflammation in the brain and spinal cord that could cause progression in the later stages of MS. […] So starting an MS treatment as early as possible is the best way to prevent the progression of disease. […] Among the lifestyle habits that may factor into progression of multiple sclerosis, smoking is a big one, Dr. Giesser says. […] Extensive research has found a clear negative relationship between smoking and overall MS disease course, according to the Cleveland Clinic. […] In MS patients, smoking has been associated with increased MS lesion volume, active brain lesions, and higher risk of brain atrophy. […] Smoking is the most important modifiable risk factor for MS progression, adds Dr. Ntranos. […] It has detrimental effects on your health in general and can also make MS worse. […] The myriad of chemicals that enter the body upon cigarette smoke inhalation can increase chronic inflammation, promote oxidative stress, and introduce toxins that can directly cause damage in the brain and spinal cord. […] A smoking cessation plan is vital if you have MS and currently smoke.

• #35 The winding path of progression – MS Australia

  https://www.msaustralia.org.au/news/winding-path-progression/

  Multiple sclerosis (MS) progression refers to the development of the disease after onset (when symptoms first appear). […] All forms of MS progress, or change, over time. […] However, true MS disease progression is the gradual accumulation of disability in between, or in the absence of, relapses. […] Acting together, these three processes lead to the increased disability that characterises MS disease progression. […] Risk factors typically have a detrimental effect, meaning that they increase the chance of greater levels of disability. […] Studies indicate that smokers had 1.5 times the risk of disease progression (meaning greater disability) compared to non-smokers. […] Lower vitamin D levels in the blood increases the risk of greater disability, suggesting that vitamin D might be protective against disease progression.

• #36 How Age Affects Multiple Sclerosis Symptoms and Progression | Everyday Health

  https://www.everydayhealth.com/multiple-sclerosis/symptoms/multiple-sclerosis-age-progression/

  The transition from relapsing-remitting MS to secondary-progressive MS appears to be age dependent, with the forties being the most common period to experience it, according to a review article published in 2021. […] The thinking used to be that MS progressed more quickly in people diagnosed at an older age. […] Indeed, research published in the Journal of Neurology, Neurosurgery Psychiatry found that children diagnosed with MS took longer to develop secondary-progressive disease (32 years) than adults diagnosed with MS (18 years), and they also took longer to reach disability milestones. […] But the study authors noted that those diagnosed as children hit disability milestones at a younger age and therefore could be considered to have a poorer prognosis. […] However, a subsequent study suggested otherwise. When researchers compared MS medications including beta interferons, glatiramer (Copaxone, Glatopa), fingolimod (Gilenya), natalizumab (Tysabri), and alemtuzumab (Campath, Lemtrada) versus no treatment at all, they found that treatment with any of these medications was associated with a lower risk of transition to SPMS.

• #37 How Age Affects Multiple Sclerosis Symptoms and Progression | Everyday Health

  https://www.everydayhealth.com/multiple-sclerosis/symptoms/multiple-sclerosis-age-progression/

  In particular, fingolimod, natalizumab, and alemtuzumab were associated with the lowest risk of progression to SPMS, and treatment was especially beneficial when started sooner less than five years after disease onset rather than later. […] A study from 2020 in the journal Neurology also identified smoking, along with older age, greater disability, motor and brain stem dysfunction, and spinal lesions at the time of diagnosis, as risk factors for transitioning from relapsing-remitting MS to secondary-progressive MS. […] Older people with MS are also more prone to such MS complications as urinary tract infections, pneumonia, septicemia (infection of the blood), and cellulitis (bacterial skin infection) than peers who don’t have MS, according to the NMSS. […] In addition, age impacts your ability to recover from an MS relapse. One study showed that it’s more difficult to rebound from a relapse as you get older.

• #38 New biomarker for predicting progression of multiple sclerosis identified – InFLAMES Research Flagship

  https://inflames.utu.fi/new-biomarker-for-predicting-progression-of-multiple-sclerosis-identified/

  Researchers at the University of Turku have discovered a new biomarker that can predict the progression of multiple sclerosis (MS). The thickness of the inflammatory cell rim surrounding brain lesions was found to directly correlate with the severity and speed of disease progression. The research combined PET imaging data from 114 Finnish MS patients with post-mortem brain tissue analysis from Dutch MS patients. Results show that the wider the inflammatory rim around a brain lesion is, the more aggressively the disease advances. When microglial cells form a thick rim around MS lesions, their harmful activity pushes deeper into healthy brain tissue, causing irreversible damage, says Professor Laura Airas. This discovery allows us not only to identify patients who need more aggressive treatment earlier but also to evaluate the effectiveness of new drug candidates by observing changes in lesion rims. The findings are expected to improve the development of treatments particularly for progressive MS, the yet undertreated form of the disease.

• #39 Science-Backed Ways to Slow Multiple Sclerosis Progression – Hoag

  https://www.hoag.org/featured-news/40385/

  In terms of MS progression and other modifiable factors, the evidence isn’t as clear, Dr. Giesser says. […] We know lifestyle factors such as eating a healthy diet, maintaining a healthy gut microbiome, exercising regularly, and taking vitamin D are helpful for our overall health. […] Some, like exercise, can help with MS symptoms, prevent complications, and possibly be neuroprotective. […] But for MS progression specifically and evidence-based data, the jury is still out for many lifestyle changes beyond smoking. […] The one factor that can almost certainly provide benefits is getting seven to eight hours of sleep a night, Dr. Ntranos says. […] Sleep is essential to restore our energy levels and promote a healthy brain homeostasis, he says. […] In animal studies, lack of sleep has been shown to increase inflammation in the central nervous system, which could potentially have implications for our MS patients. […] The research around sleep and its effect on MS progression is insufficient at present. […] And multiple sclerosis itself comes with sleep issues, with some 50% of those with the disease reporting sleep disturbance.

• #40 Stages of multiple sclerosis: Types and their progression

  https://www.medicalnewstoday.com/articles/stages-of-multiple-sclerosis

  Around 10-15% of people with MS have PPMS, which is progressive from the first onset of symptoms. […] With PPMS, people experience a gradual worsening of symptoms. […] It can be difficult to predict how RRMS may progress or how frequent relapses will be. Disease progression may be faster with typically progressive types of MS, although it is also difficult to predict the timeframe for this. […] Depending on the type of MS, symptoms can progress in different ways. People may have relapses and periods of recovery, or changes may be gradual and steady. […] The time frame for progression can vary. Treatments, such as DMTs, may help prevent or delay disease progression.

• #41 Science-Backed Ways to Slow Multiple Sclerosis Progression – Hoag

  https://www.hoag.org/featured-news/40385/

  It’s not always easy to tell if your multiple sclerosis is progressing. […] Usually, your doctor will monitor your symptoms over a six-month period, to determine if your disease course is changing but it might require one to two years to get a full picture. […] Ironically, the hallmark of progression is slow and gradual worsening disease, so identifying it can be a challenge in itself. […] One way your doctor can track your MS progression is a measure called no evidence of disease activity, or NEDA. […] This includes an absence of relapses, disability progression, and MRI activity. […] Many MS specialists use something called an Expanded Disability Status Scale (EDSS) to help them determine disability progression, says Yasir N. Jassam, M.D., a neurologist and director of the Multiple Sclerosis Neuroimmunology Program in Hoags Pickup Family Neurosciences Institute in Newport Beach, CA. […] This scale looks at measurements of impairment in eight functional systems including muscle weakness, loss of balance, swallowing, numbness, bowel and bladder function, vision issues, and thinking and memory problems. […] Another component of NEDA involves evaluating brain volume loss, says Dr. Jassam. […] When you lose brain volume, you’re losing cognitive capacity, he explains. […] And that’s a form of progression as well.

• #42 Progressive Multiple Sclerosis | Is My MS Getting Worse?

  https://resources.healthgrades.com/right-care/multiple-sclerosis/7-signs-your-multiple-sclerosis-is-progressing

  7 Signs Your Multiple Sclerosis Is Progressing […] Nearly one million people in the United States are living with multiple sclerosis (MS). A chronic condition of the central nervous system, MS damages the protective insulation around the nerve fibers of the brain and spinal cord, which interferes with communication between the brain and the rest of the body. MS can be progressive, causing more damage over time. Know the signs of progression and talk with your doctor about treatment options. […] If the time between your flare-ups is getting shorter, your MS may be progressing. Eventually, 80% of people with relapsing-remitting MS will develop secondary progressive MS (SPMS), in which symptoms no longer follow the relapsing-remitting cycle. Instead, people with SPMS will experience consistent symptoms that worsen over time.

• #43 Progressive Multiple Sclerosis | Is My MS Getting Worse?

  https://resources.healthgrades.com/right-care/multiple-sclerosis/7-signs-your-multiple-sclerosis-is-progressing

  About 80% of those with MS have fatigue. “MS fatigue” is also called “MS lassitude.” As it grows more severe, you may find it harder to meet the demands of work and home. […] MS causes damage to the nerve cells that stimulate muscles and support endurance. The result is muscle weakness and feelings of stiffness that can get worse over time. […] The fatigue, muscle weakness, stiffness, and spasticity that accompany MS progression can contribute to “gait difficulties” which make it harder to walk. […] A majority of people with MS have some form of bladder dysfunction, including frequent urination (especially at night) or incontinence (inability to “hold it in”). Others have constipation or lose control of their bowels. If these symptoms become frequent, that’s a sign your MS has progressed.

• #44 Progressive Multiple Sclerosis | Is My MS Getting Worse?

  https://resources.healthgrades.com/right-care/multiple-sclerosis/7-signs-your-multiple-sclerosis-is-progressing

  As MS progresses, you may notice it’s becoming harder to process information, learn new things, remember details, get organized, solve problems, or focus. […] If your current treatment plan isn’t keeping up with worsening symptoms, let your doctor know and ask about alternatives. One option may be disease-modifying therapies (DMTs), proven effective for many people with progressive MS. They work primarily by decreasing inflammation in the central nervous system.

• #45 Caring for someone with multiple sclerosis at end of life | Marie Curie

  https://www.mariecurie.org.uk/professionals/palliative-care-knowledge-zone/multiple-sclerosis

  People with multiple sclerosis (MS) may experience bladder and bowel problems, as well as difficulties or changes in moving, breathing, swallowing and communicating. Towards the end of life, these symptoms may become more severe. […] Towards the end of life, a person with MS might have symptoms more often or more severely. They might have more than one symptom at the same time. It is likely they will have stopped taking medications to slow down their disease and their condition will get progressively worse. […] In the most advanced stages of multiple sclerosis (MS), someone might have symptoms more frequently, more severely, or multiple symptoms. Someone with advanced MS is likely to have stopped taking medications which help reduce relapses and can help slow down the illness. […] Other signs that might show a person has advanced MS are: speech and language problems, difficulty swallowing, weak bones (osteoporosis) from lack of mobility, breathing problems, weight loss, pressure damage (pressure sores or bedsores), severe difficulty moving around, increased fatigue, problems thinking and making decisions, needing more help with personal care.

• #46 Assessing disease progression and treatment response in progressive multiple sclerosis | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-024-01006-1

  Progressive multiple sclerosis poses a considerable challenge in the evaluation of disease progression and treatment response owing to its multifaceted pathophysiology. […] Traditional clinical measures such as the Expanded Disability Status Scale are limited in capturing the full scope of disease and treatment effects. […] Advanced imaging techniques, including MRI and PET scans, have emerged as valuable tools for the assessment of neurodegenerative processes, including the respective role of adaptive and innate immunity, detailed insights into brain and spinal cord atrophy, lesion dynamics and grey matter damage. […] The potential of cerebrospinal fluid and blood biomarkers is increasingly recognized, with neurofilament light chain levels being a notable indicator of neuro-axonal damage.

• #47 Assessing disease progression and treatment response in progressive multiple sclerosis | Nature Reviews Neurology

  https://www.nature.com/articles/s41582-024-01006-1

  Moreover, patient-reported outcomes are crucial for reflecting the subjective experience of disease progression and treatment efficacy, covering aspects such as fatigue, cognitive function and overall quality of life. […] Effective treatment of progressive multiple sclerosis (MS) remains an urgent medical need. […] Traditional MRI biomarkers do not adequately track progressive MS. Advances in MRI, such as brain atrophy and lesion volume analysis, show promise in assessing disease progression and response to treatment. […] Changes in optical coherence tomography, a non-invasive imaging modality that measures retinal layer thickness, reflect brain atrophy and MS progression, offering a valuable window into neurodegeneration and treatment efficacy. […] Body fluid biomarkers, such as neurofilament light in blood, and immune activation and neuronal damage markers in cerebrospinal fluid are emerging as important tools for assessing disease activity and treatment response in progressive MS.

• #48 MS Progression & Stages: How MS Progresses From Stage-to-Stage

  https://www.webmd.com/multiple-sclerosis/how-disease-progresses

  Multiple sclerosis (MS) is different for everyone who has it. The symptoms it causes and when they flare up vary not only between people but also throughout one persons life. […] Your diagnosis is based on the symptoms you have, how and when they flare up or improve, which of your bodys functions give you trouble, and your test results. […] The way the disease changes and gets worse is different for each of the three types of MS: […] People with this type have attacks when their symptoms get worse, called relapses, followed by full, partial, or no recovery. […] People who get this type usually start with relapsing-remitting MS. Over time, symptoms stop coming and going and begin getting steadily worse. […] In this type, symptoms gradually get worse without any obvious relapses or remissions.

• #49 MS Progression & Stages: How MS Progresses From Stage-to-Stage

  https://www.webmd.com/multiple-sclerosis/how-disease-progresses

  An MS relapse starts when nerves in the brain and spinal cord get inflamed (swollen or irritated). […] A plaque in the brain or spinal cord changes the electrical signals that zip up and down nerves. […] Flares can be mild and not cause major problems, or they can severely affect your day-to-day life. […] Sometimes a symptom flare has nothing to do with the course of your disease, but happens because something has aggravated your condition, like a fever, infection, or hot weather. […] This break doesnt mean that all the symptoms of MS disappear. Instead, you mostly return to the way you were before the last relapse began.

• #50 The Four Stages of MS | MS Care

  https://aspireuk.co.uk/the-four-stages-of-ms/

  In SPMS, people may find that their ability to move around and do everyday tasks becomes more challenging as time goes on. […] Unlike RRMS, where flare-ups are the main cause of disability, in SPMS, disability gets worse even when there aren’t any flare-ups. This can lead to a more gradual decline in how well someone can function. […] Not everyone with MS will progress to more advanced stages of the disease. Some individuals may remain in the early stages, such as relapsing-remitting MS, without significant progression for many years. […] Factors such as the type of MS, the effectiveness of treatment, and individual differences in disease course and response to treatment can all influence the rate and pattern of MS progression. […] At this stage, individuals may experience significant challenges with daily activities and may require assistance with various tasks.

• #51 Primary Progressive Multiple Sclerosis—A Key to Understanding and Managing Disease Progression

  https://www.mdpi.com/1422-0067/25/16/8751

  Primary progressive multiple sclerosis (PPMS), the least frequent type of multiple sclerosis (MS), is characterized by a specific course and clinical symptoms, and it is associated with a poor prognosis. […] The onset of symptoms is often difficult to discern because of their insidious and slow development over time. Thus, the identification of progression is often retrospective, and the diagnostic process may be challenging. The most common clinical manifestation at onset includes motor deficit and sensory impairment with a pattern suggestive of myelopathy, often accompanied with bowel and bladder dysfunction. […] Patients with PPMS have fewer and smaller brain lesions revealed in T2/FLAIR MR sequences but tend to have more lesions in the spinal cord. […] The initial increase in disability and the number of neurological functional systems involved at early stage of PPMS predict further rate of progression and time of survival.

• #52 Multiple sclerosis – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/multiple-sclerosis/diagnosis-treatment/drc-20350274

  A complete neurological exam and medical history are needed to diagnose MS. […] So people who are overweight have a higher chance of developing MS and people who have MS who are overweight tend to have more active disease and a faster onset of progression. […] The important thing to note is that heat does not cause an MS attack or MS relapse. […] In most people with relapsing-remitting MS, the diagnosis is straightforward. Diagnosis is based on a pattern of symptoms related to MS and confirmed by test results. […] Diagnosing MS can be harder in people with unusual symptoms or progressive disease. Additional testing may be needed. […] There is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, reducing relapses, slowing the progression of the disease and managing MS symptoms.

• #53

  https://www.roche.com/stories/disease-progression-in-multiple-sclerosis

  Most people with MS experience an increase in physical disability (The loss of abilities that results from damage to the central nervous system as MS progresses and may be irreversible) at some point in time. […] In MS, the immune system attacks nerve cells in the brain, spinal cord and optic nerves. This disease activity can cause symptoms and disability. […] Physical disability gets worse (progression) when disease activity causes more and more nerve cells to die (neurodegeneration). […] Early treatment with an effective DMT may reduce disease activity and disability progression.

• #54 Relapsing-remitting MS (RRMS) | National MS SocietyNational Multiple Sclerosis Society LogoNational Multiple Sclerosis Society LogoOpen search

  https://www.nationalmssociety.org/understanding-ms/what-is-ms/types-of-ms/relapse-remitting-ms

  Research has shown that all the MS medications can: reduce the number of relapses (also called attacks or exacerbations), limit new MS activity (new areas of damage called plaques or scars) in the central nervous system as seen on magnetic resonance imaging (MRI), and slow disease worsening (progression).

• #55 Primary Progressive Multiple Sclerosis

  https://encyclopedia.nm.org/134,55

  With primary progressive multiple sclerosis (PPMS), nervous system problems get worse from the beginning. There are no symptom flare-ups (relapses or attacks). And there is no recovery (remission). How fast the disease gets worse may vary. There can be times when things are stable. And there can be periods of short-term (temporary) minor improvements. But nervous system problems steadily get worse. […] Symptoms may include pain, trouble walking, vision problems, and muscle weakness. […] Ocrelizumab (ocrevus) is currently the only medicine approved to treat primary progressive MS. […] Primary progressive MS (PPMS) is a type of MS. It has no symptom flare-ups. And there is no recovery. Nervous system problems get worse.

• #56 How to Manage Multiple Sclerosis (MS) Relapses > News > Yale Medicine

  https://www.yalemedicine.org/news/how-to-manage-multiple-sclerosis-ms-relapses

  When patients with relapsing-remitting MS experience flare-ups, doctors may prescribe intravenous corticosteroids. These powerful medications help reduce inflammation in the body and shorten the duration of exacerbations, but they do not have a long-term benefit for treating the disease. […] In recent years, neurologists have turned to more effective treatments that target different white blood cells in the immune system known as B cells. B cells and T cells normally protect the body. When people have MS, it is now thought that B cells activate the T cells, which damage the myelin. Treatments, known as monoclonal antibodies, are used to deplete the B cells, limiting damage to the myelin. […] If you deplete the circulating B cells, it’s 98% effective in stopping relapses. Neurologists now typically prescribe B cell-depleting monoclonal antibodies to patients who are newly diagnosed with MS; we basically treat everyone with Ocrevus or its equivalent. The best thing to do is treat patients before they have any clinical symptoms. […] When patients with relapsing-remitting MS begin taking medication soon after their diagnosis, they’re more likely to have fewer relapses and less disability from the disease. The message is that the earlier you treat, the better the outcome. The key is early diagnosis, early treatment.

• #57 Multiple sclerosis: Triggers in the gut flora

  https://www.mpg.de/24685137/0507-psy-multiple-sclerosis-triggers-in-the-gut-flora-155111-x

  In multiple sclerosis (MS), the body’s own immune cells attack the insulating layer surrounding nerve fibers, damaging their function. Depending on where attacks occur, a wide variety of symptoms can arise, which is why MS is also known as the disease of a thousand faces. Impaired vision, other sensory disturbances, and paralysis are just some of the symptoms that people living with MS must contend with. […] The researchers identified 51 taxagroups of microorganisms that differed in abundance between twins with and without MS symptoms. […] Symptoms were mainly observed in mice that had been colonized with MS samples, indicating the presence of disease-causing microorganisms in the small intestines of people with MS. […] The researchers then examined the feces of the diseased mice and identified two members of the family of Lachnospiraceae (Lachnoclostridium sp. and Eisenbergiella tayi) as potential disease-causing factors.

• #58 Science-Backed Ways to Slow Multiple Sclerosis Progression – Hoag

  https://www.hoag.org/featured-news/40385/

  So if you have MS and you are trying to keep your condition from progressing, what’s the bottom line? […] I always tell my patients that MS care is like a tripod, says Dr. Jassam. […] One leg is trying to stop the disease by medication. […] Another leg is the modifiable risk factors, such as your smoking, your diet, your vitamin D. […] And the third leg is symptom management, to improve the damage or the effects that MS has already had on you. […] Continue tending to all three legs, and you’ll improve your chances of keeping MS at bay.

• #59 Psychological Perspective on the Role of Mental Health in MS Rehabilitation and Care

  https://www.neurologylive.com/view/psychological-perspective-role-mental-health-ms-rehabilitation-care

  Mental health challenges are commonly reported among individuals with multiple sclerosis (MS), with prior studies suggesting a higher prevalence of depression and anxiety compared with the general population. […] Although adjustment and grieving are expected, anxiety and depression are relatively common for newly diagnosed patients with MS as well as over the lifespan when disability accrual may occur, which can impact self-efficacy to manage ones health and motivation for engagement in ones healthcare. […] Coping with these symptoms and the variety of potential changes in visual, sensory, motor, cognitive, neuropsychiatric functioning can impact a patients engagement in their healthcare, including neurological rehabilitation and disease management. […] Motivation is an internal process whereas engagement is the degree to which we put our motivations into action. When a patient with MS is managing significant emotional distress, acutely or chronically, this can impact motivations to engage, which can ultimately be associated with unintended poorer healthcare outcomes.

• #60 Psychological Perspective on the Role of Mental Health in MS Rehabilitation and Care

  https://www.neurologylive.com/view/psychological-perspective-role-mental-health-ms-rehabilitation-care

  Many patients with MS will find themselves at one point or another in a rehabilitation setting (i.e., engaging in rehabilitation therapies to address functional changes because of MS). The continuum of care can range from intensive care unit (ICU), inpatient hospitalization, inpatient rehabilitation, outpatient rehabilitation, in-home rehabilitation and independent maintenance of ones own rehabilitation plan (i.e., home exercise program). At any point in care, a patient with MS may experience fluctuating symptoms of anxiety and/or depression that can impact rehabilitation engagement. […] CBT is an evidence-based psychotherapy framework for addressing depression and anxiety in the general population, as well as in patients with MS. […] More targeted forms of CBT have also been designed and tested with evidence to suggest it is effective in helping patients with MS to manage common symptoms, including CBT for chronic pain (CBT-CP), fatigue (CBT-F), and insomnia (CBT-I).

• #61 Psychological Perspective on the Role of Mental Health in MS Rehabilitation and Care

  https://www.neurologylive.com/view/psychological-perspective-role-mental-health-ms-rehabilitation-care

  ACT is another evidence-based psychotherapy framework for several psychiatric diagnoses, including anxiety and depression, and has been widely validated in use with people living with MS. […] Living with MS is a patient experience with a multitude of potential symptoms that can be assessed for intervention and/or healthcare management. […] Patients with MS who carry a pre-existing psychiatric diagnosis may be more vulnerable to health care provider bias and stigma. […] Despite changes in function or chronic symptom experiences, many patients with MS independently or through collaboration with their support systems (i.e., peers, family, friends, healthcare providers) develop strong skills for coping, resilience, adaptability and growth in the face of adversity.

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