Progressive-Relapsing Multiple Sclerosis

Progressive-Relapsing Multiple Sclerosis or PRMS is a form that occurs in about 5% of people with MS. It's one of the four recognized forms of multiple sclerosis. It's progressive as the name indicates. The progression is steady with periodic relapses and remissions. Occasionally this form may first be diagnosed as Primary-Progressive Multiple Sclerosis until a relapse occurs.

There may be some recovery after a relapse, but the symptoms get progressively worse not better. New symptoms accumulate over time. The level of disability continues to go up over the course of the disease because of incomplete recovery from each attack. With this form, you won't return to the previous level of ability you had before each relapse.

This form is rare – it is the least common of all the different types of MS. Even though there is a steady decline over time, it is not usually a fast progression as in Primary-Progressive MS.

It's more difficult to treat the progressive types of multiple sclerosis, but there are a few options. If you have been diagnosed with Progressive-Relapsing multiple sclerosis, mitoxantrone has been shown to help. Mitoxantrone is an immunosuppressant used in chemotherapy. It's also used in treating cancer.

It works well, but unfortunately, because of the side-effects, it can't be used as a long-term therapy. In all progressive forms except for Primary-Progressive MS, it has helped to slow the progression and lessen the number of relapses. With any treatment, progression may be slowed, but not stopped all together.

For this reason, permanent neurological problems can occur. These are symptoms that have something to do with the central nervous system. They can cause physical or cognitive disabillity.

Because this is the rarest form of the disease, there is not as much research about it. A small study of 16 patients – 9 men and 7 women, over a 4 yr period - showed these results:

  • Average age at onset was about 35
  • Most common symptom was a progressive myelopathy
  • Average length of the disease was about 10 yrs
  • Average time to first exacerbation was about 4 yrs
  • Average relapses in a year was around 3
  • EDSS or Expanded Disability Status Scale was 6.0

What does this all mean? They found that the Time to reach the EDSS of 6.0 was closely related to the time of first exacerbation. They also found that there was no relation between the number of relapses and the time to EDSS 6.0. In other words the number of relapses had nothing to do with the level of disability.

They further found that relapses in Progressive Relapsing MS may actually occur more often and disability may accumulate more rapidly in PRMS than in PPMS or Primary Progressive MS.

To read the full article, go here Multiple Sclerosis Journal

Here is a video by the National MS Society (NMSS) that explains what PRMS is.



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