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Primary progressive multiple sclerosis (PPMS) is characterized by very slow, gradual accumulation of disability from the very onset of symptoms. Patients are often unable to pinpoint the time that symptoms started and often initially dismiss subtle problems as ‘getting older’ or due to something like a mild injury. Patients with PPMS never have exacerbations or attacks although they can have pseudo-relapses (Click Here to learn more about relapse vs. pseudo-relapse). Inflammation is very rarely observed and MRI’s often show very little evidence of disease activity. This makes PPMS a much more difficult form of MS to treat, however, Ocrelizumab is now FDA-approved to treat PPMS.
However, this is an area of intense research, including at the Tisch MS Research Center. Scientists have created a lab model that allows for pathological analysis of the disease mechanisms pertaining to progressive tissue. IMSMP neurologists together with Tisch MSRCNY scientists are dedicated to discovering new treatments for progressive MS and researching whether or not they will benefit our patients. PPMS accounts for about 10% of MS cases, but these patients tend to have more disability than other types of MS and also require more symptom management, intensive physical therapy, and social work services. The IMSMP can coordinate appointments with these different departments on the same day for our patients.
Although RRMS can evolve into SPMS, there is no overlap between PPMS and the other forms of MS.