| Summary points: | A 38-year-old woman presents with a long history of difficulty in walking, incoordination in upper limbs, and urinary incontinence. She had spastic paraplegia, brisk tendon reflexes, bilateral Babinski signs, decreased vibratory sensation in lower limbs, tremor and dysmetria in upper limbs, and a left deafferented pupil. The authors discuss testing, radiological findings, diagnosis, and treatment of the primary progressive form of multiple sclerosis. |