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Clinical characteristics of progressive relapsing multiple sclerosis
M J Tullman1, R J Oshinsky, F D Lublin
1Department of Neurology, The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, The Mount Sinai Hospital, New York, NY 10029, USA. mark.tullman@mssm.edu
Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 26, 2004
Summary
Progressive relapsing multiple sclerosis (PRMS) patients may experience more frequent relapses and faster disability accumulation than previously thought. This study highlights key clinical features and suggests differentiating PRMS from primary progressive MS.
Area of Science:
- Neurology
- Neuroimmunology
- Clinical Neurology
Background:
- Progressive relapsing multiple sclerosis (PRMS) is characterized by incomplete recovery from exacerbations and ongoing deterioration.
- Primary progressive multiple sclerosis (PPMS) involves continuous disability accumulation.
- Limited data exists on PRMS clinical characteristics, with relapses reportedly infrequent.
Purpose of the Study:
- To delineate the clinical features of a cohort of patients diagnosed with progressive relapsing multiple sclerosis (PRMS).
- To provide insights into the natural history and disease course of PRMS.
Main Methods:
- Retrospective chart review of 16 patients with a PRMS diagnosis.
- Data collected from two academic multiple sclerosis (MS) centers over a four-year period.
- Analysis included age at onset, presenting symptoms, disease duration, relapse rates, and time to disability milestones.
Main Results:
- The cohort comprised nine men and seven women with a mean age at onset of 35.1 years.
- Progressive myelopathy was the most common presenting symptom.
- Patients experienced an average of 2.8 relapses, with an annualized relapse rate of 0.6. Time to Expanded Disability Status Scale (EDSS) 6.0 correlated with time to first exacerbation.
Conclusions:
- Relapses in PRMS may be more frequent than previously reported in the literature.
- Disability accumulation in PRMS might be more rapid compared to PPMS.
- The findings support the need to distinguish PRMS from PPMS for accurate diagnosis and management.