What Happens

In general, multiple sclerosis follows one of four courses:

• Relapsing-remitting, where symptoms may fade and then recur at random for many years. The disease doesn't advance during the remissions. Most people who develop MS have a relapsing-remitting course. In 8 to 9 out of 10 people with this course of MS, the relapsing-remitting phase lasts about 20 years.¹
• Secondary progressive, which at first follows a relapsing-remitting course. Later on, it becomes steadily progressive.
• Primary progressive, where the disease is progressive from the start.
• Progressive relapsing, where steady deterioration of nerve function begins when symptoms first appear. Symptoms appear and disappear, but nerve damage continues. Few people have this course of MS.

MS is different for every person. You may go through life with only minor problems. Or you may become seriously disabled. Most people are somewhere in between.

The duration of the disease varies. Most people who get MS live with it for decades.

Progress of MS

MS usually progresses with a series of relapses that occur over many years (relapsing-remitting MS). In many people the first MS attack involves just a single symptom. It may be weeks, months, or years before you have a relapse.

As time goes by, symptoms may linger after each relapse so you lose the ability to fully recover from the relapse. New symptoms often develop as the disease damages other areas of the brain or spinal cord.

Events that can mean you may have a more severe type of MS include:

• Frequent relapses during the first few years of the disease.
• Incomplete recovery between attacks.
• Early, lasting motor problems that affect movement.
• Many lesions that show up on an MRI early in the disease.

Some people have a few mild attacks from which they recover entirely. This is called benign MS.

Although rare, a small number of people die within several years of the onset of MS. This is called malignant or fulminant MS.

Because MS may affect your ability to move and walk, it can place limits on your daily living, particularly as you age. If you or someone in your family has MS, talk to your doctor about how MS may affect daily living. Knowing what to expect will help you plan for the future.

Complications of MS

Complications that may result from MS include:

• Urinary tract infections (UTIs).
• Constipation.
• Pressure sores.
• Reduced ability to move and walk. This makes it necessary to use a wheelchair some or all of the time.