Multiple sclerosis (MS) is an autoimmune disease which attacks the central nervous system. Although there is no cure, several treatment option exist that may limit relapses of the disease and decrease the progression of damage and limitations.
Integrate Disease-Modifying Medications
Using disease-modifying medications can improve the long-term course of the disease, specifically if you are diagnosed with relapsing remitting multiple sclerosis (RRMS), secondary progressive multiple sclerosis (SPMS), or clinically isolated syndrome (CIS). The established course of RRMS is one with periods of stability (remission) where symptoms do not become worse or new symptoms do not appear and periods of relapse. In SPMS the pattern of MS symptoms begins much like RRMS, with periods of relapse and remission. Over time, the disease changes course to a steady increase in symptoms and change in functioning.
Although CIS is not technically MS, it may be the first documented attack of the disease. Some disease-modifying medications are approved for CIS, especially in people who have a high likelihood of going on to develop MS. Neurological changes, such as brain lesions and decreases in nerve conduction, increase the likelihood someone with CIS will be diagnosed with MS. In general, disease-modifying medications increase the duration of remission and help reduce the appearance of new brain lesions. There are several disease-modifying medications available and you will likely need to go through trial and error before finding one that helps reduce relapses.
Manage Relapses
Corticosteroids are often used during relapses of MS, specifically when relapses are severe and significantly impact daily functioning. The use of high doses of steroids can help reduce inflammation quickly and possibly decrease the duration of a relapse. Depending on the intensity and symptoms during a relapse, steroids may be given as an infusion for faster onset or as an oral medication. Steroid therapy is usually given as a "burst" dosing, meaning they are prescribed in high doses for up to five days. Since steroids are not effective for the long-term management of MS, it is important to participate in a therapeutic regimen designed for long-term use, such as disease-modifying medications.
In a small percentage of people, corticosteroids may not be enough to control a relapse. When severe relapses occur that are not adequately controlled by corticosteroids, "blood-cleansing" may be an option. Plasmapheresis is the process by which blood is extracted from your body and filtered to separate the red and white blood cells. Autoantibodies that are associated with autoimmune diseases can be removed during the filtering process. Once the blood is "cleaned," it is returned back to you. The process is quite similar to plasma donation.
Engage In Therapies
Different types of therapies are important to manage long-term functioning. Physical therapy is a common component of a MS treatment plan since many people experience at least some changes in physical functioning. The damage to neurons that occurs with MS may cause problems with coordination, balance, walking, and dexterity. Routinely engaging in physical therapy exercises that target the affected nerves may help slow the incidence or progression of physical limitations, especially when combined with medications.
In severe circumstances, MS relapses may affect speech or the ability to engage in typical functioning, such as eating. Speech therapy may become a necessity for people who develop aphasia. The goal of incorporating speech therapy is to potentially help regain lost speech or adapt to alternative methods of communication. Some people may need to relearn how to chew and swallow foods to gain nourishment and prevent choking or aspiration of food and possibly avoid a feeding tube. Early intervention and use of therapy when new symptoms occur can be critical for preventing or delaying long-term changes in functioning.
MS can cause significant physical and cognitive changes in those affected, and with an unpredictable course, the diagnosis can be frightening. As treatment options for MS improve, more people with a diagnosis of MS can expect a better chance of longer remission from life-changing symptoms. For more information about the condition and how to deal with it, contact a clinic like Allegheny Brain And Spine Surgeons.
