Treatment of Multiple sclerosis

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MS is a very variable condition. There is no drug that can cure MS, but treatments are now available which can successfully manage and treat the symptoms. Treatment will depend on specific symptoms.

Treatment of Multiple Sclerosis will depend on the symptoms and stage of the disease. The National Institute for Clinical Excellence (NICE) and the National Collaborating Centre for Chronic Conditions (NCC CC) issued a new clinical guideline for the NHS in England and Wales on the management of multiple sclerosis (MS) in November 2003.

If your symptoms are mild , with no relapses, no treatment may be needed.

If you have a relapse and symptoms are due to MS, you should be prescribed a high dose Corticosteroid (methylprdnisolene). This may reduce the inflammation and shorten the length of your relapse. Steroids shouldnâ€™t be taken more than 3 times a year or for more than 3 weeks at a time.

If you have had several relapses or have secondary progressive MS, you may be prescribed beta interferon, which may reduce how many relapses you have and delay disability or glatiramer acetate, which may reduce relapses if you have relapsing-remitting MS. These are injected into the muscle or under the skin.

This treatment is available at some hospitals and is prescribed by a specialist neurologist.

These medicines are available if

You are 18 or over, and
You can walk at least 100 metres without assistance
You have had at least two relapses in the past 2 years, and
You do not have another medical conditions that may interfere with the way the medicines work

Or for those with secondary progressive MS with relapses if

You are 18 or over
You can walk at least 10 metres without assistance
Disability due to MS has been minimal over the past 2 years
There have been at least 2 relapses in the last 2 years
You do not have another medical conditions that may interfere with the way the medicines work

Regular check- ups are needed. If you remain well while on the medicines, the treatment should be continued. If however the medicine appears not to be working or is causing unacceptable side- effects then discontinuing the treatment will be discussed.

You will be advised to take linoleic acid (17-23g/day) (found in capsules, also sunflower, corn, soya and safflower oils), which may reduce progression to disability.

You should be referred to a specialist neurological rehabilitation service for help with equipment or care if it becomes difficult to carry on with normal daily activities. You should have a multi- disciplinary assessment involving specialist nurses, physiotherapists, occupational therapists, speech and language therapists and social workers can provide equipment and many services.

There are some treatments that may be suggested as part of a trial or with very close monitoring. It is unclear whether they work.

If your MS is very active, getting injections of mitoxantrone (calms the immune system) plus methylprednisolone may reduce how many relapses you get.
Azathioprine- calms the immune system and may reduce the number of relapses
Intravenous immunoglobulin may make disability milder in relapsing, remitting MS
Plasma exchange may reduce disability if you have become recently disabled

There may be some clinical benefit from taking Amantadine (200mg) daily) to reduce fatigue.

There is some evidence to suggest the following Complementary therapies may help

Reflexology
Fish oils
Magnetic field therapy
Neural therapy
Massage and body work