You can expect your disease to follow one of these four paths.
How Does the Disease Progress?
The course of multiple sclerosis varies for each person. Because of this uncertainty, doctors often tell their patients that they "probably" or "possibly" have MS. Your diagnosis is based on the combination of problems, patterns of recurrence, which systems are impaired, and your test results. There is no way to predict how each person's condition will progress. It often takes years before a doctor can be certain of an MS diagnosis and have some idea on how the disease will progress.
There are four courses that MS takes:
Most people with MS are diagnosed between the ages of 20 and 40, but the unpredictable physical and emotional effects of the disease continue throughout the person's life.
What Is a True Exacerbation (Relapse) of Multiple Sclerosis?
A true exacerbation of multiple sclerosis is caused by an area of inflammation (swelling) in the nerves of the brain and spinal cord system followed by something called demyelination, which is the destruction of myelin. The myelin is the fatty sheath that surrounds and protects the nerve fibers.
Demyelination results in the formation of an abnormal area called a plaque within the brain and/or spinal cord. A plaque causes the nerve impulses to be slowed, distorted, or halted, producing the symptoms of MS. One example of an exacerbation of MS would be the development of optic neuritis, an inflammation of the optic nerve (which is in the back of the eye) that impairs vision.
An exacerbation of MS may be mild and not cause a noticeable impairment in functioning or may significantly interfere with a person's daily life. Exacerbations usually last from several days to several weeks, although they may extend into months.
Exacerbations or relapses of MS are often treated with medications called corticosteroids. These drugs reduce inflammation. It is generally accepted that taking corticosteroids for a short amount of time will shorten an exacerbation and/or reduce the severity.
What Is a Pseudoexacerbation in Multiple Sclerosis?
Sometimes an increase in symptoms has nothing to do with the underlying multiple sclerosis, but is caused by factors such as fever, infection, or hot weather that can temporarily aggravate MS. This is referred to as a pseudoexacerbation. For example, some people report a worsening of their symptoms during or after periods of intense stress.
What Is Remission in Multiple Sclerosis?
A remission does not mean that all the symptoms of multiple sclerosis disappear, but rather that a person with MS mostly returns to the way they were before the last exacerbation or relapse began.
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