Multiple sclerosis has recently been found to affect twice as many people as recently. Because it can be a very serious and debilitating condition, it is important to identify symptoms early so that treatment is more productive. What many people don’t realize is that there are multiple types of multiple sclerosis. Primary progressive multiple sclerosis is only diagnosed in a small number of MS patients and does not have a chance to relapse, mainly because it does not go into remission. What characterizes EMPP to identify it separately from other types of MS?
Characteristics of primary progressive multiple sclerosis
Most of the time, primary progressive multiple sclerosis is diagnosed in a larger population than in other types of MS. More importantly, this form of the disease continues to cause deterioration, with symptoms that worsen once it begins to affect the body. Knowing the causes and symptoms of early identification can do a lot to reduce the effects or slow the progression of the disease, especially in PPMS.
Causes of Multiple Sclerosis
MS is an autoimmune disease, which means that it is the result of the body’s attack on itself by the immune system. Several diseases are caused by this “malfunction” of the body. In the case of multiple sclerosis, the target of the immune system is myelin, which is the substance that covers the nerves located in the spinal cord and the brain.
In other types of MS, there is significant inflammation caused by this attack on myelin. However, with PPMS, the inflammation is minimal. Instead, the main problems are due to nerve damage and the growth of scar tissue along these areas in the spinal cord and brain. Doctors refer to this scar tissue as legions, preventing proper signaling from occurring, leading to the symptoms of multiple sclerosis.
What are the symptoms of primary progressive multiple sclerosis?
Most patients diagnosed with PPMS first notice a weakening of their legs to the point of visiting their doctors. Other initial symptoms include:
- Leg stiffening.
- Balance issues.
- Dificulty to walk.
Other symptoms that can appear early are:
- Fatigue and constant pain.
- Constant headaches
- Difficulty speaking or swallowing.
- Vision problems.
- Difficulty controlling the bladder or bowels.
Some of the more serious symptoms can also include:
- The sensation of an electric shock in the back and extremities when the neck is bent.
- Numbness and itching
- Extreme dizziness or tremors.
- Paralysis, temporary or permanent.
- A difficulty with clear thought processes.
- Unexplained mood swings
- Symptoms of depression
Diagnosis of primary progressive multiple sclerosis
A doctor has several methods to determine if a patient has PPMS. The process of diagnosing the disease begins with a discussion of the symptoms experienced to form a clear picture of the medical history and changes in your health. This will likely progress to a physical exam, checking the current function of the nerves and muscles.
The next step may be an MRI of the brain and spinal cord. These images would capture any evidence of nerve damage or inflammation in the spinal cord or brain that could indicate multiple sclerosis.
Alternatively, there are two tests that the eyes use to make a determination. Visual evoked potentials, or VEPs, test the functionality of the optic nerve, while an optical coherence tomography (OCT) measures nerve fibers located within the retina.
A lumbar puncture, also known as a spinal tap, involves removing a sample of cerebrospinal fluid so that it can be examined to see if it reveals any signs of MS. Unfortunately, unless there is already serious progression, most tests will not offer much insight into whether the type of multiple sclerosis could be PPMS, as nerve damage occurs and worsens over time. That means that even though a diagnosis of MS can be made, it may not be possible.
There is no cure for PPMS, and since the definition of this type of multiple sclerosis is that symptoms get worse over time, the main goal of patients with the disease is to find a way to manage the symptoms to the best of their ability.
Because symptoms often get worse if body temperature rises, people with PPMS should avoid spending long periods of time in the sun or exercising long distances without enough cooling air. Anything that causes overexertion could cause the body temperature to rise, leading to more frequent symptoms.
Moreover, regular exercise can help reduce the severity of symptoms, mainly stiffness and pain, while getting plenty of sleep will lessen the effects of weakening muscles and joints. In fact, many patients engage with physical and occupational therapists to learn more about the techniques that work best and strategies for managing new symptoms.
If speech problems become a problem, there are also speech therapists available who can help reduce the damage this causes, including social anxiety and nervousness around others due to changes in voice or modulation. . This type of therapy can also help with swallowing problems.
Medication for PPMS
Ocrelizumab hasn’t been around for long, but it has shown promise for people with primary progressive multiple sclerosis. Basically, it reduces the number of cells in the bloodstream that initiate an attack on the body by the immune system. This reduces inflammation and slows the progress of nerve damage, which also helps slow the overall progress of the disease.
This medicine is given as an infusion, similar to the way chemotherapy is given, under the supervision of a doctor every six months. It is considered a first-line drug, which means that the patient does not have to try other treatments and “fail” to receive this therapy. The most common side effects are itching or rash, redness, or fever.
Some medications may be prescribed to help control certain symptoms that are more prevalent and debilitating than others, such as medications to:
- Tense and stiff muscles.
- A difficulty with bladder and bowel control.
- General pain
- Debilitating fatigue