Fast Five Quiz: Multiple Sclerosis Presentation and Diagnosis

Christopher Luzzio, MD


July 30, 2020

Figure 1. MRI of brain showing MS.

Approximately 85% of all MS cases present as RRMS. The categories are based on frequency of clinical relapses, progression, and lesion development, as detected by MRI. RRMS is characterized by recurrent attacks of neurologic deficits referable to different parts of the central nervous system that resolve completely or almost completely over a short period of time with little to no residual deficit. Clinically isolated syndrome (CIS) and benign MS are sometimes counted as subgroups of RRMS. CIS describes a single episode of neurologic symptoms, whereas patients with benign MS achieve almost complete remission between relapses, with little or no accumulated physical disability over decades.

About half of patients diagnosed initially with RRMS will convert to a secondary progressive pattern within 10-15 years. Once patients have SPMS, they may or may not experience relapses but the disease will continually progress, with increasing disability. PPMS is associated with steady functional decline with no relapses; it accounts for 10%-15% of MS cases. Less than 5% of patients with MS have PRMS, in which the disease is progressive, with occasional relapses.

Learn more about the types of MS.


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