Primary progressive multiple sclerosis is a debilitating autoimmune disease characterized by the gradual onset of myriad symptoms and increasing neurological damage. In multiple sclerosis (MS), the protective myelin sheath that covers the nerves (often compared to the covering surrounding the wires on an electrical cord) becomes damaged, causing nerve impulses to misfire, and a range of MS symptoms to develop. Some PPMS symptoms come and go, while others can be permanent and irreversible.
The Facts
According to the Multiple Sclerosis Association of America, approximately 20 percent of individuals with MS are diagnosed as having primary progressive multiple sclerosis. Primary progressive multiple sclerosis symptoms vary by individual, and no two disease courses are the same, which makes it difficult for doctors to diagnose how the disease will progress.
Fatigue
According to the National Multiple Sclerosis Society, fatigue, one of the most common MS symptoms, occurs in approximately 80 percent of those with MS. MS fatigue, often compared to the exhaustion that accompanies the flu, worsens with exposure to heat, whether that heat is from external sources (the weather or a hot bath) or internal sources (fevers).
Pain
Chronic and acute pain symptoms associated with primary progressive multiple sclerosis include dysesthesia (more commonly known as the "MS hug"), which is a tightness, or "girdling" feeling around the torso; and trigeminal neuralgia, a spontaneous, lightning-like facial pain, according to the Mayo Clinic. L'Hermitte's sign, an electric shock-like pain that can occur with certain head movements, is another common MS symptom. According to the National MS Society, pain, burning, spasticity (muscle spasms), and "pins and needles" in the extremities, especially the legs, are also common primary progression multiple sclerosis symptoms.
Gait and Mobility-Related Symptoms
Numbness, leg weakness, and balance-related issues can make walking difficult. Some of the most common primary progressive multiple sclerosis symptoms include the "toe drag," "foot drop," monoparesis (weakness in one leg) and paraparesis (weakness in both legs). Vertigo---a sensation of spinning or dizziness---causes a loss of balance that leads to ataxia, an unsteady or "drunken" gait, according to the Multiple Sclerosis Foundation.
Bowel, Bladder and Sexual Symptoms
According to the Cleveland Clinic Neurological Institute, bladder and bowel-related MS symptoms include incontinence, loss of sensation, urine retention and constipation. Sexual changes occur in 90 percent of men and 70 percent of women with MS, according to the Multiple Sclerosis Foundation, and can include loss of sensation, decreased sex drive and loss of interest.
Less Prevalent Symptoms
Some typically common MS symptoms---visual and cognitive dysfunction, and tremors---seem to be less prevalent in PPMS than in other forms of MS, according to the Cleveland Clinic Neurological Institute.
PPMS Symptom Management
Though researchers have yet to discover a cure for primary progressive multiple sclerosis, there is no shortage of MS symptom management tools: medication, assistive devices, alternative therapies, occupational, physical and speech therapy, acupuncture, massage, and meditation---or any combination thereof.
In addition, exercise can help alleviate PPMS symptoms, keep depression at bay, and increase energy levels. The Multiple Sclerosis Foundation and local chapters of the National MS Society offer modified classes in yoga, T'ai Chi, and other forms of therapeutic exercise and assistive relief.
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