What is a relapse?

A relapse in multiple sclerosis is the appearance of new symptoms or the reactivation of existing symptoms that last for at least 24 hours. There must be at least 30 days between two relapses. If the time interval is shorter, this is defined as a relapse.

It can often happen that typical MS symptoms only last temporarily because the body temperature is elevated. However, if the symptoms subside as soon as you have cooled down, this may be the Uhthoff phenomenon and not a relapse. It is therefore particularly important to specify how long symptoms must persist.

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Relapsing-remitting MS (RRMS)

Relapsing-remitting MS is the most common form of the disease, affecting around 85% of patients. RRMS occurs in irregular relapses that are clearly separated in time. In this form of multiple sclerosis, the symptoms can regress completely or partially. Symptoms remit.

Symptoms that have already occurred during a previous relapse can occur during each relapse. However, new symptoms can also occur and the severity of the symptoms can vary. A flare-up can last between days and weeks. The duration and frequency of new flare-ups varies from patient to patient.

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Secondary progressive MS (SPMS)

If continuously increasing symptoms replace relapses, this is referred to as secondary progressive, i.e. continuously increasing MS. Symptoms therefore no longer occur in episodes, but become a continuously increasing companion.

The transition to SPMS usually takes 10-20 years. In female patients, there may be an overlap with the menopause during this time, which can lead to a misinterpretation of the symptoms that occur.

The course of multiple sclerosis is individual. In the context of the different forms of progression, it can therefore be a transition from RRMS to SPMS, but patients can also remain in a relapsing-remitting course. Studies have shown that after 10-15 years, 30-40% of patients with MS progress to secondary progressive MS.

The treatment of SPMS may differ from the treatment of RRMS. In addition to medications that are also approved for relapsing forms of MS in order to prevent further relapses, certain medications are specifically approved for SPMS. If you notice any changes in your symptoms, it is best to discuss these with your healthcare professional.‍

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Primary progressive MS (PPMS)

If very severe symptoms occur very early on in the disease that do not regress, this is referred to as primary progressive multiple sclerosis. This means that symptoms worsen continuously from the beginning (primary). Individual relapses are usually indistinguishable.

At around 10%, this form of multiple sclerosis is the rarest form. On average, sufferers are between 35 and 39 years old at the time of the disease.