Primary progressive multiple sclerosis (PPMS) affects approximately 10 to 15% of patients diagnosed with multiple sclerosis (MS). It gets its name from being the primary form of the disease that features progressive symptoms, unlike the more common Relapsing-Remitting form of MS, which is what patients are most often initially diagnosed with. Usually diagnosed in individuals around 40 to 50 years of age, primary progressive Multiple Sclerosis is discovered later than relapsing remitting MS. Nevertheless, in some cases PPMS is discovered in patients younger or older than the norm.
This condition affects men and women equally, another characteristic that differentiates it from Relapsing-Remitting MS, which occurs more often in women than men. Even so, the most evident difference between PPMS and relapsing remitting MS is the absence of relapses.
Symptoms and Diagnosis of Primary Progressive Multiple Sclerosis
Primary Progressive Multiple Sclerosis mainly affects spinal cord nerves, which is why most symptoms often relate to problems with walking, having stiff or weak legs, and balance issues. Other symptoms of Progressive Multiple Sclerosis may also include vision problems, fatigue, problems with swallowing and speech, pain, as well as bladder and bowel problems.
Diagnosing any type of multiple sclerosis may take a long time, since symptoms are vague and similar with many other diseases. Primary progressive Multiple Sclerosis is most commonly diagnosed in individuals between 40 and 50 years old, the ages when the probability of having other conditions that interfere with mobility and walking is higher, which can also difficult the diagnose.
Causes of Primary Progressive Multiple Sclerosis
Multiple sclerosis, regardless of the type, is believed to be an autoimmune disease. In these cases, the defense system of the body attacks the protective insulation around the nerves (named myelin) of the spinal cord and the brain, which will lead to nerve damage and inflammation.
PPMS is different because little inflammation occurs. Instead, the damage in the nerves is more dominant, and when nerves are damaged, the transmission of nerve signals is interrupted, which results in neurological symptoms. In some cases, it’s possible that plaques of scar tissue or lesions appear beside the damaged nerves in the spinal cord and the brain.
Treatment for Primary Progressive Multiple Sclerosis
Is believed that the medication usually administrated to treat MS – disease modifying drugs, or DMDs – is less helpful for Primary Progressive Multiple Sclerosis. DMDs act to lessen inflammation and reduce the amount and intensity of relapses, but since inflammation and relapses don’t tend to occur in patients with PPMS, most doctors opt not to prescribe those forms of medication.
Research to find a treatment is ongoing, but so far the FDA hasn’t approved any drugs for primary progressive multiple sclerosis. This way, treatment is aimed at symptoms management and quality of life maintenance. Some drugs can be prescribed to ease symptoms like pain, fatigue, muscle tightness, or bladder and bowel difficulties. Issues related with speech, swallowing and doing everyday task can be improved through rehabilitation.