Relapsing-remitting multiple sclerosis is an autoimmune disease that causes inflammation in the central nervous system. There are several types of MS that cause different patterns of symptoms, but relapsing-remitting MS is characterized by acute flare-ups followed by periods of time with no symptoms.
Multiple sclerosis affects women more than men, and the relapsing-remitting course of the disease is up to three times as common in women. About 85 percent of people with MS are first diagnosed with the relapsing-remitting course of the disease.
Multiple sclerosis affects millions of people around the world. It’s important to understand what the disease is, what the common symptoms are, and what treatment options are available.
What Is Relapsing-Remitting Multiple Sclerosis?
Multiple sclerosis is a central nervous system disease that causes the immune system to attack the body’s myelin, the protective sheath that covers the brain and nerves. Over time, the nerves can deteriorate and become permanently damaged.
Relapsing-remitting multiple sclerosis is the most common form of the disease. This course of the disease causes occasionally attacks of symptoms, or relapses, in between periods of recovery or remissions.
During a relapse, there is an inflammatory attack on the myelin, which causes nerve damage. Relapses can last anywhere from one day to several weeks. During remission, some of the symptoms may get better or all the symptoms may disappear entirely.
Relapsing-remitting MS is typically diagnosed in people who are in their 20s and 30s, but it can affect people of all ages. It usually changes into secondary progressive multiple sclerosis after 10 to 20 years. With this course of the disease, relapses don’t occur as often, but the symptoms gradually get worse.
Symptoms and Causes
Multiple sclerosis causes a wide variety of symptoms, and different people have different experiences with the disease. Some symptoms may come and go with relapses and remissions, and some may constantly be present.
The most common symptoms of relapsing-remitting MS include the following:
- Vision problems
- Numbness or tingling
- Fatigue or weakness
- Balance problems
- Difficulty concentrating
- Problems with bladder control
- Mobility issues
- Slurred speech
Because MS attacks the entire central nervous system, it can affect the body in several different ways. Most people with relapsing-remitting MS have a combination of these symptoms, but no two patients have the exact same symptoms.
Doctors aren’t sure what causes multiple sclerosis, but most agree that the disease is triggered by a combination of factors. The disease occurs when there is an abnormal immune response that causes inflammation in the central nervous system. Researchers have recently been able to identify some of the specific immune cells that attack the nervous system in people with MS, and they will hopefully also discover what puts this response in motion.
Environmental factors also seem to play a role. MS is more common in regions that are farther away from the equator, and researchers are looking into geography, genetics, and migration patterns to understand why. For example, people who were born in an area with a high occurrence of MS but moved to a lower-risk area before age 15 assume the risk of their new location. This may mean that exposure to something in the environment before puberty may cause a predisposition to developing MS later in life.
Some viruses and bacterial infections seem to be linked to MS as well. Researchers have paid especially close attention to the Epstein-Barr virus in recent years as many people with MS had been infected with EBV earlier in life. This connection suggests that a previous infection with Epstein-Barr or another illness may increase the risk of developing multiple sclerosis.
After the disease has developed, certain factors can trigger relapses. Getting sick may make the symptoms worse because the immune system becomes more active to fight off the illness. As the immune system works harder, it may also attack the myelin and nerves more aggressively. Stress, lack of sleep, low vitamin D levels, and smoking can all cause flare-ups, too.
Diagnosis
There is no single test to identify multiple sclerosis, so it can take a long time for patients to be diagnosed. Doctors usually begin by ruling out all other possible health conditions. Then, they’ll look at a variety of factors and tests to diagnose MS:
- Cerebrospinal fluid analysis
- MRI to detect lesions
- Changes in reflexes
- Responses to sound and touch
- History of flare-ups
Multiple sclerosis is usually diagnosed by a neurologist. Once the doctor determines a patient has MS, the patient’s history of symptoms will indicate whether they have the relapsing-remitting or progressive form of the disease. If they’ve had at least two attacks followed by periods of remission, they have relapsing-remitting MS.
Treatments
There are many FDA-approved medications that prevent relapses and slow the progression of the disease. The best way to manage multiple sclerosis is to begin taking medication as soon as possible after the diagnosis. Some of the most common MS medications include the following:
- Beta-interferon
- Dimethyl fumarate
- Fingolimod
- Glatiramer acetate
- Monoclonal antibodies
- Teriflunomide
Some MS patients also take medications to alleviate symptoms like muscle spasms, urinary incontinence, fatigue, and depression. Steroids can help reduce symptoms during relapses as well.
In addition to medications, doctors also recommend lifestyle changes and other treatments to manage relapsing-remitting multiple sclerosis. Physical therapy can be particularly beneficial for those who experience muscle spasms, and speaking to a counselor is helpful for those who have depression, which commonly occurs alongside MS.
Following a healthy diet and exercise plan is essential for managing the symptoms of MS. Most people with MS benefit from eating a diet low in saturated fat and high in omega-3 fatty acids, which can fight inflammation. It’s also important to get plenty of vitamin D. Exercise helps with mobility, mood, and energy levels, but it’s important to speak to a doctor before starting a new workout regimen.
Relapsing-remitting multiple sclerosis can be challenging, but it is manageable with treatment. When people with MS receive the right medical care, their relapses become less frequent, and their quality of life improves.