Here is My Question:
How can you tell when the MS seems to be changing from RRMS to Secondary Progressive MS? The bangers are gone but there is a slow gradual downslide.
It can be very difficult to determine if you are developing secondary progressive MS, mostly because this is a clinical diagnosis that is usually made after a period of steady worsening in your neurological examination and function over more than 6 months. Part of the problem is that MS relapses tend to disappear over time and, if you are sufficiently old (generally over age 60) progressive worsening without relapses can be a result of an accelerated aging process on top of prior damage to the nervous system from MS.
It is best to define Secondary progressive MS in people with steady worsening of their exam and function over more than 6 months in the absence of relapses. If relapses are present as well, this is just severe relapsing MS
Revere (Rip) Kinkel MD
Professor of Clinical Neurosciences
Director of the Multiple Sclerosis Program
Clinical Neurosciences Director
University of California San Diego
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