Types of MS
MS is categorised into several forms. There are three main types of MS.
Last updated: 10th April 2025
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MS comes in several forms, including relapsing-remitting MS, secondary progressive MS and primary progressive MS.
The course of MS is difficult to predict. Some people may feel and seem healthy for many years following diagnosis, while others may be severely debilitated very quickly. Most people fit somewhere between these two extremes. Every individual will experience a different combination of MS symptoms, and it is hard to predict how MS will affect a person over their lifetime.
Clinically isolated syndrome
Clinically isolated syndrome (CIS) is an early sign of MS, but not everyone who experiences CIS goes on to develop MS. It is the first episode of neurological symptoms experienced by a person, lasting at least 24 hours. The person may experience a single sign or symptom, or more than one at the same time. It is caused by inflammation and demyelination in the central nervous system. Researchers don’t yet know why CIS turns into MS for some people but not others. If someone with CIS also has lesions (as seen on a brain MRI scan) that are similar to those seen in MS, then they are at higher risk of developing MS. Research suggests that early treatment of CIS can delay conversion to MS for people at high risk.
Relapsing-remitting MS
In relapsing-remitting MS (RRMS, sometimes referred to as relapsing MS), people experience attacks or exacerbations of symptoms (relapses), which then fade or disappear (remission). The symptoms experienced during a relapse may be new, or existing symptoms may become more severe. Relapses can last for varying periods – from a few days up to months – and then the disease may then be inactive for months or years. About 85 per cent of people with MS are initially diagnosed with RRMS.
RRMS can be categorised by whether it is active or not active (someone who has active MS experiences relapses and/or evidence of new MRI activity). It can also be classified as worsening (a confirmed increase in disability over a specified period of time following a relapse) or not worsening.
These descriptions are important as they can affect whether a certain type of treatment will be effective or not. The graph below, from the National MS Society USA, provides a useful description of what disease activity (active, worsening and progression) looks like in RRMS.
Secondary progressive MS
Secondary progressive MS (SPMS) is a secondary phase of MS that may develop years or even decades after a diagnosis of relapsing-remitting MS. Most people who have RRMS will transition to SPMS. In SPMS there is progressive worsening of symptoms over time with no definite periods of remission.
SPMS can be categorised by whether it is active or not active (someone who has active MS experiences relapses and/or evidence of new MRI activity). It can also be classified as with progression (evidence of disease worsening over time, with or without relapses) or without progression.
These descriptions are important as they can affect whether a certain type of treatment will be effective or not. The graph below, from the National MS Society USA, provides a useful description of what disease activity (active, worsening and progression) looks like in SPMS.
Primary progressive MS
About 10 to 15 per cent of people with MS are diagnosed with primary progressive MS (PPMS). People with PPMS have steadily worsening symptoms and disability from the start, rather than relapses followed by recovery.
PPMS can also be categorised by whether it is active or not active (someone who has active MS experiences relapses and/or evidence of new MRI activity). It can also be classified as with progression (evidence of disease worsening over time, with or without relapses) or without progression.
The descriptions of active, worsening and progression are important as they can affect whether a certain type of treatment will be effective or not. The graph below, from the National MS Society USA, provides a useful description of what disease activity (active, worsening and progression) looks like in PPMS.
Thessaloniki, Greece, 10/2011. Finding an effective MS therapy has been a particular challenge for Vasiliki Garopoulou; every medication she tried has caused intolerable side effects. On average, she has a relapse once per month, many of which land her in hospital for cortisone treatment. Credit: Maximiliano Braun. Published on this website by kind permission of the European Multiple Sclerosis Platform.
"It doesn’t matter that I am in a wheelchair. Life goes on. I have just changed the way I get around." Wu Yanxiao, 28, from Beijing, has had MS for 8 years. Reproduced with the kind permission of Li YouHao,© 2014 Li