4. The Constant Tide: Primary-Progressive MS (PPMS)
The final stage, Primary-Progressive MS (PPMS), presents a different face of MS altogether. Unlike the preceding stages, PPMS is characterized by a constant worsening of neurologic function from the onset of symptoms, with no distinct relapses or remissions.
The flow of PPMS can be likened to a constant tide, relentlessly moving in without any significant retreat. There might be occasional minor improvements or plateaus, but the general current is one of progressive disability. This unrelenting tide makes PPMS a unique and challenging stage of MS.
In terms of prevalence, PPMS is less common than other forms of MS, affecting approximately 10-15% of people diagnosed with MS. Interestingly, it is often diagnosed at a later age than RRMS, typically in the late 30s or early 40s.
The continuous nature of PPMS might seem like a tough tide to weather, but knowing its steady nature can bring a level of predictability. While it doesn’t offer the breaks seen in earlier stages, its lack of sharp peaks (relapses) and sudden drops (remissions) presents a different kind of challenge – a steady, constant tide that individuals learn to navigate over time.
In the context of MS, PPMS signifies the final evolution of the disease. However, it’s important to remember that the rate of progression can vary widely among individuals. The tide may be constant, but it moves at different speeds for different people. Understanding the nature of this tide, while challenging, is vital in developing strategies to live with PPMS. (4)
