[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.211.227.36. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Hypothesis
February 2002

Medical HypothesisWhy Secondary Progressive Multiple Sclerosis Is a Relentlessly Progressive Illness

Author Affiliations

From the Department of Neurology, Sonny V. Montgomery Department of Veterans Affairs Medical Center and University of Mississippi Medical Center, Jackson.

Arch Neurol. 2002;59(2):301-304. doi:10.1001/archneur.59.2.301
Abstract

Secondary progressive multiple sclerosis is a relentlessly progressive, usually ascending, disease process. Once secondary progression begins, regardless of how long the disease was present before secondary progression began, patients appear to progress at a uniform rate. Recent studies show that it responds poorly to medications effective in relapsing remitting disease, although these drugs decrease relapses and have a substantial effect on lesions seen on magnetic resonance imaging. Disruption of axonal transport is known to occur in demyelinated fibers. Synapses, vacated when axons are destroyed, cause sprouting in surviving terminal axons, resulting in metabolic overload in the terminal axons. This noninflammatory process would not be expected to be altered by current disease-altering therapies.

×