Secondary Progressive MS is characterized by progression that follows an initial relapsing-remitting course.

• A. True.
• B. False.
• C. It occurs before RRMS.
• D. It is the same as CIS.

Answer: (A)

Secondary progressive MS is defined by a gradual progression of disability that follows an initial relapsing-remitting course. In RRMS, there are discrete relapses with partial recovery; over time, many people transition to SPMS, where disability accumulates more steadily and relapses may become less prominent or absent. This makes the statement true. It isn’t before RRMS, since SPMS develops after the relapsing-remitting phase; it isn’t the same as CIS, which is a single demyelinating event that may herald MS; and SPMS is distinct from primary progressive MS, which starts with progression from onset without a preceding RR phase.