Primary Progressive Multiple Sclerosis

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 happens 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.

There are 4 disease courses that have been identified in multiple sclerosis: relapsing-remitting MS (RRMS), primary-progressive MS (PPMS), secondary-progressive MS (SPMS), and progressive-relapsing MS. Each course might be mild, moderate, or severe. Therefore, MS affects people differently. 

PPMS is identified by steadily worsening neurologic functions in the beginning without distinct relapses (attacks or exacerbations) or remission. The rate of progression may vary with occasional plateaus and temporary minor improvements, but declining neurologic progression is continuous. 

Facts about primary progressive MS

People with PPMS tend to experience problems with walking. They may also have more trouble doing their jobs and their normal activities. Men and women are evenly affected by this type.

About 10% 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.


These are symptoms of MS:

  • Trouble walking

  • 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


If you have the primary progressive form of MS, it may take your healthcare provider longer to diagnose it. Methods that your healthcare provider 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 healthcare provider can look for signs of damage that suggest MS

  • A spinal tap, which allows the healthcare provider 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


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

Your healthcare provider may still be able to use 1 of these medicines in your case. But more likely your healthcare provider will try to provide treatments that relieve symptoms and improve your quality of life. These may address problems like depression, sexual dysfunction, and fatigue.


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 healthcare provider 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.