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Primary Progressive Multiple Sclerosis

By Metcalf, Eric
Content provided by: Better Medicine from Healthgrades

Multiple sclerosis (MS) is a disease that interferes with your brain's ability to operate your body. It can be disabling. Evidence suggests that the disease occurs 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, as well as nerves involved in your vision.

The disease affects people differently. For example, some people with MS have flare-ups of symptoms interspersed with periods of recovery. This is called relapsing MS. With the type called primary progressive MS, the disease keeps getting worse from the beginning. In general, this type affects you steadily without causing flare-ups or improvement in the condition.

Facts about primary progressive MS

Compared with people who have relapsing MS, those with the primary progressive form don't usually get as much benefit from treatment. They may also have more trouble doing their jobs and their normal activities. Men and women are evenly affected by this type.

About 10 percent of people diagnosed with MS have this type. On average, people with the primary progressive form of MS start having symptoms between ages 35 and 39.

Symptoms

These are symptoms of MS:

  • Trouble walking—this is especially common with the primary progressive type.

  • Vision problems

  • Muscle weakness

  • Difficulty staying balanced

  • Paralysis

  • Numbness

  • Prickling sensations

  • Dizziness

  • Shakiness

  • Difficulty thinking clearly

  • Mood changes

  • Depression

  • Sexual dysfunction

  • Trouble with bowel and bladder control

Diagnosis

If you have the primary progressive form of MS, it may take your doctor longer to diagnose it. Methods that your doctor may use to diagnose primary progressive MS include:

  • Discussing your symptoms with you

  • Performing a physical examination to see how your nerves and muscles are working

  • MRI scans of your brain and spinal cord; these create images so your doctor can look for signs of damage that suggest MS

  • A spinal tap, which allows the doctor to remove a sample of spinal fluid to check for signs of MS

  • A test called visual evoked potential testing to see how well your optic nerves are working

Treatment

Several drugs are available to treat relapsing forms of MS. But the FDA hasn't approved any medications to treat primary progressive MS. These drugs treat a process in the body that occurs more in the relapsing form than the primary progressive form.

Your doctor may still be able to use one of these drugs in your case. But more likely your doctor will try to provide treatments that relieve symptoms and improve your quality of life. These may address problems like depression, sexual dysfunction, and fatigue.

Prevention

Experts don't know of a way to prevent MS. But if your body temperature goes up, it may make your symptoms worse for a short time. As a result, you may want to avoid overheating.

Managing this condition

Physical and occupational therapy may be helpful. For example, therapists may teach you exercise strategies and how to manage new symptoms that develop. Your doctor will also probably want to meet with you on a regular basis to monitor your disease.

Regular exercise and getting plenty of sleep may also help.

Medical Reviewer: Petersen, Sheralee, MPAS, PA-C; Sohrabi, Farrokh, MD Last Annual Review Date: 2012-06-24 Copyright: 2000-2012 Krames StayWell, 780 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.

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Which of these age groups is more likely to experience initial symptoms of multiple sclerosis?