Keep in mind that the authors of the current classifications of MS are neurologists. It has been changed over the years by the way.
1. Benign: (BMS) Mild infrequent sensory exacerbations with full recovery
2. Relapsing Remitting: (RRMS) Episodes of exacerbations and remissions where not all symptoms resolve completely. A person can have some permanent disability which may vary in severity. Relapses usually more severe than in Benign MS. Relapses also become more severe with time.
3. Secondary Chronic Progressive: (SPMS) People with relapsing/remitting disease begin to gradually worsen over time with an accumulation of neurologic signs and symptoms. Relapses become more severe while remissions are less complete, shorter in duration, usually remissions stop all together. SPMS continues to progress steadily.
4. Primary Progressive: (PPMS)There are no relapses. The disease begins with a slow progression of neurologic issues. Problems appear and gradually worsen over time. Common problems include spastic paraparesis, cerebellar ataxia, urinary incontinence.
5. Progressive-relapsing: (PRMS). In this relatively rare type of MS, people experience both steadily worsening symptoms and attacks during periods of remission.
6. Progressive-relapsing (PRMS) This is a rare type of MS, people experience both steadily worsening symptoms and attacks during periods of remission.
Numbers 1&6 are controversial and some neurologists say they do not exist. Neurologists can’t seem to agree about many important points concerning MS. Causal factors, types & numbers of symptoms are two important ones. They do not however, have any difficulty pushing disease modifying drugs (DMD’s). Studies for these drugs are often skewed. It would be impossible for an acting physician to closely monitor what is happening with drug trials and studies. They are too numerous and the literature is daunting for even the most conscientious, experienced and well trained doctors to wade through. Drug representatives are their main source of information. There are no specific educational requirements to become a pharmaceutical sales representative. All of the information they have about the drugs they peddle is what the drug companies tell them. The only real requirement is that they know how to look business like and have the instincts of a car salesperson.
Shouldn’t it bother everyone that their doctor may be prescribing medication for them based on the limited knowledge and expertise of a non-medical sales rep? There are 82,000 working drug sales reps in the US alone. It is their job to quietly befriend doctors, keeping close track of which doctors take the free gifts and then determining which drugs the doctors later prescribe.
Our health-care system now is regarded as a business, period. Drug companies spend a great deal of money wining and dining physicians who prescribe their drugs There’s a wide range in value of the free gifts offered to doctors — from lavish trips to free Mother’s Day flower bouquets for doctors willing to hear a pitch about a new osteoporosis medicine. An exampthe yearly gathering of one of the most prestigious medical groups, the American College of Physicians. It was like a carnival: Doctors could be seen taking free massages, free food, free portraits, free Walkman players, free basketballs, and from one company pushing a new antacid drug, free fire extinguishers.Top drug makers shower doctors with ethically questionable or illegal financial incentives to prescribe certain drugs. Research has found that these payoffs may influence doctor choices in ways that are not beneficial to patients — for example, getting doctors to use drugs for risky off-label uses that have not been approved by the FDA. More commonly, these practices have been found to increase healthcare costs by bribing doctors to prescribe more expensive drugs that aren’t any more effective than alternatives — sticking Medicare and Medicaid with the tab.