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What to Expect

While there is no way to predict with any accuracy how a person’s MS will progress, four basic clinical patterns have been defined: ♦

  • Relapsing-remitting MS is characterised by clearly defined attacks (relapses or exacerbations), which last from days to weeks and then subside with full or partial recovery and no noticeable disease progression between attacks.
  • Primary-progressive MS is characterised by a gradual but steady progression of disability from the onset with no obvious plateaus or remissions or only occasional plateaus and minor temporary improvements.
  • Secondary-progressive MS begins initially as a relapsingremitting course that later evolves into a more consistently progressive course with or without relapses.
  • Progressive-relapsing MS shows a steady progression in disability from the onset of the disease, but with clear, acute relapses (attacks) that may or may not have some recovery following the acute episode.


One of the greatest challenges presented by MS is the unpredictability and uncertainty of what is to come, particularly in the earlier stages of MS. It is virtually impossible to predict what symptoms a person will experience or how the disease will progress over time.

In addition, remissions can occur at any time over the course of the illness and last for an indefi nite length of time from months to years. This unpredictability can make life very diffi cult, particularly in terms of planning for the distant and not-so-distant future. However, with time the unpredictability related to symptoms and relapses may become less unpredictable and easier for you to manage.

A good strategy for dealing with the future might be to educate yourself about the possible changes that MS can bring, to work with our doctor, to communicate openly with family members whose daily lives will also be touched by this disease and to keep your life as full and satisfying as possible. It is easy to become overwhelmed by your fears of what the future might bring and, in the process, miss out on the enjoyments of the here and now.

♦tLublin, F.D. & Reingold, S.C. Neurology 1996; 46(4): 907-11.