Multiple sclerosis classification
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Multiple sclerosis may be classified into four groups according to clinical course of the disease.
- Relapsing-remitting
- secondary-progressive
- primary-progressive
- progressive-relapsing
Classification
Multiple sclerosis may be classified according to its clinical course into four groups:[1]
- _ Relapsing remitting:
RRMS is defined by acute attacks of neurological dysfunction followed by full or partial recovery. Patient clinical symptoms are stable between the attacks.[1]
- _ Secondary progressive:
Patient with long term RRMS can switch to SPMS, when the neurological symptoms progressively worsen between the attacks.[1]
- _ Primary progressive:
PPMS is defined by continuously worsening of neurological dysfunction with no distinct attacks and remissions.[1]
- _ Progressive relapsing:
PRMS is defined by progression of disease from the beginning with acute attack episodes.[1]
These subtypes were defined In 1996 by the US National Multiple Sclerosis Society (NMSS).[1]The fact that the clinical course of the disease is a dynamic process makes it possible that the subtypes switch to each other over time.[2]
In recent studies a new subtype recognized and named: clinically isolated syndrome (CIS). It is when the clinical presentation of a disease is suggestive of myelin sheath inflammation but cannot fulfill the diagnostic criteria of MS.[2] [3]
Another termination that we have regarding MS classification is radiologically isolated syndrome (RIS). It defines as radiological findings of myelin sheath inflammation without any sign or symptoms in patient. Although it can be an indicator of early stages of MS disease, We cannot consider it as a subgroup of MS because radiological finding of inflammatory demyelination without any sign or symptoms of the disease is nonspecific.[2]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Lublin FD; Reingold SC. Defining the clinical course of multiple sclerosis: results of an international survey. National Multiple Sclerosis Society (USA) Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis. Neurology 1996 Apr;46(4):907-11. PMID 8780061
- ↑ 2.0 2.1 2.2 Lublin FD, Reingold SC, Cohen JA, Cutter GR, Sørensen PS, Thompson AJ, Wolinsky JS, Balcer LJ, Banwell B, Barkhof F, Bebo B, Calabresi PA, Clanet M, Comi G, Fox RJ, Freedman MS, Goodman AD, Inglese M, Kappos L, Kieseier BC, Lincoln JA, Lubetzki C, Miller AE, Montalban X, O'Connor PW, Petkau J, Pozzilli C, Rudick RA, Sormani MP, Stüve O, Waubant E, Polman CH (2014). "Defining the clinical course of multiple sclerosis: the 2013 revisions". Neurology. 83 (3): 278–86. doi:10.1212/WNL.0000000000000560. PMC 4117366. PMID 24871874.
- ↑ Katz Sand I (2015). "Classification, diagnosis, and differential diagnosis of multiple sclerosis". Curr. Opin. Neurol. 28 (3): 193–205. doi:10.1097/WCO.0000000000000206. PMID 25887774.