Progressive Relapsing Multiple Sclerosis

If you have progressive relapsing multiple sclerosis (PRMS), you’ll have distinct attacks of symptoms, called relapses. You may or may not fully recover after these flares. Between relapses, the disease continues to get worse slowly.

PRMS is the least common type of multiple sclerosis. It affects about 5% of people with the condition.

You may not be able to reverse the disease, but there are treatments that can ease your symptoms and make your relapses less severe and happen less often.

 

Symptoms of Progressive Relapsing MS

No two people are likely to have the same set of MS symptoms in the same way. Some problems may come and go or happen once and not again. The way MS affects you depends on which areas of your brain or spinal cord have damage from the disease.

Symptoms of PRMS may include:

  • Eye pain and vision problems, such as double vision or jumpy vision
  • Numbness and tingling
  • Sensitivity to heat
  • Pain that runs down your spine, like a mild electrical shock, when you bend your neck
  • Dizziness
  • Bowel or bladder problems
  • Sexual problems, like trouble getting aroused or climaxing
  • Trouble moving and muscle stiffness
  • Weakness and fatigue
  • Problems with balance and coordination
  • A hard time thinking clearly
  • Depression

A relapse can last anywhere from 24 hours to several weeks. You might feel new symptoms or have old ones get worse for a time. Unlike other types of MS, you won’t have any remissions or times where you have few or no symptoms.

Tell your doctor about any signs you’re having a relapse as soon as possible. If you treat it quickly, you might reduce permanent damage and disability.

Treatment With Disease-Modifying Drugs

People with PRMS take medications called disease-modifying drugs (DMDs). These drugs help you have fewer relapses and make your symptoms less severe during these attacks.

DMDs, also called immunotherapy or disease-modifying therapy (DMT), may slow down the disease. They’re the cornerstone of treatment for most types of MS.

You take some DMDs through injections, which you can do on your own. These include:

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For other DMDs, you’ll get it through an IV at a clinic or hospital. These drugs include:

There are three types of DMDs that come in pills:

  • Dimethyl fumarate (Tecfidera)
  • Fingolimod (Gilenya)
  • Teriflunomide (Aubagio)

All of these drugs have side effects, some more severe than others. Your doctor will want to keep close track of your symptoms while you’re taking them. Together, you’ll weigh the risks and benefits of each drug.

Treating Flare-ups With Steroids

You may not need treatment for a mild flare. But for more severe symptoms that make it hard to do day-to-day tasks, steroids can help.

A high-dose, short-term course of steroids (in pills or through an IV) helps reduce inflammation and makes relapses shorter and less severe.

Besides steroids, you can also take other drugs to ease specific MS symptoms, such as pain, bladder problems, fatigue, or dizziness. Options can include:

WebMD Medical Reference Reviewed by Neil Lava, MD on June 10, 2017

Sources

SOURCES:

National Institute for Health and Care Excellence (NICE).

UpToDate: "Epidemiology and clinical features of multiple sclerosis in adults."

Multiple Sclerosis Association of America.

United Spinal Association: "Primary Progressive Multiple Sclerosis: Understanding the Differences."

National Multiple Sclerosis Society: "FDA Approves Plegridy (Pegylated Interferon Beta) For Relapsing MS."

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