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Primary Progressive Multiple Sclerosis

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A person with primary progressive multiple sclerosis (PPMS) may first see a doctor because of leg weakness or trouble walking. Those are the most common symptoms of this type of MS.

Once it starts, PPMS gets worse over time. How fast it happens or how much disability a person will have varies a lot, so it’s hard to predict. Unlike some other types of MS, there are no relapses or remissions.

Ten percent to 15% of people with multiple sclerosis have this type of the disease. They usually get their diagnosis later in life than people with other types of MS.

It can be hard for doctors to diagnose PPMS. The disease is complex and is different for everyone who has it. Sometimes people have symptoms for a few years before doctors can tell that their condition is getting worse gradually without flare-ups.

Symptoms of Primary Progressive MS

PPMS mainly affects the nerves of the spinal cord. So the main symptoms often have to do with:

  • Problems with walking
  • Weak, stiff legs
  • Trouble with balance

Other common symptoms include:

Cause of Primary Progressive MS

Doctors think MS -- no matter which type you have -- is a condition that happens when the body attacks itself, called an autoimmune disease. The immune system damages the protective coating around the nerves (called myelin) of the brain and spinal cord. This causes inflammation.

In PPMS, though, there is little inflammation. Instead, nerve damage is the main problem. It keeps nerves from sending and receiving signals to each other very well. This causes MS symptoms.

Eventually, plaques of scar tissue or lesions can form along the damaged nerves in the brain and spinal cord.

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