Lublin and Reingold described terms for the different time courses shown by patients with multiple sclerosis. These can help identify patients who may benefit from more aggressive management. The authors are from the Advisory Committee on Clinical Trials of New Agents in Multiple Sclerosis for the National Multiple Sclerosis Society.


Terms defined:

(1) relapsing remitting (RR)

(2) progressive-relapsing (PR)

(3) primary progressive (PP)

(4) secondary progressive (SP)


Terms no longer to be used:

(1) relapsing-progressive (RP)

(2) chronic progressive (CP)



relapsing remitting

clearly defined attacks from onset; after an attack may fully recover or show a residual disability; intervals between attacks are free of disease progression

progressive relapsing

progression of neurologic disability from onset with acute attacks; may recover to preattack level of function or show only partial recovery; intervals between attacks show disease progression

primary progressive

progression of neurologic disability from onset without acute attacks; may or may not have plateaus or minor improvements in function

secondary progressive

relapsing remitting pattern early; later follows progressive relapsing or primary progressive course


Additional terms:

(1) malignant multiple sclerosis: fulminant primary progressive disease with rapid progression to multiple neurologic disabilities or death

(2) benign multiple sclerosis: no neurologic disabilities at 15 years after onset (fully functional)


To read more or access our algorithms and calculators, please log in or register.