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The term is used to describe a type of multiple sclerosis called relapsing–remitting multiple sclerosis, where unpredictable relapses are followed by remission for months to years. [ 1 ] The term is also used to describe palindromic rheumatism in the context of rheumatoid arthritis , [ 2 ] catatonia , [ 3 ] [ 4 ] lupus , [ 5 ] mental ...
There are three clinical phenotypes: relapsing-remitting MS (RRMS), characterized by periods of neurological worsening following by remissions; secondary-progressive MS (SPMS), in which there is gradual progression of neurological dysfunction with fewer or no relapses; and primary-progressive MS (MS), in which neurological deterioration is ...
Most treatments have been approved for use in relapsing MS; there are fewer treatments with lower efficacy for progressive forms of MS. [207] [204] [128] The prognosis for progressive MS is worse, with faster accumulation of disability, though with considerable individual variation. [207]
In March 2017, ocrelizumab was approved in the United States for the treatment of primary progressive multiple sclerosis in adults. [22] [42] It is also used for the treatment of relapsing forms of multiple sclerosis, to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease in adults. [42]
The relapsing-remitting subtype usually begins with a clinically isolated syndrome (CIS). In CIS, a person has an attack suggestive of demyelination, but does not fulfill the criteria for multiple sclerosis. [5] [28] 30 to 70% of persons experiencing CIS later develop MS. [28]
Patients with severe forms of more common relapsing remitting or progressive MS subtypes, as well as rare Marburg variant and Balo concentric sclerosis, could be considered to have malignant MS. Patients should be carefully worked up to rule out Neuromyelitis optica (Devic's disease) due to the distinctive pathophysiology and management ...
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