Treatment
Aim of the treatment of patients with Multiple Sclerosis (MS) is -
- To reduce the severity and rate of relapse
- To reduce the number of lesions
- To delay the progression of the disease
Medication that is capable of modifying the disease are -
1. Beta interferon
This is a useful drug that reduces flare-ups and at the same time, slows the march towards disability that can occur. It is therefore used for-
- Relapsing forms of MS
- Patients with more than one attack per year
- Recovery from flare ups not satisfactory
- When new lesions are seen on the MRI
2. Glatiramer (copaxone or co-polymer1)
This is a synthetic form of the protein found in the myelin. It is administered as a single injection daily. It can be used in the relapsing-remitting types when beta interferon cannot be used and it reduces the relapse rate by a third. Side effects-flushing, shortness of breath
3. Natalizumab (tysabri)
This drug has been reported to cause a side effect called progressive multi-focal leucoencephalopathy. It is therefore reserved only for those who do not respond to the other medicines.
4. Novantrone
This is an anti cancer drug and is also reserved for those with severe attacks, rapidly progressing disease that does not respond to other drugs.
Drugs used for symptom reduction and relief include -
1. Cortico steroids -
Can be given orally or intravenously. It reduces inflammation and shortens the flare-ups.
2. Muscle- relaxants -
Baclofen and tizanidine reduces muscle spasticity`
3. To reduce the feeling of fatigue
- Amantadine
- Modanafil
- Aspirin
4. Anti depressants
Tolterodine- To control Urinary urgency and frequency
5. Gabapentine
For controlling the symptoms of ‘burning feet’
6. Physiotherapy – Can help in preventing muscle wastage in a patient who is confined to bed or a wheelchair.
7. Occupational Therapy – Helps the a patient suffering from disability to be able to engage their time in some useful work and sometimes may even help in paying small bills.
- Self help measures include - Adequate rest
- Sufficient exercise and activities such as swimming can help reduce stress and also prevent wasting of muscles
- Avoiding d exposure to extreme heat
- Well balanced diet
Periodic counseling helps the patient to come to terms with the condition and lead a less miserable life. The patient should learn how to cope with the disease by
Maintaining a normal routine as far as possible and keeping their morale high, and enrolling with support groups.
Plasmapheresis
When a patient suffers from sudden severe attacks not responding to high doses of steroids, this treatment -a filtering process of the patient’s blood is done to remove antibodies from the blood. It must be used only within 3 months of onset of nervous symptoms for optimum benefit.
