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Patients with RRMS who are untreated or ineffectively treated can go on to develop secondary progressive multiple sclerosis (SPMS) after many years. SPMS is characterized by a very gradual worsening of symptoms in between sudden attacks. Although a number of neurologic symptoms can slowly progress, many patients describe a gradual worsening of strength in their legs, muscle stiffness, and changes in their bladder function. Over time, the progression becomes more prominent and relapses may stop completely. SPMS is characterized by less inflammation and fewer changes on MRI’s than RRMS. For this reason, many of our anti-inflammatory treatments are not as effective in this group.
