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 Primary progressive multiple sclerosis (PPMS) is characterized by very slow, gradual accumulation of disability from the very onset of symptoms. Patients are often unable to pinpoint the time that symptoms started and often initially dismiss subtle problems as ‘getting older’ or due to something like a mild injury. Patients with PPMS never have exacerbations or attacks although they can have pseudo-relapses (
Primary progressive multiple sclerosis (PPMS) is characterized by very slow, gradual accumulation of disability from the very onset of symptoms. Patients are often unable to pinpoint the time that symptoms started and often initially dismiss subtle problems as ‘getting older’ or due to something like a mild injury. Patients with PPMS never have exacerbations or attacks although they can have pseudo-relapses ( 
    
     