What is the Difference Between RRMS and PPMS

Dr.Samanthi

2 years ago

The key difference between RRMS and PPMS is that RRMS is a type of multiple sclerosis that tends to have more inflammation, while PPMS is a type of multiple sclerosis that tends to have less inflammation.

Multiple sclerosis is a chronic medical condition that causes nerve damage. Multiple sclerosis is an example of a demyelinating disease where the myelin sheath (the protective covering of nerved fibers) becomes damaged. There are four main types of multiple sclerosis: clinically isolated syndrome (CIS), relapsing remitting multiple sclerosis (RRMS), primary progressive multiple sclerosis (PPMS), and secondary progressive multiple sclerosis (SPMS).

1. Overview and Key Difference
2. What is RRMS
3. What is PPMS
4. Similarities – RRMS and PPMS
5. RRMS vs PPMS in Tabular Form
6. Summary – RRMS vs PPMS

What is RRMS (Relapsing Remitting Multiple Sclerosis)?

RRMS (relapsing remitting multiple sclerosis) is the most common type of multiple sclerosis. It affects 85% of all people diagnosed with multiple sclerosis. Most people are normally diagnosed first with RRMS. However, RRMS typically changes after several decades to a more progressive type called secondary progressive multiple sclerosis.

RRMS usually involves periods of acute relapses and periods of remissions. During relapses, new symptoms can occur; sometimes, the same symptoms can flare up or become more severe. On the other hand, during remission, people may experience fewer symptoms, or symptoms can be less severe for weeks, months, or years. RRMS is a type of multiple sclerosis that tends to have more inflammation. The symptoms of RRMS may include problems with coordination and balance, numbness, fatigue, inability to think clearly, vision problem, depression, problems with urination, trouble tolerating heat, muscle weakness, and trouble walking.

Figure 01: Types of Multiple Sclerosis

RRMS can be diagnosed through MRI scans, medical history, physical examinations, and neurological examinations. Furthermore, the treatment for RRMS may include medications such as relaxers, pain relievers and steroids, physical therapy, occupational therapy, speech therapy, psychological therapy, disease, modifying therapies (DMTs) to prevent relapses and reduce their frequency, monitoring and reinforcing person’s ability to recognize the signs of disease or nerve damage and drugs such as Ocrelizumab, Siponimod, and Cladribin for relapses.

What is PPMS (Primary Progressive Multiple Sclerosis)?

PPMS (primary progressive multiple sclerosis) is one of the rarest types of multiple sclerosis, affecting about 15% of everyone diagnosed with MS. While other multiple sclerosis types are normally characterized by acute attacks called replaces, which are followed by periods of non-activity called remission, PPMS causes gradually worsening symptoms. The symptoms of PPMS may include vision problems, difficulty talking, problems walking, trouble with balance, general pain, stiff and weak legs, trouble with memory, fatigue, trouble with bladder and bowel, depression, sexual problems, shakiness, prickling feeling, numbness, paralysis, electric shock sensation, trouble staying balanced, and muscle weakness.

Moreover, PPMS is diagnosed through discussion, physical examination, MRI scan of the brain and spinal cord, optical coherence tomography (OCT), spinal tap, and visual evoked potentials. It can be treated through medication such as ocrelizumab (ocrevus), physical therapy, occupational therapy, speech therapy, exercises, other medications for tight muscle, bladder and bowel problems, sexual problems, fatigue, and counseling for mental health problems.

What are the Similarities Between RRMS and PPMS?

RRMS and PPMS are two types of multiple sclerosis.
Both types of MS are due to the inflammatory process of the autoimmune system that causes damage to the myelin sheath.
Both types of MS may have similar symptoms such as vision problems, trouble walking, fatigue, and depression.
They are treated by medications such as ocrelizumab (ocrevus) and other supportive therapies.