Treatment of multiple sclerosis

Multiple sclerosis is a degenerative neurological disease which strikes adults between the ages of 20 and 50. The disease condition can range in severity from relatively benign to an aggressive form which increases morbidity and mortality at an early age.

Treatment options for multiple sclerosis are varied and the goal of management is to control the symptoms and treat disease before permanent damage occurs. Treatment can include medications, physical on occupational therapy as well as current experimental therapies. Unfortunately, all physicians are not in concert as to when treatment should begin.

Researchers believe that the damage to the brain and spinal cord is happening early in the development of the disease, even before symptoms occur. That\’s why some physicians believe it\’s important to start treatment as soon as possible. Other physicians may take a wait and see approach with counseling and close observation, if they believe the attacks are mild or infrequent.

Because physicians and researchers are unable to effectively predict the prognosis of any patients with multiple sclerosis treatment, choices for each individual patient should be made between patient and physician after individuals have been carefully educated.

The goal of treatment for individuals with multiple sclerosis is to decrease the rate and severity of relapse which they experience. Physicians also focus on reducing the number of multiple sclerosis lesions and delaying the progression of the disease while at the same time providing symptomatic relief for the individual who suffers from these symptoms. The treatment options will also depend upon the type of multiple sclerosis which is diagnosed. In patients with relapsing-remitting type it is often difficult to determine if the symptomatic improvements are the result of therapy or just a part of the natural course of the disease.

Medication and drug therapy can include interferon beta-1b, high dose interferon, Glatiramer, Mitoxantrone, and corticosteroids. Exactly how corticosteroids work is unknown but they are thought to help by decreasing the intensity of the body\’s defense system in reaction to the myelin in the central nervous system. Physicians find that corticosteroids will hasten the recovery from acute attacks and appear to prevent damage to the blood brain barrier.

The use of Interferon and Mitoxantrone appeared to help inhibit specific cells in the body\’s defense mechanism which destroys myelin in the central nervous system and diminish the activity of the disease causing white blood cells. Individuals find that these medications will decrease the rate of relapse as well as delay the progression of the disability.

Sufferers also benefit from physical therapy and occupational therapy to maintain the current strength of their muscles in both the upper and lower extremities. While multiple sclerosis more frequently attacks the lower extremities patients who have the disease often benefit from increasing strength in their upper extremities to compensate.

Currently there are clinical trials which are attempting to improve the treatment modalities which are available for people with multiple sclerosis. While the hope of a cure is not on the horizon there are some promising medications which are helping people to live active and productive lives.

RESOURCES

MayoClinic: Multiple Sclerosis

National Multiple Sclerosis Society: Treatments

Western Journal of Medicine: Current Pharmacologic Treatment of Multiple Sclerosis Symptoms

Karolinska Institutet: Cancer Drug a Possible Treatment for Multiple Sclerosis

Wall Street Journal: New Ways to Treat Multiple Sclerosis

University of Maryland Medical Center: Multiple Sclerosis

Johns Hopkins Medicine: Treating Multiple Sclerosis