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    PPMS vs SPMS vs RRMS
    soupysue posted:
    I am newly diagnosed with MS. My provider wants to start me on meds for relapsing MS, but my symptoms are consistent with PPMS. I plan to have a discussion with before agreeing to any meds this week. I am over 50, had one "attack" that may have been the onset of MS about 11 years ago, and then went to the neuro due to neuropathy in my feet. I am also a Type 1 diabetic, so we thought it was from that, except my endocrinologist said it wasn't presenting like it usually does. Then I had an MRI which only showed a few lesions, when to a spinal specialist for back issues, was sent back to the neurologist, and had a spinal tap, which showed positive for MS.

    My symptoms are back pain and stiffness for more than a year, balance issues, bladder urgency, and stiff legs, as well as having one side weaker than the other. There's been no change until I started taking baclofen which reduced the stiffness.

    Looking for feedback on this.

    hackwriter responded:
    Dear Soupysue,

    It is a good idea to have that talk with the neurologist and ask why he/she diagnosed you with RRMS. Diagnosing any form of MS is very difficult, and the PPMS form is particularly difficult since it can include inflammatory acute attacks, which then might characterize is as progressive-relapsing.

    One reason your neuro might want you to take one of the RRMS therapies is that there are no effective treatments for the progressive forms of MS. So, if in fact your tests have suggested there has been inflammation occurring, an RRMS therapy might have a beneficial effect. If your doctor diagnosed you with a progressive form, your insurance would not approve the use of those RRMS therapies. If, in the course of using those therapies your follow-up tests show no effect, your doc might eventually change your dx to a progressive one.

    I hope you'll let us know the result of your consultation.


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