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Ethics approval and consent to participate As this case report does not meet the definition of human research, the authors declare that ethics approval was not required for this case report

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In SPMS, characterized by steady deterioration without acute attacks, treatment strategies often involve continuing or altering DMT used during the earlier RRMS phase, such as interferon beta, or considering immune-modulating agents, such as methotrexate, cyclophosphamide, or glucocorticoid pulses [142, 143]

[DOI] [PubMed] [Google Scholar] 19.Sun H, Yang T, Li Q, Zhu Z, Wang L, Bai G, Li D, Li Q, Wang W

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