Remissions after a relapse aren’t complete and symptoms continue.
However, since the development of disease-modifying therapies, the progression to secondary MS has become less frequently noted.
This could be an indication that you’re moving into SPMS.
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Some people may worry that they’re entering the progressive phase of MS because they stop having relapses.
Additionally, you no longer respond as well toSolu-Medrolduring these relapses.
These areas strongly correlate with disability.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
Enlargement of CSF-Filled Ventricles in the Brain
This is a measure ofatrophy.
As there is less brain tissue, the spaces around and within the brain get bigger.
A Decrease in Gadolinium-Enhancing Lesions
Paradoxically, the number of new, activegadolinium-enhancing lesionsdecreases in later stages of RRMS.
This is because the disease is most likely becoming more degenerative than inflammatory.
Your healthcare provider will also find more abnormalities during your neurological exam.
Lastly, people that develop SPMS tend to exhibit more cognitive impairment.
Causes
As with all types of MS, no one knows what causes SPMS.
Smoking has also been found to increase your risk of transitioning from RRMS to SPMS.
Similarly, diagnosing SPMS requires a combination of strategies, including a thorough neurological examination and repeat MRIs.
As with RRMS, there are no definitive diagnostic tests.
While there’s still demyelination and inflammation happening, it’s more widespread.
While you experienced relapses in RRMS, these will become less and less frequent.
Instead, you’ll notice that your condition is gradually worsening.
The Transition Period
There’s often a transition period between when RRMS ends and SPMS begins.
As your MS progressively worsens, you may still have an occasional relapse.
So, for instance, if your SPMS is classified asnot active without progression, it’s stable.
Like RRMS, SPMS symptoms are highly variable, and so is the rate at which it progresses.
Every situation is different; some people become more disabled more quickly than others.
Drug-Modifying Therapies
Most disease-modifying agents have not shown benefit in patients with SPMS.
In rare cases, a stem cell transplant may be an option.
Our Doctor Discussion Guide below can help you start that conversation.
Get our printable guide for your next doctor’s appointment to help you ask the right questions.
National Multiple Sclerosis Society.Diagnosing SPMS.
Olek MJ, Howard J.Clinical Presentation, Course, and Prognosis of Multiple Sclerosis in Adults.
Olek MJ, Mowry E.Treatment of Progressive Multiple Sclerosis in Adults.
Olek MJ, Howard J.Evaluation and Diagnosis of Multiple Sclerosis in Adults.
Ontaneda D, Fox RJ.Progressive Multiple Sclerosis.Current Opinions in Neurology.
2015;28(3):237243. doi:10.1097/WCO.0000000000000195.
