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The Difference Between Advanced and Progressive Multiple Sclerosis

The most well-known type of Multiple Sclerosis is Relapsing-Remitting MS (RRMS) in which the patient experiences a distinct onset of symptoms and significant improvement of the symptoms as the flare remits.  As this is a chronic disorder, repeated flares can cause permanent damage and therefore long-term and permanent disability.  The longer someone lives with MS, the physical and cognitive impairments increase. Fortunately, many treatments can slow down and even halt the attacks on the brain and the spinal cord. Even so, the disability can sometimes progress despite treatment. Many patients with relapsing MS eventually transition into secondary progressive MS in which the flares become less distinct because the symptoms no longer go away. There is a less rare form called “Primary Progressive MS” in which the symptoms never remit but continue to get worse from the onset of the disease.

The difference between “Progressive” and “Advanced” MS is that they are terms for different aspects of MS.  “Relapsing” and “Progressive” are terms describing a pattern or disease course-how the MS behaves over time.  “Advanced MS” is a description of the severity of the disease, whether it arises from RRMS or Progressive MS.

Patients with Advanced MS have substantial physical disability that requires the help of caregivers for many daily needs. The most common symptoms of Advanced MS are bladder control/urinary incontinence sometimes due to an inability to empty the bladder completely: speech, swallowing, and breathing difficulties due to muscle weakness of the vocal cords, chest, and abdomen; cognitive impairment that affects memory and decision making and is often accompanied by depression; and pressure sores due to limited mobility, dehydration and desensitization to pain.

The most important step a patient with MS can take is to become an active decision-maker in their own care.  Because there are so many different symptoms in Advanced MS, it may be difficult for both the patient and their doctors to detect new disease activity.  BeCare MS Link can help by quantifying the neuro exam, detecting subtle abnormalities, and monitoring the physical, cognitive, and mental health changes that will guide you and your doctor in making the right therapeutic decisions to make your new normal the best it can be.

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