Patients with a relapsing-remitting course are now placed on immune modulating therapy that requires injection under the skin or in the muscle once or several times a week. This may be in the form of interferon (such as Avonex or Betaseron) or another medicine called glatiramer acetate (Copaxone). They are all similar in their effectiveness and the decision on which to use depends on side-effect profile.

Other than protective therapies, steroids aregiven to decrease the severity of an attack if it occurs. Other medicines include Baclofen, Tizanidine orDiazepammay be used to reduce muscle spasticity. Cholinergic medications may be helpful to reduce urinary problems. Antidepressant medications may be helpful for mood or behavior symptoms. Amantadine may be given for fatigue.

Physical therapy, speech therapy, occupational therapy, or similar forms of therapy may be helpful. This may improve the person's outlook, reduce depression, maximize function, and improve coping skills. A planned exercise program early in the course of the disorder helps to maintain muscle tone.

Social work, counseling, and support groups may aid in coping. For this condition, see multiple sclerosis - support group. A healthy lifestyle is encouraged, including good general nutrition. Adequate rest and relaxation help to maintain energy levels. Attempts should be made to avoid fatigue, stress, physical deterioration, temperature extremes, and illness to reduce factors that may trigger an MS attack.

Prognosis

The expected outcome is variable and unpredictable. Although the disorder is chronic and incurable, life expectancy can be normal or nearly so, with a life span of 35 or more years after diagnosis occurring commonly. Most people with MS continue to walk and function at work with minimal disability for 20 or more years.

The amount of disability and discomfort varies with the severity and frequency of attacks and the part of the central nervous system affected by each attack. Commonly, there is initially a return to normal or near-normal function between attacks. As the disorder progresses, there is progressive loss of function with less improvement between attacks.

There is a rare, acute type of MS that can cause death within weeks to a few years. There is also a benign form of MS that develops relatively few symptoms for many years.

Complications

• progressive disability
• urinary tract infections
• side effects of medications used to treat the disorder

Call Your Health Care Provider If:

Call your health care provider if symptoms indicate that multiple sclerosis may be present. This is a chronic condition, but symptoms may mimic or mask (disguise) symptoms of acute, serious conditions such as stroke.

Call your health care provider if symptoms progressively worsen despite treatment.

Call your health care provider if the condition deteriorates to the point where home care is no longer possible.

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