How do you distinguish between primary progressive MS versus relapsing remitting MS with superimposed relapses in a newly diagnosed patient that is naive to treatment?
Are there emerging biomarkers that help distinguish the phenotypes in the absence of evaluation over time?
Answer from: at Academic Institution
Relapsing versus progressive MS are clinical phenotypes lacking clear objective radiologic or paraclinical distinctions. Recent literature emphasizes commonalities between these phenotypes, largely framing them as a spectrum of one disease rather than discrete disorders. Originally, these clinical p...
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Answer from: at Academic Institution
First, I scrutinize the history to look for evidence of progression over a year or more as we often determine PPMS retrospectively as it has a much more subtle presentation than RRMS. Patient specific factors such as presenting with a progressive myelopathy, male gender, age in 40s, primarily spinal...