Multiple sclerosis (MS) symptoms are likely to change with age, as the disease typically follows a pattern, moving through different variations or types over the years.
A doctor or healthcare professional can’t predict exactly how your disease will change over time. But advances in MS research are offering better treatments to slow the disease’s progression and improve the outlook for people living with MS.
MS is often diagnosed when people are in their 20s and 30s, although it can develop at any age.
MS damages myelin, the protective coating around nerves. This damage interrupts the flow of nerve impulses from the brain to the body. The greater the damage that’s done to the myelin, the more severe your symptoms will become.
Everyone with MS is different. How quickly your disease progresses and the symptoms you experience won’t necessarily be the same as someone else’s with the condition.
MS often starts with a single attack. Suddenly your vision becomes blurry or your legs feel numb or weak. When these symptoms last for at least 24 hours and this is the first attack, they’re called clinically isolated syndrome (CIS).
CIS typically starts between ages 20 and 40. It’s caused by inflammation or damage to myelin in your central nervous system. CIS can be a warning of MS to come, but that isn’t always the case.
If an MRI shows signs of brain lesions, MS is much more likely to develop.
Up to 85% of people with MS first receive a diagnosis of relapsing-remitting MS (RRMS). It typically starts when people are in their 20s or 30s, although it can begin earlier or later in life.
In RRMS, attacks on myelin produce periods of symptom flare-ups called relapses. During a relapse, symptoms may include:
- numbness or tingling
- weakness
- vision loss
- double vision
- fatigue
- problems with balance
Each relapse can last from a few days to a few months. The exact symptoms and their severity can be different for each person.
After a relapse, you’ll enter a symptom-free period called remission. Each remission lasts for several months or years. During remissions there are neither new symptoms nor worsening of old symptoms, with the exception of old symptoms because of infections, fatigue, or getting too hot.
During a remission, your symptoms don’t get worse, but an MRI may still show continued worsening of disease activity.
Some people stay in RRMS for many decades. Others progress to the secondary progressive form within a few years. It’s impossible to predict how each person’s disease will act, but new treatments are helping to slow the progression of MS overall.
About 15% of people with MS receive a diagnosis of the primary progressive form (PPMS). PPMS usually appears during the mid-to-late 30s.
In PPMS, nervous system damage and symptoms steadily get worse over time. There are no real remission periods. The disease continues to progress, and it can eventually lead to problems with walking and performing other daily activities.
Secondary progressive MS (SPMS) is the stage that follows RRMS. In this type of MS, myelin damage gets worse over time. You won’t have the long remissions that you had with RRMS. Increasing nervous system damage will lead to more severe symptoms.
In the past, about half of people with RRMS moved into the SPMS stage within 10 years, and 90% transitioned to SPMS within 25 years.
With new MS drugs, doctors are seeing changes in the time to conversion to SPMS and maybe a reduction in the number of people progressing to SPMS. It’s too early to determine the long-term impacts of the new MS drugs on progression to SPMS.
MS is a disease that starts early in life but progresses over time. Most people start with the relapsing-remitting form, alternating periods of symptoms called relapses with symptom-free periods called remissions.
Without treatment, the disease continues to the secondary progressive form. Yet, new and more effective treatments are slowing MS progression, sometimes for decades.
