Each type might be mild, moderate, or severe. MS affects people differently.
With PPMS, neurologic functions get steadily worse in the beginning. (Neurology is the branch of medicine that deals with problems affecting the nervous system). There are no symptom flare-ups (relapses or attacks). And there is no recovery (remission). How fast the disease progresses may vary. There can be times when things are stable. And there can be periods of short-term (temporary) minor improvements. But declining neurologic progression is constant.
After the general diagnosis of MS, the diagnosis of PPMS is based almost exclusively on the patient's symptom history. Because of this, it may take time for the PPMS diagnosis to be made.
Men and women are evenly affected by this type of MS. About 10% of people diagnosed with MS have PPMS. On average, people with primary-progressive MS start having symptoms between ages 35 and 39.
What causes primary-progressive MS?
MS's exact cause is unknown, but research suggests it develops when your immune system attacks a substance called myelin. Myelin acts as a type of insulation on your nerve cells. This process can lead to damage in and around the nerves in your brain and spinal cord. It can also damage the nerves used for vision.
What are the symptoms of primary-progressive MS?
The occurrence and severity of PPMS symptoms vary with each person. Symptoms can include:
Pain (for example, headaches, pain in the legs and feet, back pain, and muscle spasms)
Electric-shock sensations that run down the back and limbs when the neck is bent (Lhermitte sign)
Difficulty walking
Vision impairments and fluctuations
Muscle weakness
Unstable when standing or staying balanced when sitting
Methods that a healthcare provider may use to diagnose MS include:
Discussion. With the healthcare provider to talk about symptoms.
Physical exam. This is done to see how the nerves and muscles are working.
MRI scans of the brain and spinal cord. These images will help the healthcare provider look for signs of damage that suggest MS.
Optical coherence tomography (OCT). This test measures nerve fibres in the retina.
Spinal tap (lumbar puncture). The healthcare provider removes a sample of spinal fluid to check for signs of MS.
Visual evoked potentials (VEP). This test is done to see how well the optic nerves are working.
How is primary-progressive MS treated?
Several medicines are available to treat relapsing forms of MS, such as RRMS. There are no approved medicines to treat primary-progressive MS. The healthcare provider will try to provide treatments that relieve symptoms and improve a person's quality of life. These may address problems such as depression, sexual problems, and extreme tiredness (fatigue).
Experts don't know how to prevent MS or the PPMS type of MS. Some people limit MS relapses by avoiding specific triggers such as stress and overheating.
How to manage primary-progressive MS?
Physical and occupational therapy may be helpful. For example, physical therapists provide exercise strategies and how to manage new symptoms. The healthcare provider will also probably want to meet the person regularly to monitor the disease.
Regular exercise and getting plenty of sleep may also help. If the body temperature increases, the symptoms may worsen for a short time. So it’s best not to do things that could lead to overheating, such as extended periods in the sun or overexertion.
Note Medical conditions MUST always be diagnosed by a medical professional. The above has been structured to provide basic information to HWH Support Workers and Clinical Care Managers.
