What Is Relapsing-Remitting Multiple Sclerosis?
Relapsing-remitting multiple sclerosis (RRMS) is one type of multiple sclerosis. It is the most prevalent form of multiple sclerosis (MS), accounting for approximately 85 % of diagnoses. Relapses of MS are experienced by people with RRMS, with remissions occurring in between.
MS is a chronic, progressive state of the central nervous system (CNS) in which the immune system assaults myelin, the defensive layer around nerve strands.
When myelin is damaged, nerves become inflamed, and communication between the brain and the body becomes difficult.
What Are the Different Types of Multiple Sclerosis?
MS can be broken down into four categories. Let's take a brief look at each one below.
1. Clinically Isolated Syndrome: Clinically isolated syndrome (CIS) could be a one-time occurrence or the first sign of a neurological condition. While the side effects are normal for MS, the condition does not meet the diagnostic criteria of MS except if it repeats.
2. Relapsing-Remitting MS: Relapses of new or worsening symptoms characterize this type of MS, separated by periods of remission.
3. Primary Progressive MS: The symptoms of primary progressive multiple sclerosis (PPMS) get worse as the disease progresses. There are no complete remission periods.
4. Secondary Progressive MS: Secondary progressive multiple sclerosis, also known as SPMS, begins with a pattern of relapses and remissions before gradually getting worse. People who have RRMS may eventually develop SPMS.
What Are the Symptoms of Relapsing-Remitting MS?
Recurrent episodes of new or worsening MS symptoms are the hallmark of RRMS. These relapses can last for days or months before, with or without treatment, the symptoms gradually get better.
Depending on the individual, MS may present with symptoms like:
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Sensations of tingling or numbness.
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A feeling of weakness and fatigue.
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Stiffness or muscle spasms.
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Issues with balance and coordination.
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Problems with vision, such as double vision, a vision that is blurry, or vision loss, either partially or completely.
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Sensitivity to heat.
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Bowel or bladder problems.
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Cognitive function changes, such as difficulty with processing, learning, and organizing information.
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Tingling or a sensation resembling a shock when bending the neck forward (the Lhermitte sign).
There are periods of remission between RRMS relapses in which there is no clinical evidence of disease progression. These remission periods can last for years at times.
What Causes Relapsing-Remitting MS?
Myelin, a layer of tissue that protects and insulates nerves, is attacked by the immune system in RRMS. These assaults influence the capability of hidden nerves. MS symptoms are caused by the damage.
What precisely causes RRMS and different kinds of MS is presently obscure. It is possible that a combination of genetic and environmental factors, like smoking, a lack of vitamin D, and certain viral infections, are to blame.
How Is Relapsing-Remitting MS Diagnosed?
For RRMS, there are no specific diagnostic tests. However, tests that look for specific markers associated with MS are being developed diligently by scientists.
A specialist will begin the symptomatic interaction by taking the clinical history and carrying out a careful actual assessment. In addition, they will have to rule out any conditions other than MS that might be causing the symptoms.
Additionally, they may use tests like:
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MRI: This imaging test can look for brain and spinal cord lesions that cause myelination.
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Blood Tests: A blood sample is taken from an arm vein and analyzed in a lab. The outcomes can be used to rule out any other conditions that might be to blame for the symptoms.
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Lumbar Puncture: A lumbar puncture, also known as a spinal tap. It is used to obtain a sample of the brain's cerebrospinal fluid. This sample can be used to rule out other causes of MS symptoms and look for antibodies associated with MS.
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Visual Evoked Potential Tests: Electrodes are used in these visually evoked potential tests to collect data on the electrical signals that nerves produce when they respond to a visual stimulus.
The pattern of symptoms and the presence of lesions in multiple parts of the nervous system are used to make a diagnosis of RRMS.
RRMS is indicated by specific relapse and remission patterns. Side effects that consistently deteriorate show an ever-evolving type of MS.
What Is the Treatment for Relapsing-Remitting MS?
There is no remedy for MS yet, yet treatment can oversee side effects, treat relapses, and slow the movement of the condition.
There are numerous treatments and medications available. For instance, medications can alleviate symptoms like muscle stiffness and fatigue. A physiotherapist can help with muscle weakness or mobility issues.
Corticosteroids are commonly used in relapse treatment. Corticosteroids aid in lowering inflammation levels. Plasma exchange (plasmapheresis) is a treatment option that may be utilized in cases where the relapse symptoms are severe or do not respond to corticosteroids.
Different medications can assist with restricting the number of relapses and slow the arrangement of extra MS injuries. Disease-modifying drugs are the names given to these drugs.
Medications:
There is a wide range of disease-modifying medications for RRMS. They can be ingested, injected, or administered intravenously (IV). They consist of the following:
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Beta interferon.
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Cladribine.
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Dimethyl fumarate.
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Fingolimod.
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Glatiramer acetate.
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Mitoxantrone (for severe MS only).
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Natalizumab.
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Ocrelizumab.
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Siponimod.
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Teriflunomide.
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Alemtuzumab.
What Is the Outlook for RRMS?
Individuals' perspectives on RRMS differ. For instance, some individuals may experience rapid progression while others may experience years of stability.
RRMS can cause damage to tissue over time. About two-thirds of people with RRMS will develop SPMS later on. This transition can take anywhere from 15 to 20 years on average.
In SPMS, symptoms get worse over time without any obvious attacks. One observational study with nearly 800 RRMS patients found that progression to SPMS was a significant predictor of more severe disability.
By and large, the future for individuals with MS is 5 to 10 years, which is not exactly normal. However, as researchers continue to develop new treatments, the outlook is improving.
Conclusion
A type of MS known as relapsing-remitting multiple sclerosis (RRMS) is characterized by the occurrence of specific relapses of MS symptoms. There are periods of remission in between relapses.
When the immune system attacks and damages the myelin sheath that covers the nerves, it causes nerve function to be affected, leading to RRMS. The exact cause of this immune system dysfunction is still a mystery.
RRMS can be managed with a variety of treatments, but there is currently no cure. Additionally, these treatments focus on preventing progression and relieving relapses. SPMS, a progressive form of MS, may occasionally arise from RRMS.
