Difference between revisions of "MULTIPLE SCLEROSIS-MANAGEMENT"
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1. The treatment of acute exacerbations is high-dose corticosteroids. Do not do strenuous exercises during an acute flare. | 1. The treatment of acute exacerbations is high-dose corticosteroids. Do not do strenuous exercises during an acute flare. | ||
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<br/>2. Glucocorticoids may shorten the duration of exacerbations but do not alter the natural history of MS | <br/>2. Glucocorticoids may shorten the duration of exacerbations but do not alter the natural history of MS: IV methylprednisolone, 1g/day for 3-7 days, followed by a rapid prednisone taper. | ||
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<br/>3. 2012 Cochrane review showed no difference in outcomes when comparing oral vs. IV steroids for relapses. | <br/>3. 2012 Cochrane review showed no difference in outcomes when comparing oral vs. IV steroids for relapses. | ||
Latest revision as of 11:07, 20 March 2023
SUMMARY
1. The treatment of acute exacerbations is high-dose corticosteroids. Do not do strenuous exercises during an acute flare.
2. Glucocorticoids may shorten the duration of exacerbations but do not alter the natural history of MS: IV methylprednisolone, 1g/day for 3-7 days, followed by a rapid prednisone taper.
3. 2012 Cochrane review showed no difference in outcomes when comparing oral vs. IV steroids for relapses.
4. Parenteral corticosteroids are the treatment for optic neuritis.
5. Interferon and glatiramer (Copaxone®, a synthetic amino acid polymer) reduce relapses by 30%, while natalizumab (Tysabri; monoclonal antibody against the cell adhesion molecule α4-integrin) reduces relapses by 60%.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].
