Multiple sclerosis is a very complex disease that emerges in a wide variety of ways in different people. The course of the disease can also change and differ between cases to a significant extent, with one such example being primary progressive multiple sclerosis. Primary progressive multiple sclerosis differs from other multiple sclerosis disease courses by involving the worsening neurologic function immediately from the onset of the initial multiple sclerosis symptoms. There’s a lot more to it, though, and in this article, we take a more in-depth look at how primary progressive differs from other diagnoses.
The main differences in primary progressive multiple sclerosis
Primary progressive MS can often be more difficult to live with than other forms of multiple sclerosis, and for this reason it can require a different approach when compared to other forms of the disease. While there is certainly a case for variability determining the specific symptoms of primary progressive multiple sclerosis, this form of multiple sclerosis sets itself apart from forms of relapsing multiple sclerosis. In the case of relapsing forms of MS (known as relapsing-remitting MS or RRMS), there is usually more consistent inflammation of myelin, which can create more brain lesions (otherwise known as plaques) in those who experience RRMS. As those with primary progressive multiple sclerosis have less lesions, it is also usually the case that the lesions they do have contain fewer inflammatory cells. As there are less lesions evident in the brains of people with primary progressive multiple sclerosis, the majority of these legions will be found in the spinal cord, rather than the brain (which is the opposite case in those who experience frequent relapses). Although fewer brain lesions may sound like a positive, this often results in primary progressive multiple sclerosis being much more difficult to both diagnose and treat than relapsing-remitting MS.
More differences between PPMS and RRMS
Interestingly, gender can play a role in the development of different courses of multiple sclerosis. Females are affected two to three times more than men when it comes to relapsing forms of multiple sclerosis, while in progressive multiple sclerosis there are roughly equal numbers of men and women who experience the illness. The age of onset can also differ between the two forms – studies have shown that the average age of onset for progressive multiple sclerosis is approximately 10 years later than in relapsing forms of multiple sclerosis. In terms of physicality, people who live with primary progressive multiple sclerosis have more difficulty with walking, which can make staying in work much more difficult than relapsing forms of multiple sclerosis, and this also requires that people with primary progressive multiple sclerosis receive more care and assistance with their daily tasks.
How changes in multiple sclerosis are determined
It is usually the case that measuring disease activity and any related activity is demonstrated through MRIs and similar neurologic examinations. Regular health monitoring allows for different needs to be addressed, such as how active a specific case of primary progressive multiple sclerosis is at any one time. With enough stability, healthcare professionals will be able to confidently recommend treatment and rehabilitation options, otherwise cases involving more active cases can be recommended for certain therapies to help manage the course of the disease.
