RRMS to Secondary Progressive

How does a physician determine that a patient has gone from relapsing remitting MS to secondary progressive MS? And once that determination has been made what changes (if any) can the patient expect in mode of treatment?

[CCF-Neuro-M.D.-CS]

The diagnosis is a clinical one. In relapsing remitting MS a patient has relapses and then regains some of the function they lost. This is typically associated with an enhancing lesion on MRI. In secondary progressive MS there is a slow gradual decline in function over time with no improvement, there may still be relapses. During this stage there may be no enhancement on the MRI. There is no accepted standard for the progressive forms of MS. There is some evidence that the interferons (Avonex, Rebif, and Betaseron) may work. There is also evidence that stronger chemotherapeutic agents may help. A consultation with a MS specialty center, such as the Mellen Center at the Cleveland Clinic, would be recommended. Then based upon your case the proper therapeutic agent can be initiated. Good luck.