Which of the following describes the progression of symptoms in Primary Progressive MS (PPMS)?

Primary Progressive MS (PPMS) is characterized by a gradual and continuous worsening of symptoms from the initial onset, without any distinct relapses or remissions. This differentiates it from other forms of MS, such as relapsing forms, where patients experience clear episodes of exacerbation followed by recoveries. In PPMS, the progression is typically relentless, and while some patients may have periods of stability, the overall trend is one of slow and steady decline in functionality.

This continuous progression can manifest in various symptoms, including increased muscle weakness, mobility challenges, and cognitive changes, all of which gradually worsen over time without the typical fluctuations seen in relapsing forms of MS. The absence of distinct relapses means that patients do not experience sudden worsening followed by significant recovery, leading to a different disease management and treatment approach compared to other types of multiple sclerosis.