How To Diagnose Primary Progressive MS

How to Diagnose Primary Progressive MS
(2017 Revised McDonald PPMS Criteria)

ABOUT PPMS:
• PPMS is described as a slow steady accumulation of disability from the onset of symptom, with few or no relapses nor remissions.

• PPMS is uncommon, impacting 10-15% of the total MS population.

• PPMS age of onset is 40 years, about a decade later than in RRMS.
• It also tends to progress faster than RRMS.

• Also the female to male ratio in PPMS is 1:1, unlike RRMS which is 3:1.

• PPMS tend to have more spinal cord related disability.

ABOUT the 2017 Revised McDonald Criteria for PPMS:

1. One year of disease progression (worsening of neurological function without relapse), and

2. Two of the three:

• One or more T2 bright lesion(s) lesions in periventricular, juxtacortical, cortical or infratentorial brain locations
• Two or more T2 bright lesions in the spinal cord
• CSF with unpaired OCBs and/or an elevated IgG index

Reference: Thompson, A, Banwell, B, Barkoff, F. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald Criteria. Lancet Neurol 2018; 17(2): 162–173.

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