Some people may become disabled within a few years of diagnosis, while others may remain stable for decades.

This article discusses primary progressive multiple sclerosis and how it is treated.

It also goes over symptoms and causes.

Man suffering from Parkinson’s disease and multiple sclerosis standing near steps

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What Is Primary Progressive MS?

Primary progressive MS is a form of the disease that is progressive from the time of onset.

RRMS is characterized by acute attacks of symptoms followed by periods of remission where the MS doesnt progress.

It can also cause impairment of sexual, bowel, andbladder function.

Fatigue is also common with this and all other forms of multiple sclerosis.

These symptoms are rare in PPMS but may include:

What Causes Primary Progressive MS?

It may take several years or more to definitively diagnose PPMS, especially if your symptoms have just started.

The EEG measures slowed responses to visual events, which indicates neurological dysfunction.

Note, however, that it is more difficult than for RRMS.

Ocrevus (ocrelizumab) was approved to treat PPMS in 2017.

The first dose is given intravenously in two 300-milligram (mg) doses two weeks apart.

After that, it’s given in 600-milligram (mg) doses once every six months.

Ocrevus Zunovo (ocrelizumab and hyaluronidase) was approved in 2024 to treat PPMS.

The speed of progression for PPMS is different for everyone.

Some people progress quickly while others may progress slowly over many years.

Treatment for PPMS may involve medications and rehabilitation therapies.

National Multiple Sclerosis Society.Types of MS.

Johns Hopkins Medicine.Primary progressive multiple sclerosis.

National Multiple Sclerosis Society.What causes MS?

National Multiple Sclerosis Society.Primary progressive multiple sclerosis (PPMS).

Food and Drug Administration.Ocrevus Zunovo label.

National Multiple Sclerosis Society.Rehabilitation.

Abdelhak A, Weber MS, Tumani H.Primary Progressive Multiple Sclerosis: Putting Together the Puzzle.Frontiers in Neurology.

2017;8:234. doi:10.3389/fneur.2017.00234.

2014;83(3):278286. doi:10.1212/WNL.0000000000000560.

Olek MJ, Howard J.Clinical Presentation, Course, and Prognosis of Multiple Sclerosis in Adults.

Olek MJ, Howard J.Evaluation and Diagnosis of Multiple Sclerosis in Adults.

Olek MJ, Mowry E.Treatment of Progressive Multiple Sclerosis in Adults.