What is Relapsing-Remitting Multiple Sclerosis

Lateral view of brain with neuron inset and myelin degeneration inset; SOURCE: Pickup from ANerv_20140205_v0_003 and iConsult ortho_brain_L and ANerv_20140204_v0_006

The majority individuals with multiple sclerosis (MS) have a type referred to as relapsing-remitting MS (RRMS). It normally starts in your 20s or 30s.

If you have RRMS, you may have bouts when your symptoms occur. These are described as relapses.

An outbreak is followed by a time of recovery in which you have no few or no symptoms, referred to as remission. It can continue for weeks, months, or longer. The condition will not get worse during these breaks.

After 10 to 20 years, RRMS usually shifts to another type of MS described as secondary progressive multiple sclerosis. You won’t have relapses as frequently, but the disease becomes gradually worse.

Symptoms of Relapsing-Remitting MS
No two individuals with MS are expected to have the identical symptoms in the same way. Some symptoms come and go or appear once and never again. The symptoms you have are based on the area of your brain or spinal cord that RRMS has damaged. They can include:

Eye pain and vision issues such as jumpy vision or double vision. These problems may be the first signals you have RRMS.
Sensitivity to heat
Numbness and tingling
Dizziness
Pain that extends down the spine, like a mild electrical shock, when you bend your neck
Sexual problems, like trouble getting, aroused or climaxing
Bowel or bladder problems
Stiff muscles and trouble moving your body
Problems with balance and coordination
Feeling weak and tired
A hard time thinking clearly
Depression

An RRMS attack can endure and be ongoing anywhere from 24 hours to several weeks. It can involve:

An existing problem that gets worse
One or many symptoms
A new symptom
An existing problem that gets worse
Discuss with your doctor about signs of relapse as soon as possible. If you handle it quickly, you may be able to lessen lasting injury and disability.

Treatment
Most people with RRMS manage the disease with:

Medicine
Physical therapy, occupational therapy, and other methods of rehab
Healthy habits
For most individuals with RRMS, it’s enough to start treatment as quickly as they’re diagnosed to avoid lasting nerve damage.

RRMS Medication: Disease-Modifying Drugs
Some medications for RRMS fight the disease by turning down the body’s immune system so that it doesn’t attack nerves. These are called disease-modifying drugs (DMDs). Doctors might also call them immunotherapy or disease-modifying therapy (DMT).

These medications make relapses occur less often and make them less severe. They can keep the disease from getting worse for a while.

You can take some DMDs by injection. These drugs include:

Peginterferon beta -1a (Plegridy)
Daclizumab (Zinbryta)
Interferon beta-1b (Betaseron)
Interferon beta-1a (Avonex, Rebif)
Glatiramer (Copaxone)

You’ll need to take some DMDs through an IV at a clinic or hospital. These include:

Mitoxantrone (Novantrone)
Alemtuzumab (Lemtrada)
Ocrelizumab (Ocrevus)
Natalizumab (Tysabri)

Three kinds of DMDs are available in pill form. They are:

Dimethyl fumarate (Tecfidera)
Teriflunomide (Aubagio)
Fingolimod (Gilenya)

DMDs will likely have some side effects. You and your physician will determine whether the pros and cons of the drug make it worth taking or not. And your physician will watch your signs closely during treatment.

Steroid Therapy for Flare-ups
The symptom flares of RRMS occur when the brain and spinal cord begin to swell/ inflame. Lessening the inflammation is key to treating a relapse.

Mild flares may not require treatment. If you have serious symptoms, your doctor may prescribe steroids. You may have to take a few of these medications via an IV and others by mouth.

A short-term, high-dose course of steroids can help:

Decrease Swelling
Make the relapse shorter and less severe
Your physician may prescribe other types of drugs to treat different RRMS symptoms. For example, you might take:

Antidepressants
Pain relievers
Drugs to fight fatigue
Maintaining a Healthy Lifestyle
A healthy lifestyle is an essential way to feel your best. Be sure to:

Keep a healthy weight
Eat a nutritious diet
It’s also necessary to be active when you have MS. Exercise can help you:

Control your weight
Stay mobile
Boost your mood and energy levels
Attempt to different types of activities including exercise to get your heart pumping, like swimming or walking, and moves that strengthen your muscles and extend your body. When you develop an exercise plan, keep in mind:

Start gradually, even with 5 to 10 minutes of activity.
Avoid getting overheated if you are susceptible to temperature.
Ask a physical therapist to assist you to build an exercise program.

What is Multiple Sclerosis?