Diagnosis of Primary-Progressive Multiple Sclerosis (PPMS)
Diagnosing any form of MS can take a long time. That’s because no single test can confirm MS. The process begins with a detailed patient history and a complete neurological examination. To diagnose MS, your doctor may perform a spinal tap, visual tests, and evoked potential (EP) tests. EP tests measure the brain’s response to electrical stimulation.

An MRI scan of the brain and spinal cord can also help doctors identify lesions, a telltale sign of MS. Before making the diagnosis, other conditions with similar symptoms must be ruled out. Once the diagnosis is made, progression from the start and lack of clear relapses indicate a progressive course.

PPMS progresses once symptoms start to present, hence the name primary progressive. There may be periods of active progression and then periods of inactive progression of symptoms and disability. What differentiates PPMS from the relapsing forms is that while active progression may stop temporarily, the symptoms do not resolve. In relapsing forms, the symptoms may actually improve or return near to where they were before the most recent relapse. Another difference is that there’s not as much inflammation in PPMS compared to relapsing forms. Because of this, many of the drugs that work for relapsing forms do not work for PPMS or SPMS. Also, with PPMS, there are fewer lesions in the brain and more in the spinal cord. The progression of symptoms can worsen over a few months or several years.