2010 BC Guide in Determining Fitness to Drive

Level of disabilityor worsening of existing symptoms. Of all the types of MS, SPMS causes the greatest amount ofdisability.Primary Progressive (PPMS)It is estimated that 10% of individuals with MS have PPMS. It is characterized by a gradualprogression of disability with no relapses and minor remissions from onset. The spinal cord isthe area of the central nervous system primarily affected; therefore, cognitive impairments areunusual.Progressive Relapsing (PRMS)It is estimated that 3 to5% of individuals with MS have PRMS. PRMS is characterized by asteady progression of disability with superimposed relapses and remissions. There may besignificant recovery immediately following a relapse, but between relapses there is a gradualworsening of symptoms.The following illustration compares the course of disability over time for each of the four typesof MS. 16Relapsing –Remitting (RRMS)Secondary Progressive(SPMS)Primary Progressive(PPMS)Progressive Relapsing(PRMS)TimeParkinson’s diseaseParkinson’s disease (PD) belongs to a group of conditions called motor system or movementdisorders, which result from the slowly progressive loss of dopamine-producing brain cells. Thelack of dopamine, a neurotransmitter, interferes with the transmission of messages from the brainto nerve cells that control muscle movement and coordination. It can result in motor impairment(tremor or rigidity) and in later stages in cognitive or autonomic dysfunction. PD is chronic and16 Source: The Multiple Sclerosis Information Trust, http://www.mult-sclerosis.org.317