Relapsing Remitting Multiple Sclerosis (RRMS)

Relapsing remitting multiple sclerosis (RRMS) is a type of multiple sclerosis (MS) that involves unpredictable and recurring flare ups of symptoms known as exacerbations, followed by periods of improvement and remission. RRMS is the most common form of MS and affects around 85 percent of people who are first diagnosed with the disease. RRMS typically begins in a person’s late twenties or thirties, though it can develop earlier or later.

Signs and symptoms of RRMS

The signs and symptoms of RRMS can vary widely, depending on which part of the central nervous system (CNS) has been affected. Common signs and symptoms may include:

Numbness, prickling, or tingling sensation in the limbs
Weakness or clumsiness on one side
Unsteady balance and coordination
Vision problems, such as blurred vision or double vision
Fatigue
Dizziness
Pain or spasms
Slurred speech
Cognitive difficulties
Mood changes
Bowel and bladder problems

These symptoms may come and go with episodes of relapse and remission. During an exacerbation, the signs and symptoms may become more acute and may linger for some time. Some people may experience ongoing worsening of their symptoms, known as primary progressive MS.

Diagnosing RRMS

To diagnose RRMS, doctors will look for an MRI scan that reveals the characteristic white spots in the brain or in the spinal cord. They may also draw cerebrospinal fluid (CSF) to test for the presence of certain proteins, called oligoclonal bands (OCBs), which are found in the CSF of people with MS. Additional laboratory tests, such as a blood test or a spinal tap, may also be done to help make a diagnosis of MS.

Treatment of RRMS

Treatment for RRMS will depend on the type of symptoms that a person is experiencing, and may include medications, physical therapy, occupational therapy, lifestyle modifications, and other therapies. Medications are the most commonly prescribed treatment for RRMS. Common medications include:

Corticosteroids, to reduce inflammation and inflammation-related damage
Disease-modifying drugs (DMDs), to slow down disease progression
Immunosuppressants, to reduce immune system activity
Immune-modulating drugs, to reduce inflammation and minimize relapse
Muscle relaxants, to decrease spasticity
Pain medications, to provide symptom relief

In addition to medications, physical and occupational therapy can help improve mobility and reduce pain and fatigue associated with MS. Education and lifestyle changes can also help manage symptoms and reduce stress.

Outlook for RRMS

The outlook for individuals with RRMS is largely dependent on the severity of the disease and the individual’s response to treatment. Most individuals with RRMS are able to lead productive lives and maintain independence. Treatment can help reduce the frequency and severity of relapses and may slow or even stop the progression of the disease altogether. It is important to discuss the risks and benefits of treatment with your doctor, so that you can make an informed decision about the best course of action for you.