Observations from the Natural History Cohort of London, Ontario
Charcot recognized that a subset of patients with multiple sclerosis (MS) appeared to worsen in an insidiously progressive manner from the onset of the disease . This clinically defined disease course has been called primary progressive multiple sclerosis (PPMS). There has been a tendency to consider this disease phenotype different from that of patients whose disease course is characterized by attacks, either relapsing-remitting MS (RRMS) or the late progressive phase of that condition, known as secondary progressive MS (SPMS) (Fig. 1). In contrast to RRMS, comparatively little information is available on the clinical and demographic features and the natural history of PPMS [2–5]. Prognostic variables have yet to be addressed specifically and the natural history has been less well charted.
KeywordsMultiple Sclerosis Secondary Progressive Multiple Sclerosis Primary Progressive Multiple Sclerosis SPMS Patient Multiple Sclerosis Incidence
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