Can inactive MS skip RRMS and go straight to Progressive MS?

Here is My Question:
Can inactive MS skip RRMS and head straight to Progressive MS??

Answer:
It is not uncommon for inactive MS to turn into progressive MS with time. Only about 25 % of patients remain stable indefinitely. Remember, only the relapses that occur early in the disease (the first 5 years) are related to the rate of developing progressive disease. Relapses always tend to become less frequent with age and disease duration. After sometimes many years of this apparent stability, it is not uncommon for problems to slowly develop. These problems often involve worsening of your walking ability. 

Less commonly we see patients who experience an attack earlier in life, often optic neuritis, then remain stable for decades before developing a progressive gait impairment. These patients often do not receive a diagnosis of MS until the later problems develop with walking. Some of my colleagues in Canada call this single attack onset progressive disease.

It is our hope that the use of highly active disease modifying therapies early in the course of the disease in well selected patients, will forestall or prevent the development of this progressive disease years later. 

Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego