Secondary progressive multiple sclerosis is a subtype of the common autoimmune disorder that is characterized by steadily worsening symptoms and shorter periods of remission between episodes. Problems occur when the immune system attacks healthy nerve cells in the body, causing inflammation and eventually permanent damage to parts of the central nervous system (CNS). The nature of symptoms can vary between patients, though most people experience deteriorating vision, declining ability to control muscle movements, and concentration and memory problems. There is no cure for secondary progressive multiple sclerosis, but medications and physical therapy can help many patients find relief from some of their symptoms.
The majority of people who develop secondary progressive multiple sclerosis have already been diagnosed with a lesser form of the disorder called relapse-remitting multiple sclerosis (RRMS). Patients with RRMS typically have short symptomatic periods with weeks, months, or even years of remission. Over the course of five to 30 years, a large number of people with RRMS begin experiencing more frequent attacks that tend to last longer and cause more serious problems. Doctors are unsure why RRMS tends to become a chronic progressive problem, though it is likely that genetics, dietary and lifestyle choices, and possibly even RRMS medications are important factors.
Common symptoms of secondary progressive multiple sclerosis include fatigue, muscle weakness, and decreased touch sensations. Weakness and numbness may affect a single limb or become a body-wide problem. Other symptoms may include urinary incontinence, episodes of mental confusion, blurry vision, and sexual dysfunction. In the later stages of the disease, total paralysis and disabling cognitive deficits can arise.
A diagnosis of secondary progressive multiple sclerosis can usually be made based on observed changes in symptoms of a RRMS patient. Doctors use well-established clinical tests to see if reflexes, vision, and sense of touch are worsening. Specialists also use diagnostic imaging tests to look for increased physical damage to parts of the brain and other structures in the CNS.
Treatment for secondary progressive multiple sclerosis is different for each patient and depends on a variety of factors. Muscle relaxants and other anti-spasmodic medications may be adjusted, added, or removed from an established treatment regimen to see if symptoms improve. Drugs such as mitoxantrone, methotrexate, and interferons are commonly prescribed in an attempt to slow the steady development of new neurological problems. Patients may also be scheduled for speech and physical therapy to learn how to overcome declining physical abilities.
