Multiple Sclerosis Treatment

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Doctor's View on Multiple Sclerosis Treatment

Comment by Charles P. Davis, MD, PhD

What is multiple sclerosis (MS)?

Multiple Sclerosis (MS) is a disease that attacks the central nervous system (brain, spinal cord, and optic nerves) resulting in symptoms that range from mild (numbness) to severe (paralysis). Although the cause is not known, most researchers and clinicians think that somehow environmental, genetic, and/or infectious agents may, either alone or in combination, trigger an immune response in individuals that causes immune cells to begin to destroy the nerve-insulating myelin coverings. Myelin coverings protect nerves from interfering electrical impulses, irritating chemicals in their immediate environment, and promote good nerve signals. Simply stated, myelin acts like the insulation on wires that are bundled together in close proximity; if the wires start to lose their insulation, they may not function well and if they get wet, they can short out and not function at all. The disease has many symptoms that are nonspecific and makes MS a disease that is difficult to distinguish from many others. However, diagnosis is possible and once diagnosed, MS can be treated (but not cured).

Multiple sclerosis treatment

Just as diagnosis of MS is difficult, so is treatment. There is no known treatment that will cure MS, so MS treatments, in general, center on two main areas -- the autoimmune component and on the myriad of symptoms caused by the damaged or destroyed section(s) of nerve tissue. Consequently, most treatments center on the underlying immune disorder and the patient's individual symptoms. Many guidelines are available, but they are based on ways to use various drugs, their individual side effects, and their efficacy on symptoms of MS. For example, the American Academy of Neurology cites ten different guidelines or algorithms to treat MS while other professional medical societies have other similar treatment methods. The correct one is the one that works to reduce or eliminate most of your symptoms and is found, sometimes with difficulty, by you and your doctor discovering what plan works best for you.

Treatment protocols may include immunomodulating drugs like interferon, natalizumab, fingolimod, and many others. Symptoms such as pain, bowel problems, spasticity, and the numerous other secondary or tertiary symptoms are taken into account so that the best treatment protocol can be determined by you and your doctor(s). Some patients respond to methylprednisolone after an acute relapse of MS and plasma exchange methods may benefit some patients. Some treatments of serious symptoms such as dysphagia, contractures, or limb spasticity may be treated with surgery. In addition, some doctors and patients suggest the diet plays a role in MS and promote the use of the swank diet (high in grains, vegetables, and fruits and low in fat and meat).

MS is a disease that needs to be diagnosed, treated, and followed up by a doctor, usually a neurologist who is very familiar with the many ways MS can be treated. In addition, such doctors are usually aware of the newest drugs, both commercially and experimentally available, for appropriate patients.

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REFERENCES: "About the Swank Low-Fat Diet for the Treatment of MS." Swank MS Foundation.

"Multiple Sclerosis." American Academy of Neurology.

Luzzio, Christopher, et al. "Multiple Sclerosis." Medscape. 5 Aug. 2013.

Last Editorial Review: 8/7/2013 3:05:37 PM