Multiple sclerosis (MS) is a chronic condition that attacks the central nervous system (CNS) and often causes disability. The CNS includes the optic nerve, the spinal cord, and the brain. Nerve cells are like wires that conduct electrical impulses from one cell to another. These signals allow the nerves to communicate. Like wires, nerve cells need to be wrapped in a form of insulation to function correctly. Nerve cell insulation is called myelin.
MS involves gradual, unpredictable damage to the myelin of the CNS. This damage causes nerve signals to slow down, stutter, and distort. The nerves themselves may also suffer damage. This can cause MS symptoms such as numbness, loss of vision, difficult speaking, slow thinking, or even inability to move (paralysis).
Learn more about what to consider when you evaluate your MS treatment plan.
Every patient is different, and reacts differently to MS. For this reason, treatment plans are designed to fit individual needs. The disease may affect a given patient differently from day to day. Symptoms may come and go, or may gradually worsen. Sometimes the major symptoms disappear. It’s important to regularly communicate with your doctor, especially when symptoms change.
MS is an autoimmune disease. Treatments focus on slowing the damage caused by the immune system’s attacks on myelin. Once a nerve itself is damaged, however, it cannot be repaired. Other treatment approaches are targeted at providing symptom relief, managing flare-ups, and training patients to cope with physical challenges.
During attacks, the disease actively causes physical symptoms. Your doctor may prescribe a corticosteroid drug during an attack. Corticosteroids are a type of drug that helps reduce inflammation. Examples of corticosteroids include prednisone (taken by mouth) or methylprednisolone (given intravenously). If you’ve been prescribed corticosteroids, it’s important to understand possible side effects.
Talk to your doctor if you experience unusual weight gain, mood swings, or unexpected or persistent infections. These are potential side effects of corticosteroid use. It is ideal if there can be a balance between controlling MS symptoms and minimizing possible side effects of treatment.
The chief goal of treatment is to slow progression of the disease. It’s important to treat MS even during remission, when there are no obvious signs of illness. MS cannot be cured, but it can be managed. Strategies to slow the progression of MS include a number of different drugs. Examples include: beta interferons, glatiramer acetate, fingolimod, natalizumab, mitoxantrone, teriflunomide, and dimethyl fumarate.
These drugs work in different ways to slow myelin damage. Most are classified as disease-modifying therapeutics (DMTs). They have been developed specifically to interfere with the immune system’s ability to destroy myelin. Since most DMTs affect immune system function on some level, it’s important to monitor any side effects. These may include fevers, flu-like symptoms, or other signs of infection. Keep your healthcare provider in the loop regarding any side effects you experience.
Whatever drug your doctor prescribes, it’s important to openly discuss all aspects of your health. Some drugs may affect liver function, requiring regular blood tests to ensure that the liver is not being damaged. Other drugs may increase the risk of certain infections.
Some medications can cause birth defects, so it’s important not to take these drugs if you are pregnant. Inform your doctor immediately if you become pregnant during treatment. Be sure to also report any hair loss, nausea, diarrhea, or tingling and numbness.
It’s also important to discuss any medications or supplements you may be taking. Some drugs, such as warfarin, can interfere with certain MS drugs, causing potentially serious interactions.
Many patients can expect to live relatively normal lives given recent advances in treatments. Designing a treatment plan that works best for you will involve close collaboration with your medical practitioners. They must weigh numerous factors when evaluating treatment options.
Options have expanded greatly in the past two decades. One of the newest agents, dimethyl fumarate, was approved for use in early 2013. Some currently approved drugs are undergoing further clinical trials. This may eventually lead to their expanded use. Drugs that may encourage the regeneration of lost myelin are presently under investigation. Today, at least four new DMTs are undergoing clinical trials. They may be available soon. Stem cell therapies are also under investigation.
You must become an active participant in the battle against your disease. Follow advice, take medications, eat right, and take care of your general health. Staying physically active also helps. Recent research found that patients who exercise regularly may be able to slow some of the effects of the disease, such as a declining ability to think clearly. Ask your doctor if exercise therapy is right for you.
You may also benefit from rehabilitation. Rehab can involve occupational therapy, speech therapy, physical therapy, and cognitive or vocational rehabilitation. These programs are designed to cope with specific aspects of your disease that may affect your ability to function.
Most MS patients can expect to take DMTs indefinitely. But recent research suggests it may be possible to discontinue drug therapy in some special cases. If your disease has remained in remission for at least five years, ask your doctor if discontinuing drugs may be possible.
Although there is currently no cure for MS, there are usually unexplored treatment options available. Consider getting a second opinion if your doctor says otherwise. Remember that even when MS symptoms are under control, it may be necessary to address other aspects of your health. Complications of your disease or its treatment should not be ignored. Ask your doctor about your risk for depression, osteoporosis, or serious infections.