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Relapsing/Remitting Multiple Sclerosis

Relapsing/Remitting Multiple Sclerosis (RRMS) is one of four internationally recognised forms of Multiple Sclerosis.

RRMS is characterised by relapses (also known as exacerbations) during which time new symptoms can appear and old ones resurface or worsen. The relapses are followed by periods of remission, during which time the person fully or partially recovers from the deficits acquired during the relapse.

Relapses can last for days, weeks or months and recovery can be slow and gradual or almost instantaneous. The vast majority of people presenting with Multiple Sclerosis are first diagnosed with relapsing/remitting. This is typically when they are in their twenties or thirties, though diagnoses much earlier or later are known. Twice as many women as men present with this variety.

The following graph, showing level of disability over time, demonstrates two typical courses of RRMS.

During relapses, myelin, a protective insulating sheath around the nerve fibres (neurons) in the white matter regions of the central nervous system (CNS), is damaged in an inflammatory response by the body's own immune system. This causes a wide variety of neurological symptoms that vary considerably depending on which areas of the CNS are damaged.

Immediately after a relapse, the inflamatory response dies down and a special type of glial cell in the CNS (called an oligodendrocyte) sponsors remyelination - a process whereby the myelin sheath around the axon is repaired. It is this remyelination that is responsible for the remission.

Approximately 50% of patients with RRMS convert to Secondary Progressive Multiple Sclerosis (SPMS) within 10 years of disease onset. After 30 years, this figure rises to 90%.

At any one time, the Relapsing-Remitting form of the disease accounts around 55% of all people with multiple sclerosis.

Other forms of Multiple Sclerosis are:
Secondary Progressive Multiple Sclerosis
Primary Progressive Multiple Sclerosis
Progressive Relapsing Multiple Sclerosis

Relapsing/Remitting Multiple Sclerosis links:
What is the Course of MS?

MS Glossary
All About Multiple Sclerosis