DiagnosisMultiple sclerosis FAQsNeurologist Oliver Tobin, M.B., B.Ch., B.A.O., Ph.D., answers the most frequently asked questions about multiple sclerosis. Show
So people who are overweight have a higher chance of developing MS and people who have MS who are overweight tend to have more active disease and a faster onset of progression. The main diet has been shown to be neuroprotective is the Mediterranean diet. This diet is high in fish, vegetables, and nuts, and low in red meat. So this question comes up a lot because patients who have multiple sclerosis can sometimes get a transient worsening of their symptoms in heat or if they exercise strenuously. The important thing to note is that heat does not cause an MS attack or MS relapse. And so it's not dangerous. You're not doing any permanent damage if this occurs. Exercise is strongly recommended and is protective to the brain and spinal cord. Scientists do not yet know which stem cells are beneficial in MS, what route to give them or what dose to give them or what frequency. So at the moment, stem cell treatments are not recommended outside of the context of a clinical trial. Neuromyelitis optica spectrum disorder or NMOSD and MOG-associated disorder can give features similar to multiple sclerosis. These are more common in people of Asian or African-American ethnicity. And your doctor may recommend blood tests to exclude these disorders. Well, the first drug approved by the FDA for treatment of multiple sclerosis was in 1993. Since then, over 20 drugs have become available for treatment of MS. And the potency of these drugs has increased over time to the point where we can almost completely suppress the inflammatory component of the disease. This would not be possible if patients like you did not enroll in research studies. There are many different types of research studies, not just drug trials, but also observational studies, as all of these enhance our understanding of the disease, hopefully to lead to even better cures for multiple sclerosis. Well, the most important thing about having a diagnosis of multiple sclerosis is that you are at the center of your medical team. A comprehensive MS center is the best place for management of multiple sclerosis, and this typically includes physicians with expertise in multiple sclerosis, neurologists, but also urologists, physiatrists or physical medicine and rehabilitation providers, psychologists, and many other providers who have specialty interest in multiple sclerosis. Engaging this team around you and your particular needs will improve your outcomes over time. There are no specific tests for MS. Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination. Your doctor may then recommend:
In most people with relapsing-remitting MS, the diagnosis is fairly straightforward and based on a pattern of symptoms consistent with the disease and confirmed by brain imaging scans, such as MRI. Diagnosing MS can be more difficult in people with unusual symptoms or progressive disease. In these cases, further testing with spinal fluid analysis, evoked potentials and additional imaging may be needed. Brain MRI is often used to help diagnose multiple sclerosis. TreatmentThere is no cure for multiple sclerosis. Treatment typically focuses on speeding recovery from attacks, slowing the progression of the disease and managing MS symptoms. Some people have such mild symptoms that no treatment is necessary. Multiple sclerosis research laboratory at Mayo Clinic Treatments for MS attacks
Treatments to modify progressionFor primary-progressive MS, ocrelizumab (Ocrevus) is the only FDA-approved disease-modifying therapy (DMT). Those who receive this treatment are slightly less likely to progress than those who are untreated. For relapsing-remitting MS, several disease-modifying therapies are available. Much of the immune response associated with MS occurs in the early stages of the disease. Aggressive treatment with these medications as early as possible can lower the relapse rate, slow the formation of new lesions, and potentially reduce risk of brain atrophy and disability accumulation. Many of the disease-modifying therapies used to treat MS carry significant health risks. Selecting the right therapy for you will depend on careful consideration of many factors, including duration and severity of disease, effectiveness of previous MS treatments, other health issues, cost, and child-bearing status. Treatment options for relapsing-remitting MS include injectable and oral medications. Injectable treatments include:
Oral treatments include:
Infusion treatments include:
Treatments for MS signs and symptomsPhysical therapy for multiple sclerosisPhysical therapy can build muscle strength and ease some of the symptoms of MS.
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Clinical trialsExplore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Lifestyle and home remediesTo help relieve the signs and symptoms of MS, try to:
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Alternative medicineMany people with MS use a variety of alternative or complementary treatments or both to help manage their symptoms, such as fatigue and muscle pain. Activities such as exercise, meditation, yoga, massage, eating a healthier diet, acupuncture and relaxation techniques may help boost overall mental and physical well-being, but there are few studies to back up their use in managing symptoms of MS. According to guidelines from the American Academy of Neurology, research strongly indicates that oral cannabis extract (OCE) may improve symptoms of muscle spasticity and pain. There is a lack of evidence that cannabis in any other form is effective in managing other MS symptoms. Daily intake of vitamin D3 of 2,000-5,000 international units daily is recommended in those with MS. The connection between vitamin D and MS is supported by the association with exposure to sunlight and the risk of MS. Coping and supportLiving with any chronic illness can be difficult. To manage the stress of living with MS, consider these suggestions:
Preparing for your appointmentYou may be referred to a doctor who specializes in disorders of the brain and nervous system (neurologist). What you can do
What to expect from your doctorYour doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over points you want to spend more time on. You may be asked:
Questions to ask your doctor
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask other questions during your appointment. Jan. 07, 2022 What medication is commonly used to treat MS relapses?Oral treatments include:. Fingolimod (Gilenya). This once-daily oral medication reduces relapse rate. ... . Dimethyl fumarate (Tecfidera). This twice-daily oral medication can reduce relapses. ... . Diroximel fumarate (Vumerity). ... . Teriflunomide (Aubagio). ... . Siponimod (Mayzent). ... . Cladribine (Mavenclad).. How is MS relapse treated?The options for managing an MS relapse are: treatment with high-dose steroids, either as an in-patient, a 'day-case' or at home. rehabilitation – after steroids, or without steroids being given. no treatment.. reduce the inflammation.. shorten the duration of the relapse.. speed up recovery from the relapse.. What is the most common medication for MS?Interferon Beta (Avonex, Betaseron, Extavia, Plegridy, Rebif) How it works: These are lab-made versions of your body's infection-fighting protein. They've been around the longest and are the most widely prescribed drugs for MS.
What types of drugs are used to treat MS?The FDA has approved eight oral medications for the treatment of MS.. Fingolimod (Gilenya) ... . Teriflunomide (Aubagio) ... . Dimethyl fumarate (Tecfidera) ... . Diroximel fumarate (Vumerity) ... . Monomethyl fumarate (Bafiertam) ... . Cladribine (Mavenclad) ... . Siponimod (Mayzent) ... . Ozanimod (Zeposia). |